What You Need to Know about Work-Related Foot Injuries
Learn How Much Workers Comp Pays for a Foot Injury
Your feet are your body’s foundation. They help you get where you need to go and do what you need to do.
An injury to one foot can impact other body parts. And prevent you from walking, running, standing, jumping, driving – and even getting up and down from a seated position if you work at a desk.
Their importance to working and activities of daily living is one reason why foot injuries are some of the most common work-related injuries in Virginia. Indeed, more than 50,000 occupational injuries involving feet are reported to the Bureau of Labor Statistics each year – with the majority resulting from trauma. These work-related foot injuries cost hundreds of millions of dollars in medical expenses and lost working days.
Our law firm has handled many ligamentous injury and foot fracture cases. And this article discusses the facts we analyze when helping injured workers like you recover workers compensation benefits or fair settlement value for a foot injury. For example, a fair foot injury settlement considers the significant risk of reinjury or hurting another body part if you return to work too soon and the possibility of a joint deformity affecting your range of motion and ability to handle any occupation.
After you finish reading, call us for a free consultation with a top-rated work injury lawyer: (804) 251-1620 or (757) 810-5614. From giving proper notice to filing a claim for benefits within the statute of limitations to representing you at a workers comp hearing and in settlement negotiations, we are here for you every step of the way.
Anatomy of the Foot
Your foot has several structures: bones, joints, ligaments, tendons, muscles, nerves, and blood vessels. And they work together to help you balance, bear weight, stand, walk, run, dance, operate foot controls on cars, tractor-trailers, and machinery, and participate in sports and other hobbies. When one part of the foot becomes damaged, other parts of the foot, ankle, and lower extremity can develop pain and functional problems.
Bones and Joints of the Foot
The foot contains 26 bones divided into three regions: the hindfoot, midfoot, and forefoot.
Your body’s weight is carried through the leg and transferred to the talus (ankle) and then to the calcaneus (heel) bones. These bones form the hindfoot.
Next is the midfoot, which is a set of five bones called tarsal bones. The collection consists of the navicular and medial cuneiform bones, the intermediate cuneiform bone in the middle of the group, and the lateral cuneiform and cuboid bones. These bones work together to help your foot move.
The forefoot (front of the foot) is the third region, and it has 19 bones: 14 phalangeal bones (two in the big toe and three in each of the other toes) and five metatarsal bones that form the “ball” of the foot. These metatarsals connect to the five tarsal bones in the midfoot. And the joints that form in the ball of the foot are essential to developing a regular walking pattern (also called “gait”).
Muscles in the Foot
The muscles in your lower leg whose tendons connect to the foot provide strength to move the foot for standing, walking, running, jumping, and other motions. In addition, your foot has many small muscles that help the toes move (extension, flexion, and adduction) and provide padding in the sole (bottom of the foot).
A torn muscle in the foot may cause significant pain affecting function and often accompanies injuries to other foot and ankle parts.
Ligaments and Tendons of the Foot
Both ligaments and tendons are bands of tough, elastic connective tissue that attach to other body structures and stabilize joints.
The difference between the two structures is that ligaments connect two bones while tendons attach muscle to bone.
Some of the critical tendons and ligaments in the foot are:
- Calcaneal (Achilles) tendon – connects your calf muscles to the heel bone;
- Calcaneocuboid ligament – attaches your heel bone to the tarsal bones that form your foot’s arch;
- Lisfranc ligaments – connects the tarsal and metatarsal bones (long bones leading to your toes);
- Plantar calcaneonavicular (spring) ligament – forms the arch structure in your foot and helps support your body weight;
- Plantar fascia ligament – this ligament, which is on the bottom of the foot, runs from your heel to the base of your toes;
- Retinaculae – these are bands of fascia that pass over or under tendons and help them stay in place at the ankle joint; and,
- Tendons of extensor (dorsal foot) muscles
Nerves and Blood Supply to the Foot
Nerve damage can result in permanent impairment and lifelong disability.
And unfortunately, injuries to one or more nerves are common in occupational accidents involving the foot.
Vital nerves and blood vessels in the foot include:
- Anterior tibial artery
- Deep peroneal nerve
- Lateral malleolar artery
- Lateral plantar nerve – innervates several foot structures and provides sensation to parts of the foot.
- Medial calcaneal nerve – innervates part of the heel.
- Medial plantar nerve – innervates several bones and muscles of the foot.
- Posterior tibial artery
- Saphenous nerve – supplies sensation to the medial side of the foot
- Superficial peroneal nerve
- Sural nerve
Types of Foot Injuries
Our personal injury law firm has resolved many foot injury cases. And we often work with experts such as podiatrists, foot surgeons, vocational counselors, psychiatrists, and economists, to develop the evidence necessary to prove the claim.
Work-related injuries result from acute trauma (an injury from a single event) or chronic trauma (injuries resulting from prolonged exposure or overuse).
In some jurisdictions (including Virginia), you can receive workers comp only if you suffered acute trauma. However, you can receive benefits for chronic foot conditions caused or worsened by an acute injury such as posterior tibial tendon dysfunction, diabetic foot ulcers, Charcot foot (arthropathy), and plantar fasciitis.
Some of the most common injuries to the foot involve ligament damage and fractures.
Now we will take a closer look at these injuries.
Foot Sprains
A sprain occurs when a ligament overstretches, tearing some (or all) of the fibers forming the ligament..
Many foot sprains happen when the foot lands awkwardly or twists inward suddenly (an inversion injury) or when your feet remain stuck in place while the rest of your body turns.
Walking on uneven ground, climbing in and out of vehicles or machinery, or walking through areas with trip hazards places you at greater risk of sustaining a foot sprain.
The average healing time for a foot sprain is three to six months.
Foot Fractures and Dislocations
Falls from heights, motor vehicle accidents (including forklifts and other machinery), sports (for professional athletes or as part of recreational activities for teachers and others), physical training (such as for police and firefighters), and workplace assaults are common causes of foot fractures on the job.
Medicine classifies these fractures as one (or more) of the following:
Comminuted Fractures vs. Simple Fractures
Your orthopedic surgeon (or podiatrist) may refer to your broken foot as a simple or comminuted (multipart) fracture.
A comminuted fracture occurs when the bone breaks into more than two pieces. The more parts fractured, the more complicated the treatment and healing process. This is because comminuted fractures are more likely to cause soft tissue damage and nerve injury and require surgery. And depending on the number of bone fragments, the surgeon may have trouble stabilizing the foot.
The second type of fracture – a simple fracture – describes a bone that breaks into two pieces and is nondisplaced.
Calcaneal (Heel) Fracture
The heel bone is one of the most prominent bones in the foot, lying at the back of the foot, below the bones that form the ankle joint (tibia, fibula, talus). It is hard on the outside but soft in the middle. And it helps your foot move side to side.
Calcaneal fractures are either intra-articular (within a joint) or extra-articular (anterior process, calcaneus body, medial calcaneal process, sustentaculum tali, or tuberosity). And they are often sustained with other injuries due to the force needed to cause harm.
You may sustain a heel fracture involving one foot or both from the same accident. Indeed, five to ten percent of calcaneus fracture claims involve bilateral injuries.
Standard surgical procedures for calcaneus fractures include:
- Open reduction and internal fixation (ORIF) to reposition the bones into a normal alignment, then hold them together with metal plates and screws (and sometimes wires)
- Percutaneous screw fixation to move the bone pieces back into place (possible only if the parts are large enough)
The typical healing time for a calcaneus fracture is twelve to thirty-six months to reach a plateau. However, it could take longer to heal if you develop subtalar arthritis, peroneal nerve impingement, tendon irritation, chronic swelling, or malunion of the bones with heel deformity.
Further, a heel fracture may result in changes to your gait (walking), which in turn could cause overuse of the non-injured body part and back or hip pain.
Cuboid or Cuneiform Fracture
A fracture involving the cuboid or one of the cuneiform bones in the midfoot often results from crush injuries or damage to other parts of the foot or ankle.
These midfoot fractures account for roughly four of every 10,000 fractures.
Sometimes surgery is necessary to correct cuboid or cuneiform fractures, with subsequent casting in a boot and the use of crutches or a wheelchair.
Lisfranc Fracture
You have suffered a Lisfranc fracture when you break one or more of the bones in the midfoot that make up the arch and connect the toe bones to the hindfoot. Often a broken bone in this region also damages the Lisfranc ligament.
Direct trauma and twisting and crush injuries while flexing the foot are the most common causes of a Lisfranc fracture.
Treatment of a Lisfranc fracture depends on the damage to surrounding tissues. Sometimes it is possible to treat the fracture with a closed reduction and percutaneous fixation; however, other Lisfranc fractures require open reduction with hardware removal four to six months later. And complications such as neuroma and arthritis make the recovery process more challenging.
The Lisfranc joint has a critical role in mobility. If your job requires quick movements on your feet, a Lisfranc fracture or ligament injury can cause serious problems.
Metatarsal Shaft Fracture
The metatarsals are the long bones in the front of your foot leading to the toes. And they are among the most frequently injured parts of the foot – often from direct blows (dropping things, twisting when walking or standing on uneven ground, etc.).
Many metatarsal fractures heal non-surgically. However, some require manipulation of the bone so that they reset in a proper position.
The average healing time for a metatarsal shaft fracture is six to twelve weeks. But you may experience permanent changes in how you walk or stand.
Talus Fracture (Head, Neck, or Body of Bone)
The talus is one of the bones that form the ankle joint. And you may fracture the body (Shepherd’s fracture if it breaks the posterior portion), head, or neck of this bone.
Talus fractures are rare, often occurring during high-energy accidents, such as motor vehicle collisions or falls from roofs. Indeed, the same accident that causes the fractured talus may also result in a spine injury requiring a lumbar fusion surgery.
Hawkins’ classification divides fractures of the neck of the talus into four types:
- Type I – undisplaced fracture
- Type II – displaced fracture with subtalar joint subluxation
- Type III – displaced fracture with subluxation of both the subtalar and ankle joints
- Type IV – additional dislocation to the talonavicular joint
The third and fourth types usually require surgery, including reconstruction of the foot and ankle.
The ankle is critical for proper movement. And a fracture to any part of the talus can cause significant loss of motion and functional ability.
The average healing time for a talus fracture is four months to two years to reach a stable state. And complications may include post-traumatic arthritis of the subtalar and ankle joints, the worsening of pre-existing osteoarthritis, nonunion of the bones following surgery, or osteonecrosis.
How Much is a Foot Injury Worth in a Workers Comp Case?
Reviewing settlements and claim costs in past cases is helpful when trying to determine the settlement value of your foot injury after a work accident or car crash. This information drives many decisions by insurance carriers (Travelers, The Hartford, Liberty Mutual, etc.) and third-party administrators (TPAs) such as Sedgwick, Gallagher Bassett, and ESIS. Indeed, this data often determines the claim reserves and settlement offers.
In my experience, the usual settlement value range for a workers comp case involving a foot injury is between $25,000 and $80,000.00 (or more).
These settlement values demonstrate the potential that foot injuries have to cause you to miss work, have significant pain, develop long-term partial or total disabilities, and need to switch to a less physically-demanding position.
The top end of the spectrum often includes foot injuries such as fractures, torn ligaments, burns, and the amputation of one or more toes. And the low end involves many sprains, strains, lacerations, and other minor injuries.
These figures are consistent with other data available on work-related foot injury claims.
For example, the National Safety Council (NSC) estimates that workers compensation costs totaled $28,309 ($15,841 in medical expenses, $12,468 in compensation benefits) per claim involving the foot or toes in 2018-2019.
But remember – the facts of each case are different and result in a wide range of outcomes. So this information on average workers comp settlements for foot injuries is only another tool to help you get the best result.
What is the Most Money Your Law Firm Has Recovered in a Work-Related Foot Fracture Case?
We recovered more than $300,000.00 for a tractor-trailer driver who suffered a foot fracture during his first week of work.
Our client was able to return to work after completing treatment, which included surgery and home therapy.
What Factors Impact the Workers Comp Benefits I Receive and the Settlement Value in Foot Injury Cases?
Several factors influence compensation payouts for foot injury claims. These include:
- Age – Insurance industry data indicates that the older you are, the more difficult it will be to transition into a new career. Therefore, you are more likely to receive wage loss benefits for an extensive period.
- Award letter – You have more leverage in settlement negotiations if you have received a Workers Compensation Award Letter providing wage loss payments or medical benefits for the foot injury. Negotiation from a strong position often results in higher settlement offers.
- Causation evidence – If you have not received an award letter stating that workers compensation law covers your foot injury, you will have to prove a causal relationship between your employment and the foot injury. Indeed, in some states (including Virginia), you must identify a specific work accident that caused the damage to your foot because repetitive motion/cumulative trauma injuries are not compensable. Initial work injury reports, medical records detailing the history of the current foot problem, diagnostic imaging (x-rays, CT, bone scans, MRI), your past medical history, work abilities immediately before the incident, and doctor letters on causation can strengthen your case by showing acute trauma.
- Complications – Other conditions may develop from your work-related foot injury. And if there is a causal relationship between the injury and these conditions, the insurer will have to pay for treatment and disability for these complications as compensable consequence injuries. For example, compartment syndrome is an emergency medical condition that may result from a severe bruise or crush injury that damages blood vessels in the foot, as is avascular necrosis (death of bone from lack of blood supply) resulting from fracture of the talus. And an acute foot injury on the job may cause or contribute (aggravate, accelerate, exacerbate, etc.) to arthritis.
- Current symptoms – Your symptoms contribute to medical work restrictions and permanent impairment. Therefore, they also influence the settlement value of the case. For example, your testimony and the evidence should address: pain (location, duration, nature, constancy, etc.), skin appearance (discoloration, swelling, etc.), skin temperature, sensation (numbness and tingling), presence of crepitus (crackling or popping when you move the foot), and range of motion of the foot and ankle joints.
- Defense medical examination (DME) – The insurer has the right to ask you to attend an examination with a doctor of its choosing. This exam is called an Independent Medical Examination (IME), though there is rarely anything independent about it because the insurer has handpicked the doctor. Usually the IME report is unfavorable to the injured employee’s case. However, sometimes the IME doctor supports the employee’s claims of causation and disability. If so, you can expect the insurer to put more settlement value on your foot injury case.
- Disability (medical work restrictions) – Your claim has greater value if your treating physician (orthopedic surgeon, neurosurgeon, podiatrist, pain management doctor, etc.) has restricted you to light duty instead of releasing you to full duty. For example, in writing, your doctor should state any limitations involving walking, running, climbing and descending stairs, using ladders or step stools, and driving.
- Future medical expenses – Many workers comp settlements involve cashing out a lifetime medical award (or the right to seek medical coverage). This is one reason why many lawyers suggest waiting until you have reached maximum medical improvement (MMI) to settle – unless there are causation issues. The greater your projected future medical costs, the greater the potential value of your foot injury case. So, for example, determine the cost of future surgery you may require for the injury (and follow up care).
- Other injuries from the same accident – The slip and fall or work-related car crash that caused your foot injury may have also resulted in a low back injury, concussion, or cervical sprain. Further, many injured employees develop depression or PTSD after an occupational injury. When making a settlement demand, I recommend considering these other injuries and conditions, or you may cost yourself tens of thousands of dollars.
- Past disability benefits – In most workers comp claims, there is a cap on the number of weeks of wage loss benefits you can receive. Therefore, the longer you wait to settle your foot injury case while receiving weekly payments, the lower the value because the insurer will have paid a lot of what it potentially owes.
- Payment of past medical treatment – Your employer (or its insurance company) is responsible for medical bills for surgery, hospitalizations, doctors’ appointments, therapy, prescription drug medication, orthotics, assistive devices (canes, crutches, wheelchairs, etc.), and other health care related to your foot injury. When negotiating a settlement, make sure you include any outstanding bills or payments made by private health insurance for medical attention related to the foot injury (or Medicare or Medicaid).
- Permanent impairment – Your case has more value if the foot injury results in permanent impairment and loss of use of the foot or lower extremity (leg) through a reduced range of motion. The percentage impairment helps calculate the amount of compensation you receive for permanent loss of use (Permanent Partial Disability benefits). For example, in Virginia, the total loss of use of the foot is worth 125 weeks of compensation, while permanent impairment of a toe is worth 5 to 30 weeks of payments.
- Pre-injury wages – In most jurisdictions, the amount of weekly compensation loss benefits depends on how much you earned when you were hurt (your pre-injury average weekly wage). And usually, these benefits are paid at 66.6% of your pre-injury compensation. However, high-wage earners in Virginia cannot receive more than $1,195.00 per week – even if this figure is less than two-thirds of the average weekly wage.
- Resignation – If you have returned to work for your pre-injury employer but have to sign a resignation and release of potential claims to settle the workers comp case, make sure you get fair value for the resignation.
- Social Security Disability (and Medicare compliance) – You can receive Social Security Disability Insurance (SSDI) benefits when receiving workers comp. However, receiving Social Security Disability benefits often means you will become Medicare eligible within the next 30 months. If so, any foot injury settlement must protect Medicare’s interests under the Medicare Secondary Payer Act. And complying with this law costs the insurer more money increases settlement value.
- Type and severity of the foot injury involved – The kind of foot injury suffered is a critical factor in determining the settlement payout in your case. Your attorney and the insurer will use this information to project how long the healing process might take and if you will have permanent restrictions that the pre-injury employer cannot accommodate. Typically, complex fractures of multiple bones in the foot result in the largest payouts.
- Whether you have found a new job – You can find (and accept) a new job when receiving workers compensation. Whether you are entitled to temporary partial disability benefits depends on the facts of your situation. However, obtaining new employment with a different company is often an excellent time to settle.
- Work experience – A severe foot injury often results in restrictions limiting a person to a desk job or light security position. If your past work includes physical jobs in construction or nursing, the insurer should understand it may take even longer to find a light-duty job that you have no experience doing. This raises the potential value.
Call Us for Help with Your Foot Injury Claim
If you have suffered a foot injury in a workplace accident or motor vehicle crash and want to consider your legal options, call my firm at (757) 810-5614 or (804) 251-1620 or contact us online for a free consultation.
The choices you make soon after the accident can have a lifelong impact on you and your family. For example, you must choose the best physician from the list offered by the employer. The wrong decision can create hurdles to compensation.
We can discuss all potential sources of recovery under negligence and tort law (including third-party civil actions) and help you get the workers compensation settlement and benefits you deserve so that you can focus on healing and live a full life.
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