How Much Compensation Will I Get for a Work-Related Knee Injury?
A Guide to Increase the Workers Comp Settlement Amount for Knee Injuries
Injuries to the knee frequently happen in the workplace. Both employees with physical jobs requiring lifting, carrying, squatting, kneeling, and driving and those working in mostly sedentary positions sustain disabling knee disorders regularly. Indeed, U.S. Bureau of Labor Statistics data indicates that knee injuries impact hundreds of thousands of employees yearly (with numbers comparable to hand, shoulder, and back injuries).
Naturally, our knee injury lawyers frequently analyze, try, and settle knee injury claims. We also research the average compensation payouts for workers compensation claims involving severe knee injuries (ACL/MCL tears, knee fractures, meniscus tears, dislocations, osteoarthritis, amputations, burns, etc.). And then try to beat the average knee injury settlement amounts for our clients.
This article explains how we analyze and negotiate fair workers comp settlements for knee injuries.
After reading it, we hope you understand more about:
- The knee’s anatomy
- Potential diagnoses associated with knee symptoms
- Common knee injuries and conditions
- Proving causation between the work accident and the injury to the knee
- The conservative treatments and surgeries available in knee injury cases
- Typical recovery time for your specific knee condition
- Strategies for winning a contested knee injury claim at the workers comp hearing
- Determining a fair compensation payout for the injury to the knee
If you want to talk to a top-rated personal injury attorney who has resolved hundreds (if not thousands) of claims under workers comp law, call me today: (804) 251-1620 or (757) 810-5614. My firm will ensure that you receive fair compensation for your knee injury.
Anatomy of the Knee
The knee is the largest joint in the body. And the most complicated one. We use it for almost every movement of the lower body.
The knee joint consists of bones, ligaments, tendons, cartilage, and meniscus. Indeed, it includes three smaller joints where different bones – the femur (thigh bone), tibia (shin bone), fibula, and patella (kneecap) -meet. These are the medial femorotibial, lateral femorotibial, and patellofemoral joints.
The knee is a synovial joint. A capsule surrounds it. Synovial tissue lines the capsule and secretes fluid to lubricate the knee and provide nutrients to the joint.
The capsule is flexible enough to allow a wide range of movement but strong enough to hold the different parts of the knee joint together.
The knee can move in many ways. It can bend (flexion), twist (rotation), and straighten (extension). Then, it is no surprise, that we use our knees for many activities at work and home – sitting, standing, walking, bending, kneeling, crouching, crawling, lifting. You name it – your knees, which are load-bearing joints, likely have a role in the movement and activity.
As you can see, we put tremendous pressure on our knees. Unfortunately, this pressure often results in injury to one or more of the knee’s structures.
Knowing each part of the knee and how they work together helps the knee injury lawyer prove your disability and need for treatment come from a work-related knee injury instead of a non-work-related cause such as overuse or a sports injury.
Let us look at the parts of the knee.
Bones
Four bones surround the knee and play a role in its function.
Femur
The femur is your thigh bone. It runs from the pelvis to the knee joint and is the longest bone in the body. The femur connects to the tibia.
Tibia
The tibia, also called the shinbone, runs from the knee to the ankle. It is the is the more prominent bone in your lower leg.
The upper part of the tibia is flat and is known as the tibial plateau.
Patella
The patella, commonly called the kneecap, is a small, triangle-shaped bone that moves with the knee.
Situated at the front of the knee joint, the patella is thick so that it can endure significant force.
Fibula
The fibula is a long bone that starts below the knee and runs down the side of the lower leg, adjacent to the tibia.
Muscles
Several muscles support the knee joint (or increase the likelihood of harm or prolong the recovery process if weak). These muscles include the following:
- Hamstrings: The three hamstring muscles run down the back of your thigh and help you move your leg back and bend your knee.
- Quadriceps: The four quadricep muscles are large muscles located at the front of your thigh. They control the ability to extend the leg and help you move, stand, walk, run, and squat.
- Calf muscles: The calf muscles pull the heel up to help you walk.
Knee Ligaments
Four ligaments (bands of tissue that act like ropes and connect bones to other bones) provide stability to the knee:
Anterior Cruciate Ligament (ACL)
The ACL is located in the middle of the knee and controls your shin bone’s rotation and forward movement.
Lateral Collateral Ligament (LCL)
The LCL is on the outer knee and prevents your knee from bending outward too much.
Medial Collateral Ligament (MCL)
The MCL is on the inner knee (the part closes to the other side) and connects your thigh bone to your shin bone. The MCL keeps your knee from bending inward too much.
Posterior Cruciate Ligament (PCL)
The PCL is located in the middle of the knee and controls the shin bone’s backward movement.
Bursae Surrounding the Knee
The knee has fourteen bursae.
A bursa is a fluid-filled sac that cushions and reduces friction between bones and soft tissues such as muscles and tendons.
Cartilage
The knee joint has two types of cartilage: the meniscus and articular cartilage.
Meniscus
A knee meniscus is a crescent-shaped pad of cartilage sitting between your femur and tibia.
Each knee has two menisci: the medial meniscus (inside the knee) and the lateral meniscus (outside of the knee).
The menisci act as cushions and absorb the impact when your knee moves or carries weight. As a result, they help distribute your body weight across the knee joint. Indeed, one study found that the menisci transmit more than 80% of the force across the knee.
Articular Cartilage
Articular cartilage covers the surfaces of your knee bones where they meet – the tibia’s top, the femur’s bottom, and the back of the patella.
Articular cartilage is slippery and robust. It allows the knee bones to glide over each other as the knee straightens and bends, and it serves as a shock absorber cushioning the bones against each other.
Tendons
Tendons are strong bands of tissue that help stabilize the joint. They are similar to ligaments, but tendons connect bone to muscle instead of bone to bone.
The two major tendons in the knee are: (1) the patellar tendon (which connects the patella to the tibia) and (2) the quadriceps tendon (which connects the quadriceps muscle to the patella).
What is the Average Workers Compensation Settlement Amount for a Knee Injury?
In my experience the average workers comp settlement for a knee injury ranges from $35,000 for a non-operative muscle or ligament injury or dislocated kneecap to $215,000 or more for injuries requiring arthroscopic surgery or total knee replacement.
These amounts are in addition to any benefits (medical or wage loss) the insurer may have paid before you negotiated your knee injury settlement. It is common for employers and insurers to have paid thousands of dollars (sometimes six-figures or more) before the injured employee accepts a leg injury settlement.
What Factors Impact How Much Workers Comp Pays for a Knee Injury?
The settlement range for work-related leg and knee injuries is wide because many factors impact your claim’s value.
These variables include:
- How much money you earned when you were hurt. Your pre-injury average weekly wage serves as the basis for indemnity benefits.
- Whether you have a Workers Compensation Award Letter. If you have proven a compensable accident and receive ongoing medical and wage loss benefits (an open award), you have leverage in negotiations. The power comes from the insurer knowing it will have to continue paying you (or medical providers on your behalf) until the claim resolves.
- The strength of the employer’s defenses to your initial workers comp claim (or change in condition). If the insurer refuses to pay the benefits sought, use the discovery process (interrogatories, requests for production of documents and admissions, medical records requests, depositions, doctor disability letters) to evaluate the defenses. You may determine that the potential evidence is stronger or weaker than you thought, impacting the settlement range for your knee injury.
- The severity of the knee injury: Claim adjusters have access to data on how long it will likely take you to recover and reach maximum medical improvement (MMI) for your specific knee injury and the cost of treatment for that injury. The more severe your leg injury, the higher your claim’s settlement value.
- Whether you have pre-existing knee problems such as arthritis: Arthritis is a common cause of disability from work. And the knee is the joint most likely to develop osteoarthritis. Insurers try to deny claims based on evidence of past injuries or the development of arthritis. But you can overcome this defense with medical evidence showing that you suffered an injury by accident and that this injury caused or contributed to (aggravated, worsened, exacerbated, or accelerated) the degenerative disc disease in the knee. You only need to show that the work-related knee injury contributed “one iota” or “to a minute degree” to receive benefits at the employer and insurer’s expense.
- Functional Capacity Evaluation (FCE) results from post knee injury: Your treating physician may refer you for an FCE. These are one-day (often three to four hours) examinations used to determine your ability to return to work. The examiner compares your results to a formal functional job analysis for your pre-injury job and states if you are capable of returning to that job or, if not, what level of work you can perform. FCEs are more common in physical injury cases than those involving head injury, traumatic brain injury, concussions, and post-concussive syndrome.
- Your level of permanent impairment from the knee injury: When your post-injury condition stabilizes, it is time to get a permanent impairment rating that calculates the permanent loss of use of the leg. This rating (based on the AMA Guides) determines your eligibility for compensation for permanent loss of use (permanent partial disability benefits). In Virginia you can receive up to 175 weeks of disability benefits for a knee injury resulting in permanent loss of use of the leg (in addition to medical coverage and other wage loss payments). Other states may offer more or less weeks of benefits for permanent disability related to a workplace knee injury.
- Projected future medical needs: You may need lifelong medical care after a knee injury. Consider the future expenses associated with diagnostic imaging (x-rays, MRIs, CT scans), therapy, follow-up doctor visits, and surgery. The cost of a total knee replacement and residual treatment can exceed $100,000.00.
- The possibility that you will injure your opposite leg or another body part because of weakness associated with the knee injury. An injured knee may result in overuse of and reliance on the non-injured knee. Over time this can result in osteoarthritis. Further, a knee injury may increase the likelihood that you fall because the hurt leg gives out, causing damage to another body part. The insurer is responsible for disability and medical care for these other injuries under the doctrine of compensable consequences.
- How much the employer and its insurer have paid in medical and wage loss benefits. In most cases in Virginia there is a limit on the number of weeks of wage loss and permanent partial disability benefits you can receive. Other states have similar caps on how many weeks of workers comp benefits you can receive. The longer you wait to settle your knee injury case, the lower its potential value if you are under an award. Generally you will get more money if you settle before a recommended surgery instead of after.
- Your age: Data indicates that the older you are, the more difficult it will be to transition to a new career if your knee injury prevents you from returning to your pre-injury job. For example, the Social Security Administration treats disability applicants differently when they reach ages 50, 55, and 60 (it is easier to receive SSDI and SSI).
- Your weight: The more you weigh, the more pressure and force you put on the injured knee and leg. This increased weight may result in a more extended recovery period or increase the likelihood of re-injury.
- Your job experience: If you have knee problems, it will be more challenging to return to a job requiring medium or heavy-level exertion than a sedentary (desk) job. The more physically demanding your pre-injury job, the greater the potential value of your knee injury settlement because it is less likely you will be able to return to your pre-injury employment (full duty). Instead, the insurer will have to find light-duty work that you can perform.
- The injury’s impact on your mental health: Chronic pain and physical limitations from the knee injury may cause depression and anxiety. And the initial workplace accident could cause Post Traumatic Stress Disorder (PTSD). The development of mental and emotional health conditions impacts your claim’s value.
- Whether you are dealing with a self-insured employer, an insurance carrier (Travelers, Liberty Mutual, The Hartford, etc.), a third-party administrator (Sedgwick CMS, Coventry, Gallagher Bassett, etc.), or a state or local government. Different employers have different approaches to settling cases. Generally insurers and third-party administrators are more likely to pay a fair settlement for a knee injury than self-insured employers who are involved in the negotiation or government entities.
- Is Medicare Review or Approval Necessary? If you are Medicare-eligible or expect to be within thirty months, you need to take precautions when settling. This means including a Workers Compensation Medicare Set-Aside Arrangement (WCMSA) as part of the settlement. The WCMSA indicates how much of the knee injury settlement you will allocate toward future medical expenses. An expert witness can help you determine the appropriate value.
- Does the insurer or employer require that you resign when you settle? Employers and insurers often ask an injured employee to sign a resignation and release when settling a workers compensation case. Unless you continue to work for the pre-injury employer or have a potential employment law claim (discrimination, etc.), the resignation likely has minimal additional value.
- Third-Party Action: You may have a civil action against the person or company that caused your workplace knee injury if that person does not work for the same employer and is not an independent contractor for your employer. This lawsuit is in addition to your workers comp claim. The insurer has a lien against the settlement proceeds or verdict from the third-party claim. The more likely it is that you will receive a significant recovery in the third-party lawsuit, the more likely it is that the insurer will pay fair value to settle your workers comp case. This is because it knows the lien allows it to recover some of what it has paid.
- Other Disability Benefits: You can receive workers comp while receiving Social Security Disability, Long Term Disability, or Virginia Retirement System (VRS) disability payments. However, your workers comp benefits may offset (reduce) how much you receive in other disability payments. In this situation a settlement can increase those other payments – with the appropriate settlement language.
- Other Health Care Coverage: Government health care coverage (Tricare, Medicare, Medicaid) or private health insurance may have to pay for your knee injury if the insurer denies or disputes the workers comp claim.
I recommend gathering and developing evidence for these factors to increase the settlement value for your knee injury. This is not a complete list of the variables that matter. But it is a good start.
Common Knee Injuries and Joint Diseases (with Average Recovery and Healing Times)
There are several types of knee injuries on the job because the knee joint has many different parts.
Your doctor will diagnose the type of knee injury you have based on your patient history (high-speed motor vehicle accident, sudden stop, slip and fall, fall from a height such as a ladder or roof, pivoting, non-contact, etc.), the physical exam, imaging studies, and arteriograms (tests vascular sufficiency).
The most common types of work-related knee injuries are:
- Chondromalacia Patellae. This condition refers to softening and damage of the cartilage under the kneecap (patella). A knee injury at work may result in posttraumatic arthritis or worsen existing arthritis, leading to misalignment of the kneecap and damage to the underlying cartilage.
- Knee Dislocation: A fall, car accident, or collision with an object may result in one of the knee bones coming out of place. Sometimes the knee pops back into place on its own. But other times you may need medical treatment to reset the bone.
- Knee Fracture: Your kneecap shields the joint and often makes the first contact with the other object in a traumatic event. Its location makes the kneecap susceptible to a break. Kneecap (patella) fractures are serious injuries that require immobilization and sometimes surgery.
- Knee Ligament Injuries: Knee ligament injuries are common in sports and the workplace. Any movement that puts pressure or force on the knee can impact the ligaments. Many knee injury cases involve injuries to the anterior cruciate ligament, posterior cruciate ligament, or medial collateral ligament. It may take one to fourteen months to return to work after an ACL injury.
- Knee Tendon Tear: A fall, awkward landing, or quick movement may injure one of the tendons in your knee.
- Leg Amputation/Loss of Limb: A leg injury can result in one of three types of amputations: below the knee amputation, above the knee amputation, or total leg amputation at the hip. Amputation injuries may result in eligibility for permanent and total incapacity benefits.
- Meniscal Tear: Meniscus injuries often result from twisting injuries. A damaged (or removed) meniscus affects your knee’s integrity and may cause long-term problems. Healing time for a torn meniscus ranges from two weeks to six months.
- Muscular Injury: A pulled leg muscle can impact your knee.
- Tibial-Plateau Fracture: A tibial plateau fracture breaks the more prominent leg bone below the knee. Typical healing time ranges from three to six months. Potential complications after a tibial plateau fracture include arthritis, ligament instability and injury, and nonunion.
- Tibial Shaft Fracture: Healing time for tibial shaft fractures range from ten to thirty weeks.
Can I Receive Workers Comp for Degenerative Joint Disease and Osteoarthritis in the Knee?
Yes.
The Subcommittee on Osteoarthritis of the American College of Rheumatology Diagnostic and Therapeutic Criteria Committee dfines osteoarthritis as “a heterogenous group of conditions that lead to joint symptoms and signs, which are associated with defective integrity of articular cartilage, in addition to related changes in the underlying bone at the joint margins.”
Osteoarthritis is a leading cause of work limitations. And it has many potential causes: age, obesity, previous trauma, family history, gender, knee alignment, occupational requirements, physical exercise, and cigarette smoking.
If you have osteoarthritis in the knee, you may suffer from joint swelling, pain, and loss of range of motion.
Having preexisting arthritis does not mean you lose your workers comp claim automatically. But you will need to work with your authorized treating physician and other experts to develop the evidence.
Suppose your doctors state that a work accident aggravated or worsened your osteoarthritis or sped up the need for knee surgery. In that case, you can receive workers compensation benefits such as lifetime medical coverage for the knee and temporary total disability payments.
Surgical Options for Knee Injuries
Sometimes conservative treatment works and your knee injury heals with physical therapy and rest.
But some of you may need surgery for your work-related knee injury.
My firm has helped many injured employees overcome medical treatment denials and obtain authorization and payment for the following knee operations (or settlements that include adequate funds to cover surgery):
- ACL Repair or Reconstruction: This surgery replaces the anterior cruciate ligament to regain knee stability. Many injured employees requiring ACL reconstruction will need six months or more of light-duty work. And some can never return to employment that requires frequent bending, stooping, and twisting. ACL repair or reconstruction ranges from $10,000 to $30,000 or more.
- Arthroscopic Surgery for a Tibial Fracture: This surgery ranges from $15,000 to $25,000 or more.
- Knee Arthrotomy: An arthrotomy is an exploratory surgery that assesses the soft tissues. Your surgeon may “clean out” the knee joint by removing bone fragments or irrigating the joint. An arthrotomy ranges from $5,000 to $10,000 or more.
- Knee Osteonecrosis: This medical condition is progressive and results in arthritis.
- Knee Osteotomy – An osteotomy is a surgical operation where your surgeon cuts the bone to change its length (sometimes with the help of a bone stimulator or bone graft) or to change its alignment. An osteotomy is an option if arthroscopic surgery or ligament reconstruction failed or a fractured bone did not heal properly and needs straightening. It may take up to 6 months for you to reach maximum medical improvement following an osteotomy, and there is an increased risk of permanent restrictions.
- Knee Replacement (Total or Partial): Your doctor may recommend partial or total knee replacement (arthroplasty) if you have severe arthritis. My firm has obtained workers’ compensation approval for knee replacement surgeries in multiple cases. You will likely be limited to sedentary or light work for the remainder of your career following a total knee replacement. A partial or complete knee replacement operation can cost $40,000 or more. Read more about settlements for total knee replacement here.
- Kneecap Repair or Revision: A kneecap repair surgery (to treat a fracture or displaced patella) can cost $15,000 or more.
- Lateral Release Knee Surgery: This surgery removes tissue outer knee tissue to improve patellar tracking.
- Meniscectomy: An arthroscopic partial meniscectomy treats a torn meniscus. Your surgeon will use a small camera and tool to remove a portion of the torn meniscus. Meniscus surgery ranges from $7,500 to $12,000 or more.
- Meniscus Repair: If the meniscus tear occurs in a part of the meniscus with adequate blood supply for recovery, your doctor may repair the torn meniscus instead of removing it. You will receive a brace and crutches after the surgery and should stay off the leg for several weeks.
- Meniscus Transplant Surgery: Your doctor may transplant a donor’s meniscus to your knee if you continue to have knee pain after a complete meniscectomy.
- Microfracture Knee Surgery: This surgery repairs articular cartilage damage and chondral defects by creating minor bone fractures. The procedure’s goal is to create new cartilage from a super-clot.
- Patellar Tendon Repair: You may need surgery to repair the quadriceps or patellar tendon. This surgery is typically an open procedure (rather than arthroscopic), and you could end up with scarring.
Call a Top-Rated Workers Compensation Attorney for Help Winning Your Knee Injury Case or Negotiating a Fair Leg Injury Settlement
I have spoken with many injured employees who tried to ignore their knee pain and “deal with it.” But eventually, the pain and limitations became too much to dismiss, and they sought legal help.
Act quickly to protect your right to workers comp for a knee injury.
Prompt action after a workplace accident puts you in a better position – even if you are not ready to move forward with arthroscopic surgery to repair a torn meniscus or ACL or a total knee replacement surgery to repair the worsening of osteoarthritis. Submitting a workers comp claim tolls the statute of limitations and protects your right to medical care and payments.
Call now for help: (804) 251-1620 or (757) 810-5614 – even if the commission has scheduled a workers comp hearing. There are methods to get more time to prepare, including a continuance or a motion for a nonsuit.
We handle the insurance company while you focus on your health and recovery.
- Will the Dollar Tree Store Closures Affect My Workers’ Compensation? - March 14, 2024
- SSA Proposes a Rule Change to Work History Evaluation - November 1, 2023
- VA Workers Comp Lawyer: We Win Work Injury Claims - May 8, 2017
