According to a 2016 survey of our readers, one of the most common body parts injured at work is the back. We asked our readers about their experiences filing a workers’ comp claim for a back injury, including how much they received in benefits, how long their cases took to resolve, and more.
What's the Likely Outcome of a Workers’ Comp Case Involving a Back Injury?
Workers who filed claims for a back injury were very likely to receive at least some compensation through workers’ comp. According to our survey, 74% of workers with back injuries received compensation, either through a voluntary settlement or through an award by a judge after a workers’ compensation hearing. Only 26% of workers with back injuries did not receive a settlement or award. (Although those figures derive from our 2016 survey, there is little reason to believe that today's success rates are much different.)
What's the Average Workers' Compensation Award for a Back Injury?
Of workers with back injuries who received a settlement or award, the average compensation was $23,600. This is slightly higher than the average compensation for workers with all types of injuries, which was $21,800. (As a result of inflation, the average compensation today is likely higher than when our survey was conducted in 2016.)
Data gathered by the National Council of Compensation Insurance for 2019-2020 revealed that average workers’ comp settlements were around $38,000 for lower back injuries and $37,000 for claims involving upper back injuries. However, those figures included the costs of medical care. Our readers likely did not include those costs in their reported settlements.
Without medical care included, the average settlements were consistent with our survey's results: $20,480 for lower back injuries, and $18,955 for upper back injuries.
While these figures represent an average, back injuries tend to range in severity, from mild strains requiring only physical therapy and rest to herniated discs that require surgery and ongoing care. Because of this, the amount each worker receives can vary significantly.
According to our survey, the majority of workers received a relatively modest amount in compensation; 68% of workers with back injuries received $20,000 or less.
However, the remaining 32% of workers received significantly higher settlements or awards: 6% received between $20,000 and $40,000, 17% received between $40,000 and $60,000, and 9% received more than $60,000.
Workers' Comp: How Long Do Back Injury Claims Take?
Although workers with back injuries received more in compensation than the average worker, their workers’ compensation cases took longer to resolve. On average, it took 17.9 months for workers with back injuries to resolve their cases. This is a little over two months longer than the average for workers with all types of injuries, which took 15.7 months to resolve.
This might be because workers with back injuries tend to receive medical treatment for a longer period of time and take longer to reach maximum medical improvement. For example, one worker who suffered back injuries in 2009 didn’t settle until 2014 because of ongoing medical treatment.
What Happens If My Workers' Comp Claim for a Back Injury Is Denied?
While initial denials were common for workers with back injuries, that wasn’t necessarily an indicator of whether the workers would ultimately receive workers’ comp benefits. In fact, of workers with back injuries who received a settlement or award, 63% received an initial denial of their claims. In other words, an initial denial from the insurance company does not mean the end of the road for most workers.
A denial did, however, mean that a large number of workers with back injuries had to take extra steps to secure their benefits. After receiving a denial, 45% of these workers had to file an appeal or request a workers’ compensation hearing before they got a settlement or award.
The most common reason workers received for a denial was that they had a preexisting condition that caused their back injuries: 23% of back claims were denied on these grounds.
For example, the insurance company might blame a worker’s back pain on the effects of aging, especially when it comes to older workers. Or, the insurance company might blame your back pain on an old sports injury, a car accident that happened while you were off duty, or other activities outside of work.
For more on denied claims, see Survey Statistics: Denied Workers’ Comp Claims.
Other reasons for a denial given by the insurance company included:
- the worker missed a deadline for reporting the injury or filing a workers’ comp claim
- the injury happened while the worker was off site and off duty
- the worker wasn’t hurt enough to need medical treatment or time off work, and
- the accident or injury never took place.
While these reasons might be legitimate in some cases, many workers felt that the insurance company was just giving any reason it could to avoid paying out on the claim. For example, one worker reported that the insurance company denied her claim because it didn’t think her back injury was serious enough, even though she ended up receiving a permanent disability rating between 16% and 30%.
Should I Hire a Workers' Comp Lawyer for a Back Injury?
Three-fourths of workers with back injuries hired a lawyer to represent them in their workers’ comp cases; only 25% didn't hire a lawyer. This makes sense, given that many workers with back injuries ended up appealing their cases through the state workers’ compensation agency.
The appeals process can be quite complex, as it requires the parties to file certain forms, attend hearings, and follow procedural rules for gathering and presenting evidence.
To learn whether a lawyer could improve your odds, see our article Is a Workers' Comp Lawyer Worth the Cost?
Of workers who hired lawyers, 49% were either satisfied or very satisfied with their lawyers. Several workers reported that the key was finding a good lawyer, which meant doing some background research and meeting with a couple attorneys before choosing one. (For help finding a lawyer, see Selecting a Workers’ Comp Attorney.)
About This Report
The reader survey data referenced above is from Martindale-Nolo Research's 2016 workers' compensation study, which analyzed responses from readers who had workers' comp claims, had researched hiring a lawyer, and agreed to participate in the survey. The names of any quoted readers have been changed to protect their privacy.
