While a herniated disc injury may not be fatal in most cases, it can sometimes be disabling enough to keep you out of work for days or even years. You can claim a l4-l5-s1 workers’ comp settlement if your injury is work-related.
But how much settlement can you get?
In general, estimating the settlement amount from a herniated disc is difficult. Many factors can affect the amount of a workers comp settlement, and each case has different circumstances.
According to OSHA data, a hernia workers comp settlement can cost businesses anywhere from $40,000 to $80,000. At the same time, the National Council of Compensation Insurance (NCCI) estimates that lower back injuries like a herniated disc can fetch an average workers comp settlement of $37,000.
However, a survey revealed that the average workers’ compensation settlement for back injury claims is between $20,000 and $25,000.
To determine how much settlement you should get, you must first understand the nature of herniated disc injuries and how the workers’ comp system works.
UNDERSTANDING HERNIATED DISC
If you’re familiar with our body’s anatomy, you’ll know that our spine is made of stacks of bones. In between these bones is a rubbery disk-shaped material we call the spinal disk. These disks serve as cushions and keep the bones from rubbing together.
While the disk has a rubbery exterior, it is a soft, jelly-like material inside. A herniated disc happens when the rubbery exterior gets damaged, and the jelly-like center pushes out. This can irritate nearby nerves, leading to various symptoms.
A herniated disk can happen anywhere on your spine. The symptoms will depend on where the disk is located and whether or not it’s affecting a nerve. But in general, you can feel:
- numbness or a tingling sensation (if your injury involves a nerve)
- weakness in your muscles, which can affect your ability to walk or hold and lift things
- burning pain in the arms and legs, particularly in the buttocks, thigh, and calf
A herniated disc is often a cumulative injury, meaning it doesn’t happen instantly but results from repetitive movements over time.
This is why people who often use their back muscles to pick up or lift heavy objects are more at risk of getting a herniated disc.
You can also get a herniated disc from a traumatic injury like falling on your back or a hard object hitting your spine, though this is very rare.
In most cases, however, it’s hard to pinpoint the actual cause of a herniated disc. This makes it challenging to claim workers’ compensation.
The treatments can also vary because a herniated disc injury can vary in severity.
For less severe cases, the doctor may advise you to avoid movements that can worsen your condition. These include lifting heavy objects, pulling, pushing, twisting, or bending sideways. If these movements are unavoidable in your work, you may need to skip work until the pain subsides temporarily.
You may also be advised to take pain medications and muscle relaxants. Some doctors may even recommend cortisone injections if the painkillers don’t work.
In sporadic cases, your condition may need surgery. If the entire disk needs to be removed, you may need to wear a metal plate on your spine for months.
HOW TO CLAIM WORKERS COMP SETTLEMENT FOR HERNIATED DISC
Workers’ compensation laws vary per state. Thus, the process of filing a workers comp claim can also vary. But in general, claiming workers comp settlement for a herniated disc involves the following steps:
1. REPORT YOUR INJURY
Depending on your state, the first step to filing a workers comp claim is to report your injury. Most states only give you up to 30 days to do so. Otherwise, your claim can be denied.
Your employer must inform your insurance provider about your injury. In Florida, your employer must report the injury within 7 days. Failing to do so will give your insurance provider an excuse to deny your benefits.
2. GATHER EVIDENCE TO SUPPORT YOUR CLAIM
After reporting your injury, you must gather evidence to support your claim.
One of the most critical requirements in workers’ comp claims is that the injury must be work-related. However, as mentioned, a herniated disc is usually a cumulative injury, and proving it is work-related can be difficult.
So, if you want to get workers comp for a herniated disc, you need evidence to prove that your injury is indeed work-related. This usually includes:
- medical records
- employment history
- witness testimonies
- doctor/medical expert testimonies
Depending on the nature of your injury, you may also need to provide evidence that it is disabling enough to warrant an absence from work.
3. WAIT FOR YOUR INSURANCE PROVIDER’S DECISION
Your insurance provider will evaluate the evidence you submitted. An insurance adjuster will also be assigned to your case to determine your eligibility for benefits.
If they find your evidence satisfactory, they will approve your claim. But if there’s doubt that your injury isn’t work-related or that it’s not disabling enough, your claim may get denied.
In the latter case, you can still appeal your claim by submitting new evidence or sitting down for a mediation session. If that doesn’t work, you can take your case to court.
WHAT WORKERS COMP BENEFITS CAN YOU GET?
Your workers’ comp settlement amount will depend on the benefits you’re entitled to. Depending on the circumstances of your injury, you may be eligible for:
In Florida and most states, the insurance company should pay all medical expenses related to your injury. This includes expenses for:
- emergency treatment
- doctor’s consultations
- surgery (if necessary)
- physical therapy (if required)
- any other costs needed to treat your injury or illness
Remember, however, that your insurance provider must accredit your treating doctor for you to claim medical benefits.
LOST WAGES COMPENSATION
If you’ve missed work because of your injury, your insurance company must compensate you for lost wages. The policy for wage loss compensation varies per state. In Florida, however, you will only receive lost wages benefits for the first seven days if your injury extends to over 21 days.
How much wage loss benefits you’ll get also varies per state. You can generally receive up to two-thirds of your average weekly wage before you get injured. However, it will also depend on whether your injury is total or partial and temporary or permanent. To ensure you’re getting the wage loss benefits you’re entitled to, check your state’s workers comp laws.
If, for instance, you died from your injury, your beneficiaries will be entitled to death benefits. This includes funeral expenses, compensation to dependents, and educational benefits to your surviving spouse (if any).
HOW MUCH SETTLEMENT CAN YOU EXPECT?
Though the average workers’ comp settlement for a herniated disc is around $40,000, your settlement can be much lower or much higher than that. As mentioned, each case has different circumstances, and how much payment you’ll receive generally depends on:
- the medical treatments and medications you’ll need
- the number of days you need to stay at the hospital
- how long you’ll be out of work
- whether you’ll receive the settlement in a lump sum or periodic payments
Workers’ Compensation Calculation
Workers’ compensation settlements are calculated based on several factors that consider the specifics of the worker’s injury and its impact on their ability to work. Here’s a general overview of how it works:
This is one of the most significant factors in calculating a workers’ comp settlement. The default rule is for workers to receive 66 and two-thirds percent of their average weekly pre-injury earnings. However, this figure may be adjusted based on the severity of the injury and its impact on the worker’s ability to earn income in the future.
The cost of medical services forms a significant part of the settlement calculation. This includes all past medical expenses from the accident date and estimated future medical expenses based on the duration of the injury or illness.
To calculate your workers’ comp settlement or reward, your disability rating is multiplied by the number of weeks for the injured body part. A doctor usually gives this rating, reflecting the severity of your injury and its long-term impact.
Specific Loss and Scarring
If the injury results in a specific loss (such as the loss of a limb) or significant scarring, this can also contribute to the overall settlement amount.
To illustrate with an example, let’s say a worker has an average weekly wage of $1,000 and suffered a back injury that resulted in them being unable to work for 20 weeks. If their disability rating is 50%, the calculation will look something like this:
- Lost wages: $1,000 x 0.6667 (the usual percentage of wages covered) x 20 weeks = $13,334
- Medical expenses: Past and future medical costs total $15,000.
- Disability payout: 50% (disability rating) x 20 weeks (for the body part injured) x $1,000 (average weekly wage) = $10,000
- Adding these together, the total workers’ comp settlement would be $38,334.
Remember that each case is unique, and settlements can vary based on specific circumstances. Hire an experienced workers’ compensation lawyer like Victor Malca to ensure you get what you deserve. He’s been helping injured workers in Florida for almost two decades, and he can help you get the benefits you rightfully deserve. Call us now for a free consultation.
VICTOR MALCA – Florida Workers Compensation & Social Security Disability Attorney
Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success when fighting for his clients puts him among the most trusted workers’ compensation attorney’s in Florida. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits.
Book a free consultation today. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida.
About The Author
Judy Ponio is a writer and editor for the Victor Malca Law P.A. website and blog. She enjoys helping people in need with questions about social security disability and workers compensation law. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives.