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Lower Back Injury Settlement Amount Workers Compensation

  • Dave Brown, Esquire
  • 08/20/2023

Settling Your Lower Back Injury Workers’ Compensation Case

If you have been unfortunate enough to sustain a lower back injury at work in Pennsylvania, you’re probably experiencing pain, have seen a few medical providers, and are unable to do your job. Will you be able to settle your workers’ compensation claim for your lower back injury? The Philadelphia workers’ compensation lawyers at Pearson Koutcher Law are here to give you an idea of what factors an insurance company considers in deciding how much money to offer in a settlement.

Is A Lower Back Injury Common? How Does A Lower Back Injury Happen?

A work injury to the lower back is very common – it can happen in a number of ways. Examples include lifting a heavy box, slipping on a greasy floor, and getting rear-ended in a work vehicle that you’re driving. These injuries can cause you pain, not only to your lower back, but also pain that radiates to one or both of your legs, sometimes down to your toes. Your ability to stand, walk, bend, squat, lift, and carry can also be affected.

Do I Need To Go To The Hospital? What Will Happen When I Go To The Hospital For My Lower Back Injury?

If your lower back symptoms are severe enough, you may need to go to a hospital emergency room where you are likely to undergo an X-ray and possibly a CT-scan to your lumbar spine (medical terminology for your lower back). You may also be prescribed medication.

Where Should My Employer Direct Me After My Lower Back Injury?

Regardless of whether you go to an emergency room, your employer may direct you to an occupational health facility that is on its list of panel medical providers which an injured worker must treat with for a work injury during the first 90 days.

What Type Of Treatment May I Receive After I See A Doctor?

The occupational health facility may order a lumbar spine MRI, recommend physical therapy, and refer you to a specialist, such as an orthopedic surgeon.

How Much Will They Pay Me If I Reach A Workers’ Comp Settlement?

While you’re enduring the pain from your injury and the aggravation dealing with the insurance company, you may be asking yourself: Can I reach a settlement of my PA workers’ compensation claim? How much will they pay me? The answers to these questions depend on several factors:

Insurance Company Accepts Or Denies My Workers” Compensation Claim
The Insurance Company’s Acceptance or Denial of your Claim—The workers’ compensation insurance company for your employer has 21 days from the time it is notified of your injury to accept or deny your claim. If the insurance company accepts your claim for lost wages, it will start sending you a check each week for workers’ compensation benefits. If it denies your claim – and don’t be surprised if it does — you will need to hire a the Philadelphia workers’ compensation lawyers at Pearson Koutcher Law to file a Claim Petition for benefits that will be heard by a Workers’ Compensation Judge.

Will A Settlement Offer From An Insurance Company Be For As Much As If It Had Accepted My Claim?
Once an insurance company accepts your claim and sends you a check every week, it cannot stop paying you until a Judge finds you have fully recovered from your injury, or you have returned to work. The insurance company may be concerned about the possibility of paying you benefits indefinitely and try to settle your case. On the other hand, if the insurance company has denied your claim because it thinks you didn’t injure yourself at work or are not disabled by your injury, it may dig its heels in and fight your case before the Judge. Under these circumstances, if the insurance company makes you a settlement offer, it probably will not be for as much money than if it had accepted your claim.

What Is My Weekly Workers’ Compensation Rate?
Your Weekly Workers’ Compensation Rate – How much an insurance company will pay you in a settlement is dictated largely by your workers’ compensation rate. This is determined by your “average weekly wage,” which is calculated based on your wages for your employer over the one-year period prior to your injury. Your rate will be as high as 90% of your average weekly wage and as low as 66.7%; the money is not taxable so you should take home as much money on workers’ comp. as when you were working.

How Does The Insurance Company Determine What To Offer You In A Workers’ Comp Settlement?
The insurance company will look closely at the amount of your benefits on an annual basis. Some examples: If your weekly workers’ compensation rate is $200, the maximum amount the insurance company would have to pay you in lost wages over a year is about $10,500. But if your weekly rate is $1,000, the insurance company would pay you $52,000 a year. If your rate is somewhere in between, let’s say $500 per week, this would equate to approximately $26,000 per year in benefits. The insurance company will give great weight to your workers’ compensation rate when deciding what to offer you in a settlement.

How Does The Nature of your Lower Back Injury Affect My Settlement Offer
It may sound obvious, but the more serious your back injury, the higher the settlement value of your case. If the MRI of your lumbar spine shows a herniated disc for which you undergo injections, or worse yet surgery, your case has the potential to be worth a lot of money.

If your MRI is normal, however, or reveals only minor findings that are related to your age and not your work injury, this will significantly limit the value of your case. Your doctor may also order a nerve study for you called an EMG. This study sometimes shows lumbar radiculopathy, a fancy term for nerve damage. A finding of radiculopathy also will likely increase the amount that an insurance company will be willing to pay you. We have to tell you, though – if your MRI is normal and so is your EMG, that’s good news for your back condition but bad news for your wallet. If that is the case, you can bet that the insurance company will take the position that you only sustained a minor injury to your lower back, a lumbar sprain, and not be willing to pay you much in a PA workers’ comp settlement.

How much will the Insurance Company Pay you in a Settlement?
We cannot give you a number but can only say that in deciding how much money to offer you in a settlement, most insurance companies give strong consideration to the factors we have described. Keep in mind that there is no money for “pain and suffering” in a PA workers’ compensation case. We’re afraid this means if your lower back injury causes you so much pain that your sleep is interrupted and you cannot participate in hobbies which you could before your injury, you cannot get extra money. A settlement of your lower back injury claim is based only on your lost wages and payment of medical bills.

Hurt At Work? Call The Pennsylvania Workers’ Comp Lawyers At Pearson Koutcher Law

In sum, if you injure your lower back at work, or any other body part for that matter, whether your claim is accepted or denied, whether your workers’ compensation rate is high or low, and whether your injury is major or minor, you need an experienced Philadelphia workers’ compensation lawyer by your side. At Pearson Koutcher Law, workers’ comp. is all we do, every day. All of our lawyers have more than 25 years of experience representing injured workers and will zealously represent you in your claim. We will try to get the best settlement for you based on the facts of your case. Please call us today for a free, comprehensive consultation with one of our lawyers.