How Much Does Workers’ Compensation Pay for a Back Injury?

October 13, 2021 | Back Injuries

The amount that workers’ compensation pays for a back injury varies on the severity of the injury, how much medical treatment the employee received, and how long their recovery will take. That said, the National Safety Council (NSC) showed how the average cost for workers’ compensation claims for lower back injuries was $36,882 and $33,154 for upper back injuries based on data from the National Council on Compensation Insurance (NCCI).

You can work with a workers’ compensation lawyer in your area to calculate the approximate value of your back injury case based on medical expenses, income loss, and other damages. Many law firms offer free case reviews to go over your rights and explain the workers’ compensation claims process in your state. If necessary, a lawyer can also help you file an appeal if the insurance company denies your claim.

Workers who suffer back injuries may pursue compensation from their employers

In most states, the general rule for qualifying for workers’ compensation is that you must suffer a work-related injury during standard work hours.

Other eligibility requirements include:

  • Your employer must have workers’ compensation insurance, meaning they are a business that requires it by their state’s standards.
  • You must be an employee, not an independent contractor or volunteer.
  • Your injury occurred within reasonable work tasks and not as a result of horseplay or other work violations (e.g., being intoxicated while working).

If you decide to hire a workers’ compensation lawyer, they can inform you about other eligibility requirements specific to your state that you must know when filing your claim.

Workers may seek compensation even if they are at fault

Workers do not need to prove negligence when filing for compensation. Even if their actions led to their injury (e.g., a worker mistakenly drilled into their hand), the employer is still liable for work-related harm.

Exceptions to this rule are when a worker purposefully puts themselves and others in harm’s way through alcohol and drug consumption, horseplay, or intentional wrongdoing.

Workers’ compensation protects employers from lawsuits

Employers who purchase workers’ compensation insurance do so to protect themselves from receiving lawsuits from their employees. Through this arrangement, employees can receive compensation for their injuries and lost wages without putting their employer at risk for bankruptcy.

This principle means you cannot sue your employer for a work-related injury; however, this rule does not apply to other parties separate from your employer.

Workers’ compensation pays for damages related to your back injury and salary

The U.S. Department of Labor lists the damages covered by workers’ compensation for federal workers, though most state workers’ compensation commissions require compensation for the same damages. If you are a non-federal worker, your lawyer can look into the compensation rates you qualify for and take appropriate steps to claim these figures.

In general, you may receive compensation for:

Medical expenses

Your lawyer can calculate your current and projected costs for medical treatment by referring to your invoices and medical records. If possible, they may be able to consult an industry expert who can provide analysis on future medical expenses based on the severity of your back injury, the likelihood that it will heal, and common procedural practices.

Medical expenses are a broad category that can include costs for:

  • Doctor’s appointments, as referred by your employer’s insurance
  • Surgical procedures, including future procedures you might need
  • Medical equipment, such as wheelchairs, back braces, or ergonomic items
  • Emergency room treatment
  • Ambulance rides and paramedic care
  • Hospitalization
  • Imaging exams, such as X-rays, MRIs, or CT scans
  • Bloodwork and other lab tests
  • Chiropractic treatment, including physical therapy

Income loss

Most states will compensate two-thirds of your weekly wages for a set time, which varies on the program. In many cases, there is a waiting period before you can receive benefits. If you do not receive benefits after the waiting period is over, contact your employer, as they are often responsible for ensuring your payments go through to you.

If your physician states you are likely to recover from your back injury, you may receive workers’ compensation benefits until you reach maximum medical improvement (MMI). MMI is the medical standard for determining when a patient has reached a physical state where there is no expectation of further improvement. This state does not mean the patient cannot improve. It means any possible further improvement would require more extensive medical care.

Permanent or temporary disability benefits

If your work-related accident led to a temporary or permanent disability, you may be entitled to receive disability benefits.

These benefits include:

  • Temporary total disability (TTD) benefits: Workers who temporarily cannot work due to back injuries may receive TTD benefits. This benefit can also apply if your employer cannot supply another position that allows you to do light work or work within your capabilities.
  • Temporary partial disability (TPD) benefits: Workers who can perform light work as an alternative to their regular work duties may receive TPD benefits to cover the difference between their standard salary and the current wages of their modified position.
  • Permanent total disability (PTD) benefits: Workers who reach MMI but still retain permanent injuries that prevent them from working may receive PTD benefits. Rules of how long you can receive PTD benefits vary by state, with some states allowing employees to receive benefits for a set amount of weeks while others cap benefits after a set age.
  • Permanent partial disability (PPD) benefits: Workers who cannot return to their regular position due to a permanent disability but can continue working in a lighter position may receive PPD benefits. These rates can shift per year based on state average weekly wages.

As with compensation for wages, there may be a waiting period before you receive disability benefits (typically so many business days). Your lawyer can explain these rules according to your state’s workers’ compensation laws.

Vocational rehabilitation

If you can’t return to your regular position due to your back injury, many states’ workers’ compensation programs offer vocational rehabilitation, which offers resources to:

  • Search for other employment you qualify to apply for
  • Get additional job training to prepare you for other employment
  • Receive counseling and guidance for the next steps in your life
  • Evaluate your current job skills and refer you to other positions or companies

You may go through a functional capacity assessment to determine which job positions you qualify to work in based on your work history, training, and education.

You may file a personal injury lawsuit against another involved party

If another party contributed to the cause of your back injury, you may be able to sue them for compensation through a personal injury claim or lawsuit. Some law firms offer legal guidance for both workers’ compensation and personal injury cases, but not all. If you retain two separate attorneys, they can work together on your case to share information.

The following includes general information that may apply to your case if you decide to take action against a third party.

While a plaintiff cannot sue their employer, they may be within their right to sue a third party that contributed to their injuries.

For example, you might name one or more of the following as a liable third-party:

  • A manufacturer for a machine you used at work if a malfunction from a design or production error led to your injury
  • The maintenance company that last worked on the vehicle you drove for work
  • A coworker who is not your employer but contributed to your accident

Your lawyer may investigate your accident to see whether other parties fall within liability, then advise you on your legal options to pursue compensation from them if applicable.

Personal injury cases allow you to pursue more types of damages

Workers’ compensation strictly covers damages related to your injuries and wages, so they do not cover any pain and suffering you experienced or continue to experience. However, with a personal injury case, you can pursue compensation related to your physical and emotional injuries as well as other financial losses.

The following types of damages are compensable in personal injury cases:

  • Current and future medical care costs
  • Current and future income loss, including loss of benefits and pensions
  • Current and future pain and suffering
  • Emotional distress
  • Permanent disability or physical disfigurement
  • Reduced earning potential
  • Diminished quality of life
  • Property damage costs
  • Other financial damages, such as domestic care costs or home modification costs

This list of damages is not complete, so your attorney may suggest other damages to pursue based on what your state allows plaintiffs to claim in their cases.

Make sure to file your case within the statute of limitations

Another thing to note includes your state’s statute of limitations, which determines how long you have to file your case. Some states give plaintiffs a year to file, such as Louisiana, while others give up to four years, such as in Florida. Certain exceptions may alter your case’s deadline, which your attorney can inform you about when handling your case.

Workers’ compensation lawyers offer several services to help clients file their claim

If you are considering hiring a workers’ compensation lawyer but are unsure about what services a lawyer can offer you, here are some typical tasks to expect from your attorney:

  • They will prepare your workers’ compensation claim and fill out other legal paperwork as necessary.
  • They will help you retrieve evidence to support your claims, such as medical records or exams, video footage, and salary information.
  • They will appear in court hearings to represent you and petition for compensation on your behalf.
  • They will update you as you receive notices on your claim, then answer your questions.

If you decide to pursue a personal injury claim or lawsuit, your lawyer may also investigate your accident to establish negligence in your case and work to negotiate a settlement deal with the opposing party.

Your workers’ compensation lawyer can guide you through the appeals process

If you submitted a workers’ compensation claim but your state’s workers’ compensation board denied benefits, you may have options to appeal your case and continue pursuing compensation.

Your attorney may guide you through this process in your state or the federal workers’ compensation program and offer to:

  • File an appeal with your state’s workers’ compensation commission or program
  • Gather new evidence to support your appeal, which may include an additional medical examination
  • Prepare and present an oral argument on your behalf to petition for workers’ compensation
  • Petition for reconsideration on your claim after bringing appropriate corrections
  • Review your original claim and edit accordingly
  • Attend hearings with the Appellate Board to represent you
  • Handle communications from the Clerk’s office

In some cases, you may go through several appeals before your claim gets approved. Your lawyer can explain what obstacles to expect during this process and answer your other questions.

Chris Dixon & Greg Motil

A workers’ compensation lawyer in your area can help you pursue a payout

If you or a loved one sustained a back injury while working, you may be entitled to file for workers’ compensation through your employer’s insurance. If so, you can hire a St. Louis compensation lawyer in your area to assist you with the claims process. They can discuss how much you might get paid for your back injury and other qualifying damages based on the rules of your state.

If you have already submitted a workers’ compensation claim in your state and received a denial for benefits, a lawyer can go through the appeals process and provide guidance as you pursue compensation.

The Dixon Injury Firm
9666 Olive Blvd #202,
St. Louis, MO 63132
Phone:(314) 208-2808