Workers Comp Back Injury

Workplace back injuries have steadily decreased over the past 10 years – there were 128,220 cases in the U.S. reported by the Bureau of Labor Statistics in 2020, down from 183,100 in 2011. That said, back injuries are still the most common specific body part injury suffered by workers, and can cause long-term problems and rack up medical bills.

The average workers comp claim for an upper back injury costs employers $37,309; lower back injuries cost $35,833. When all costs, including wage loss benefits, medical bills and more are added in, the average cost can be between $40,000 and $80,000, the Occupational Safety and Health Administration estimates.

“The nature of work has changed,” said Alan Pierce, of Pierce, Pierce and Napalitano, a Massachusetts firm specializing in workers compensation claims. “Where lifting is part of the job, I think employers have done a fairly good job of teaching their workers how to properly lift. The classic bending, lifting and going ‘oh, my back hurts,’ … those aren’t happening as much.”

An aging workforce and sedentary lifestyles, though, mean back injuries are still a common workers comp issue.

Average Workers Comp Settlement for a Back Injury

Health care costs for workers with back pain are about 60% higher than those without, one study found. Back injuries can be long-term and hard to heal. Workers who suffer from back pain are also more likely to suffer from depression and chronic fatigue. All of the associated costs of a back injury can add up and lead to partial or permanent disability.

A survey by Martindale-Nolo found that, of those surveyed who received workers comp settlements for a back injury, the average was between $20,000 and $25,000.

Still, the amount varies widely depending on how much the worker was making, the severity of the injury and what state the injured worker lives in. And that’s when there’s actually a settlement.

“Not every case that is a workers comp case settles,” Pierce said. Many cases result in the worker going back to work with modifications or restrictions.

“Some people hurt their backs, they get workers comp, the back gets treated and they go back to work,” he said. “If it settles, it settles because it’s a long-term case and nobody knows how long this person will be disabled. The insurer may have evidence that the person can do other types of work, and our claim would be that he can’t do other types of work because he’s not trained for anything except the act of physical labor.”

The two parties – the employer (and its insurer) and the worker (and their attorney) negotiate. “Medical bills get paid separately, so what you’re settling out is the disability,” Pierce said.

In Massachusetts, the highest per-week compensation is close to $1,400, but many qualify for much less. “I had a client who just walked out of here and his compensation rate is $500 a week,” Pierce said.

What state the injured worker lives in also plays a huge art. Most states use a schedule that lists type of injury (fracture, strain, sprain, etc.) and body parts to determine how much workers comp will pay. But some injuries, including some types of back injuries, have other qualifications.

Depending on the state, compensation for a sever back injury may rely on:

• Percentage of physical impairment.
• What impact the injury will have on an estimation of the workers’ ability to earn a living in the future.
• How much actual income the worker is losing at the job they held at time of injury.
• Bifurcated compensation depending on whether the worker had to take a wage cut or, if not, level of impairment.

Types of Back Injuries in the Workplace

Workplace back injuries can range in severity and type, and be caused by the job or be a condition caused by disease or aging, then made worse by the job.

The most common back injuries in the workplace are:

Lower Back Strains and Sprains

Tears or overstretching to soft tissue like muscles, ligaments or tendons, which are the most common type of workplace back injuries reported to OSHA. They can happen suddenly in falls, sudden twisting or bending, or lifting something heavy. They can also be the result of an accumulation of physical stress.

Pinched Nerve

A pinched nerve happens when there’s too much pressure around a nerve by a bone, ligaments or tendons. It can be caused by repetitive motion, or by holding the body in one position for a long time. Pinched nerves can be minor and temporary, or severe and long term, and cause pain and numbness.

Herniated or Bulging Disc

A herniated disc is when the ligaments that surround and protect the discs that separate the vertebrae (bones surrounding the spine) tear or stretch, the discs can push through the ligaments and into the spine, causing pain and loss of range of motion in severe cases. Discs can also bulge, something that happens to most people over 40, and not cause pain or problems, but can eventually lead to pain or injury.

Fractured Vertebrae

The vertebrae are the bones that surround the spine. They can break either by stress or trauma, or because they’re weakened by disease or aging

Degenerative Back Injuries

Aging brings diseases like arthritis, spinal stenosis and degenerative disc disease, all of which can cause the discs, tendons and bones that support the spine to weaken or stiffen, causing pain, loss of range of motion and injury.

Common Causes of Work-Related Back Injuries.

The most common causes of work-related back injuries are:

• Lifting or moving heavy objects, or not lifting correctly, can put force on sensitive parts of the back causing strains, tears or more serious injury.
• The same motion over and over again, particularly if it involves back movement like bending or twisting, can cause injury.
• Sitting for long periods of time, particularly with bad posture or a poorly-designed seat, or standing in one position without stretching or moving, can lead to injury because pressure is being put on parts of the back without letup.

How to Prove a Back Injury at Work

Imaging like CAT scans and MRIs are detailed enough to show a work-related back injury – doctors, workers, and insurance companies don’t have to rely on general claims about pain.

On the other hand, Pierce said, they also show more degenerative issues that are age-related, not work-related.

This has made proving back pain is work related in some states, like Massachusetts, where the worker has to prove that the major factor of the back pain is a work injury.

“The older you are, the more prone you will be to back problems, so we have to sort out the distinction between the trauma that may have injured the back from the underlying degenerative disc disease that may account for some of the abnormalities.”

He said a lot of litigation he’s involved in focuses on whether it’s a work-related back injury or the result of the aging process.

He said doctors that perform insurance examines may look at an MRI and agree the worker has back pain, but that the major cause is degenerative disc disease and the work injury was a minor cause that temporarily exacerbated the symptoms. He said the older the claimant, the more that issue presents itself.

“To prove the back injury is work related, get it property reported, properly treated, and [the worker’s] doctor needs to understand what we need to prove. We need to prove that more likely than not, it’s work related,” Pierce said.

When a worker hurts their back on the job, or suspects back pain is work-related, they should report it their employer immediately, Pierce said.

A worker with bank pain should also follow the steps to file a workers comp claim, including getting the claim number, and whatever else is required, before going to the doctor if possible.

Another important step is to give the initial doctor as detailed an account of what happened. Having that information on the initial medical record will help prove the claim.

When a client comes to Pierce with a work-related back injury, the first thing he asks is, “What is the history you gave the emergency room?”

Ideally, he’d like the medical record to say something like: “The patient last week at work felt a twinge, thought he could work through it, kept on working, it got worse over the weekend and today he came in to have it looked at.”

Pierce said what he hears more often is some variation of: “Patient’s back hurt and he came in” or “Patient can’t remember specifics, but the back hurt, then got worse today.”

While a claim is being pursued, the worker must also not behave in ways that would make it difficult to prove the claim. Pierce said many employers do “activity investigations,” including videotaping an injured worker to try to prove they’re exaggerating the injury. Social media can also crush a claim.

“I tell my people ‘Don’t do anything you shouldn’t be doing medically,” Pierce said. For instance, he doesn’t want to see a client with a bad knee on Facebook water skiing or dancing at a wedding. “But by the same token, you have to live your life. If the doctor says it’s OK to mow the lawn, then mow the lawn.”

If an employer has video of a client carrying a grocery bag or doing some other activity, and they ask the worker about it, “Don’t lie,” Pierce said. It’s better to explain the bag had diapers in it, not bricks, than to hurt the case when the employer has it on tape.

Returning to Work after a Back Injury

When you return to work after a back injury, strictly adhere to the restrictions that the doctor has given, as well as any exercise or therapy regimen that’s been prescribed.

It’s important to put yourself first – focus on healing, not re-injuring yourself and adhering to a healthy lifestyle. As many as 70% of workers don’t stick to the exercises they’re supposed to do to help their injury heal and build strength to avoid further injury.

There may be restrictions to how much you can lift, or other movement, as well as modifications to your work station. There also may be a limit, like 30 or 60 days, on the restrictions.

Workers comp comes under the Americans with Disabilities Act, which means workers are protected if what they’re asked to do exceeds the restrictions put on their return to work. For instance, if you are told you can’t lift anything over 20 pounds, it’s all right to refuse to lift something heavier.

“The employer does have a duty to adhere to those modifications,” Pierce said. “The problem I run into is that some employers will not accommodate those restrictions. They will not take you back at all if there are restrictions, or if they do, they say they’ll accommodate the restrictions, but in a busy workday and the job needs to get done, either the employer will give my client work beyond his or her restrictions or the client [will do work beyond the restriction].”

He said there is no penalty for workers if they exceed the restrictions, but may be penalties for employers who order workers to work beyond their restrictions.

A worker’s compensation claim can be complicated, both before and after it is settled. In the case of a potentially expensive back injury case, an employer may push not to pay. Hiring an attorney who specializes in workers comp claims can ensure that you are treated fairly.