Are you or a family member one of the more than 1 million American workers who suffer a back injury at work each year?
Then you know that a workplace back injury can cause severe consequences, including:
As if these consequences aren’t enough, many of you will face aggressive insurance carriers or third-party claim administrators such as Sedgwick, Gallagher Bassett, or Coventry that refuse to accept your claim and pay benefits without litigation and the need for a workers comp hearing.
Fortunately, help is available. And you are in the right place to learn how to get medical treatment and every dollar you deserve for a back injury under workers compensation law.
This article aims to help you get benefits and a fair workers compensation settlement for a back injury. Its purpose is to discuss common back injuries and the medical, legal, and vocational factors that impact back injury claims’ settlement value. Please use this information to get the medical attention you need to recover and cash payments that provide financial security after a work-related back injury.
If you have questions about your legal rights after a work injury or want help negotiating a workers comp back injury settlement, call me: (804) 251-1620 or (757) 810-5614. See why my fellow attorneys and past clients have named me a Top 100 High Stakes Litigator and one of the Best Workers Comp Lawyers for Claimants in America. I’m ready to get results for you.
Yes.
No one wants to believe that they can get hurt on the job. But it happens. And back injuries are the most common work-related injuries.
The data shows that about 80 percent of adults will suffer a back injury or experience back pain during their lifetime – and that hurting your back once increases the likelihood of chronic episodes of back pain.
Lumbar spine and back injuries account for roughly one-third of all workers compensation claims. Many of these injuries are life-changing, resulting in time missed from work to recover and the need for back surgery. You might never return to full duty work after a back injury.
Data from the U.S. Bureau of Labor Statistics (BLS) supports these numbers.
The BLS defines musculoskeletal disorders as injuries occurring when the body uses muscles, tendons, and ligaments to perform tasks. Overexertion – lifting, carrying, pushing, or pulling too much weight – is a primary cause of these injuries.
Work-related musculoskeletal injuries resulting in days missed from work often involve the back. According to the Bureau of Labor Statistics, more than 38 percent of all work-related musculoskeletal injuries involved back injuries.
So if you are reading this article because you hurt your back at work, you are not alone.
Work-related back injuries are common in all occupations and industries.
You have a greater risk of hurting your back at work if your job involves any of the following duties and responsibilities:
In 2018, ten occupations made up 40 percent of all workers comp cases arising from musculoskeletal injuries. You have a greater risk of hurting your back at work if you are a:
A single traumatic event can cause back pain. Or your symptoms might develop gradually due to repetitive activity or motion over time.
The distinction is significant because some states’ workers comp laws do not cover cumulative trauma injuries.
Common acute traumas resulting in back injury include:
The name given to your back injury is not as crucial to your workers comp case as the recommended treatment and disabling nature of your pain.
However, the exact diagnosis provides clues to what you can expect, impacting the insurance carrier’s settlement offer for your back injury.
Work-related back injuries fall into the following categories:
Your spine is held in place by muscles, ligaments, and tendons.
Ligament injuries are called sprains.
Injuries to muscles and tendons are called strains.
Lumbar strains and sprains are common work-related injuries. These types of musculoskeletal impairments are referred to as lumbago when they are not accompanied by radiating pain.
Back strains are classified as follows:
Back sprains are classified as follows:
Unless you suffer a Grade III lumbar sprain or strain, treatment will consist of resting the back to avoid re-injury, medications to relieve pain, muscle spasms, and swelling, and therapy and reconditioning.
You have 24 moving vertebrae in your spine, nine of which are fused.
A disc sits between each vertebra and acts as a shock absorber that cushions the vertebra from trauma. Each disc has a tough covering, with its interior being soft and jelly-like.
If a disc is squeezed suddenly by the vertebrae above and below it, which may happen when a person is lifting a heavy object or struck in a motor vehicle crash, the disc covering may tear. This is called a rupture. The disk’s interior can squeeze through the tear and bulge out. This is known as a herniated disk.
The disc bulge can compress, irritate, and damage its accompanying spinal nerve root, which causes more pain. A herniated disk can also cause sciatica.
The MSU Classification describes the disc herniation’s location.
A Grade A herniation occurs at the midline.
A Grade C herniation is a lateral herniation that protrudes into the intervertebral foramen, where the spinal nerves travel.
Grade B herniated discs occur between grades A and C, with the facet joint serving as the lateral border’s focal point.
A herniated disc may require surgery. For more information on this topic, read my article: Workers Compensation Herniated Disc Injury Settlements.
Sciatica is a common cause of back pain and a form of lumbar radiculopathy.
Sciatica is the term given to pain radiating from the low back into the legs and feet because a herniated disc compresses a sacral or lumbar nerve root.
Usually, sciatica affects just one side of the body. But it’s possible to have sciatica impacting both legs.
Treatment for sciatica includes doctor visits, physical therapy, prescription medication, and pain management. If this conservative treatment fails, your orthopedic doctor may recommend surgery.
Read this article for more information about workers comp settlements for sciatica.
Most of us will have asymptomatic degenerative disc disease when we reach our 30s. This means that objective diagnostic imaging from Magnetic Resonance Imaging (MRI) or a CT scan would show lumbar spine damage, though you have no symptoms.
Lumbar spine degenerative disc disease can take many forms:
The extent of the lumbar disc disease, its impact on nerve roots and disc stability, and your symptoms determine if you are a surgical candidate.
You might see the term “lumbar radiculopathy” when reviewing your medical records.
Lumbar radiculopathy refers to pain, numbness, and tingling that runs from your back down your legs or feet. It results from compression, injury, or inflammation of a spinal nerve root. The pressure on the nerve root causes the symptoms you are experiencing.
Lumbar spine radiculopathy often accompanies spinal stenosis or a herniated disc.
A work-related car accident, slip and fall, or assault can cause a spinal fracture. And a spinal fracture can cause bone fragments from your vertebrae to damage spinal nerves.
There are different spinal fractures: compression (wedge), burst, flexion-distraction, and fracture-dislocation.
Burst fractures are the most severe type of spinal fracture – I’ve represented many burst fracture victims who became paralyzed. But any lumbar fracture can cause difficulty walking, sitting, standing, or using your arms and legs.
If you suffer a spinal fracture, including a compression fracture, you may require surgery. And paralysis may result in the need for home health care or placement in an assisted living facility.
Each year more than 500,000 Americans have back surgery. Of these, about 100,000 to 200,000 have only partial or no pain relief.
If you underwent back surgery but continue to suffer, you may have failed back syndrome, called postsurgical spine syndrome or post-laminectomy syndrome.
The International Association for the Study of Pain (IASP) defines failed back surgery syndrome as: “Lumbar (cervical) pain of unknown origin either persisting despite the surgical intervention or appearing after surgical intervention for spinal (origin) pain originally in the same topographical distribution.” Failed back syndrome can occur after any type of spine surgery but most often occurs after a laminectomy
There are several reasons why your back surgery may fail to relieve pain. For example:
Failed back syndrome is a big problem. Those of you living with it may have a lower quality of life than those with other pain conditions such as Chronic Regional Pain Syndrome (CRPS, also called Reflex Sympathetic Dystrophy), Fibromyalgia, and Rheumatoid Arthritis. And the loss of enjoyment of life and ability to work, combined with the cost of medical treatment, equals tens of billions of dollars per year.
Sacroiliitis is the medical condition involving inflammation of one or both of your sacroiliac joints.
The sacroiliac joints are where your lower spine and pelvis connect.
Sacroiliitis can cause pain in your low back and buttocks, extending down one or both legs.
The potential settlement value for a work-related back injury claim depends on how the trauma impacts the lumbar spine, the medical treatment required (surgical vs. non-surgical), and whether you have permanent restrictions that prevent you from returning to your pre-injury job.
In my experience, the average workers comp settlement amount for low back injuries ranges from $45,000 to $500,000 or more, depending on the need for surgery or a career change.
This is higher than the average settlement amount for work-related upper back injuries is lower, ranging from $35,000 to $175,000 or more.
The average workers comp settlement amount for failed back syndrome is from $125,000.00 to $650,000.00 or more. Your claim has more value if you require pain management for the rest of your life and will have permanent light-duty restrictions that prevent you from returning to your pre-injury position.
The potential for surgery explains the difference in typical settlement amounts for upper and low back injuries, and even with similar injuries and lumbar spine conditions. Many low back injuries require spine surgery, while few upper back and thoracic spine injuries do.
My estimates are consistent with data from the National Council on Compensation Insurance (NCCI). According to the NCCI, the average workers compensation costs for a low back injury were about $37,000, while insurers paid about $33,000 for a claim involving an upper back injury.
The Occupational Safety and Health Administration’s (OSHA’s) data also supports my ranges. According to OSHA, the average cost of a workers comp back injury claim is between $40,000 and $80,000 per employer. This amount includes medical treatment, wage loss benefits, vocational rehabilitation services provided when the case remains open, and a negotiated settlement.
Several factors determine the appropriate settlement range for your work-related back injury.
These factors include:
Collecting medical records is one of the first steps an attorney takes in a personal injury case. This involves submitting a Medical Records Release Letter and Authorization to Disclose Information Form to your medical providers and using the HITECH Act to keep legal expenses low.
When reviewing a client’s medical records, I look for:
I use this information to:
There is a strong likelihood that the insurance company will deny your back injury claim initially. Or that if it accepts that you suffered a back injury at work, it will offer an agreement form that covers only a lumbar strain and not your lumbar spine.
But suppose the insurance carrier accepts that you suffered a back injury and agrees to the entry of an Award Order that covers all injured body parts. In that case, your case has more settlement value because it will be more difficult for the insurer to escape liability for wage loss and medical benefits.
You can also receive an Award Order by proving your case at a trial.
A primary factor in determining the workers comp settlement amount for a back injury is whether you need surgery or only conservative treatment.
Conservative treatment for back injuries includes:
Some of you will require more than conservative treatment for your back injury. You’ll need surgery.
There are several surgical options for back pain.
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Some of these procedures are performed together, such as laminectomy and discectomy.
Other procedures, such as spinal fusion, are performed when another back surgery has failed.
Most workers comp settlements include a cash buyout of future medical needs. You will need to calculate projected medical expenses for the back injury, including any aggravations and additional episodes you might experience in the future.
Below is information to help you calculate a fair back injury settlement:
The need for surgery increases the potential workers comp back injury settlement value.
Lumbar spine and back surgeries cost anywhere from $25,000 to more than $150,000.00.
A lumbar discectomy or laminectomy costs from $25,000 to $75,000, with a spinal fusion ranging from $80,000 to $150,000 or more.
Many of you will require continued pain management post-surgery, especially if you are diagnosed with failed back syndrome. You might even need additional surgery. Include these risk and possibilities in your settlement evaluation.
Your pre-injury earnings determine the amount of workers compensation payments.
Your case is worth more if you earned more money when injured.
All other factors equal, your back injury claim has more value if your pre-injury job was physical. By that, I mean that your job involved lifting, carrying, standing, walking, running, or driving – more than sedentary desk work.
For example, a nurse or construction worker who suffers a back injury on the job and undergoes a lumbar fusion will likely have permanent restrictions that prevent them from returning to the pre-injury position.
On the other hand, a person with a sedentary job that requires no lifting who injures his or her back in a work-related car crash and undergoes a diskectomy may be able to return to work with no problems within a few months of the accident.
Suppose you are unable to return to your pre-injury job because of a work-related back injury. In that case, you will be eligible for more temporary total disability and temporary partial disability payments. Studies show that more than 25% of you will experience a total disability of 6 months or more because of your back injury.
You will also be eligible for vocational rehabilitation services at the employer’s expense. These services, designed to find alternate employment, are expensive.
You are eligible for permanent partial disability benefits if the back injury results in permanent loss of use and function of one or more legs or arms.
These benefits are payable even if you have returned to full duty work. But you must prove that you have reached Maximum Medical Improvement (MMI) for the back injury and obtained a permanent impairment rating signed by a medical doctor.
Many employers and insurers ask for resignation as part of the settlement.
Studies show that an injured employee is more likely to have a second (or third) workers comp claim. Insurers want another company to be liable for the next case.
Ask for additional settlement monies if a resignation is required.
Insurers and claim administrators deny many back injury claims initially. This is because of the potential cost of lifetime medical treatment for back injuries and the possibility that you will be out of work for an extended period.
But you can fight the insurance company’s denial and use the workers comp discovery process (interrogatories, depositions, requests for production of documents, subpoenas) to find the defenses and determine how to defeat them.
Typical workers comp defenses in back injury claims include:
No matter why the insurer denies your back injury claim, you have the right to your day in court before the Workers Compensation Commission. I recommend pursuing benefits no matter what the insurer says – and hiring an attorney to fight for you.
Research indicates that you have a greater likelihood of developing long-term pain or failed back syndrome if:
Because back pain is common, insurance carriers often dispute and challenge workers comp claims arising from back injuries.
But with a skilled attorney, you can get the workers comp benefits and settlement you deserve – even if you have pre-existing lumbar spine disease or suffered a back injury before.
Receiving these benefits is important because once you have low back pain, there is a good chance you will have another occurrence within a year. You are at greater risk of chronic, recurrent episodic back pain throughout your career, causing multiple absences from work. And the only way to get medical and financial protection for what may happen in the future is to pursue your back injury claim now.
I understand that a back injury at work can cause physical disability and mental stress, depression, and anxiety. Many of my clients qualify for workers comp and Social Security Disability for back pain that affects every area of their life. And I am ready to use my knowledge and ability to help you get every medical treatment and dollar you deserve.
Call now for a free consultation: 804-251-1620 or 757-810-5614. With offices in Richmond, Newport News, and Maryland, I help employees with back injuries across the state, including those of you in Virginia Beach, Norfolk, Chesapeake, Suffolk, Hampton, Williamsburg/James City County, Petersburg, Fredericksburg, Staunton, Stafford, Manassas, Fairfax, Winchester, Roanoke, Harrisonburg, Bristol, and Abingdon. But you must act fast – you have only thirty days to give written notice of the accident to your employer (you can use my sample work injury report letter) and two years to submit a claim to the Workers Compensation Commission.