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What Is the Average Workers’ Compensation Back Injury Settlement?

If you settle your workplace back injury, will the Washington Department of Labor and Industries (L&I) pay you what they pay everyone else? That’s a reasonable question to ask. The state controls every aspect of the worker’s compensation system. It makes sense to have concerns about claim fairness and equity.

If you want to know for sure, you must compare your potential settlement to L&I’s average workers’ comp. back injury settlement. Unfortunately, that’s not that easy to do. While you’ll find a great deal of data on paid claims, the L&I website provides mostly settlement rates, disability percentages, and disability guidelines. When you need straight answers about claims procedures, disability requirements, and average settlements, a worker’s compensation lawyer is your best resource.

L&I Injury Data

L&I produces and maintains meticulous online resources. But because they release data in compliance with federal and state privacy laws, you might not have access to all the information you want. Their injury data page provides links to years of statistics and decades of reports.

When you search their files, you’ll find details about types of injuries and body parts, industries involved, injured workers’ occupations, and other information. You’ll also find comprehensive information about state-funded back injury claims paid during the last fiscal year.

Back injuries are the second most frequent workplace injury. With 13,453 accepted claims, only finger and fingernail injuries occur more frequently. Available claim data includes totals paid on closed claims and estimated costs for open claims.

The data from the most recent year is:

  • Total accepted back injury claims: 11,358. These include traumatic back and spinal injuries, strains, surface wounds, open wounds, burns, multiple traumas, and other categories.
  • Total paid on back injury claims: $115,689,721.
  • Average incurred cost per back injury claim: $10,186.

What Settlements Does L&I Pay?

Not every injured worker qualifies for a back injury settlement. It’s often up to you to explore the possibilities. Whether you temporarily cannot work or you may never go back to work, you may pursue three different types of settlements.

Claim Resolution Structured Settlement Agreements

Washington Administrative Code gives L&I the authority to negotiate a structured settlement agreement with you. Their ideal structured settlement candidate is a 50-year-old worker with an accepted claim lasting 180 days or more.

They suggest that you might also be a candidate if you have:

  • An open lost-time claim;
  • A supplemental income (Social Security, retirement, etc.);
  • A desire to return to work; and
  • No interest in retraining.

A structured settlement is a negotiated arrangement that allows you to exchange your current benefits for future lump sum payments. You, your employer, or L&I have the right to initiate the process. If you have a legal representative, you should discuss the benefits and drawbacks before you complete the settlement process.

Once you negotiate the payment terms, you sign a contract that describes all the terms of your agreement. In some cases, when you accept a structured settlement, you give up your right to recover additional medical benefits for your injury.

Permanent Partial Disability Awards

When you’ve reached maximum medical improvement, you may qualify to receive a payment based on any permanent partial disabilities (PPD) you sustained. L&I pays PPD benefits based on your injury, its severity, and a physician-assigned PPD rating.

A physician who wasn’t involved in your treatment usually conducts an independent medical examination and issues a disability rating. Each rating corresponds with a total body impairment percentage. Cervical, lumbar, and dorsal back injuries have separate rating categories.

Under the PPD award system, the independent physician is solely responsible for rating your disability. As these ratings determine how much money you receive, Washington Administrative Code, WAC §296-20-2010, provides statutory rating guidance for medical care professionals. L&I chooses the doctor and that doctor’s disability rating controls your PPD payment amount. The potential conflict of interests does little to inspire confidence in the overall process.

L&I uses your disability rating and a Disability Category Awards schedule to calculate your PPD settlement.

They apply a formula that includes:

  • Back injury category (cervical, lumbar, dorsal);
  • Category impairment ratings from 2 to 8;
  • Brain and back impairment percentages from 10 percent to 75 percent; and
  • Whole-body impairment value, currently $214,222.98.

You receive your PPD settlement in monthly installments. You may also qualify to receive a PPD down payment.

Your Right to Protest or Appeal a PPD Decision

If you, your doctor, or your employer disagree with L&I’s PPD findings, you have the right to protest or appeal. You must file your protest or appeal within 60 days of the decision. You may write a protest letter and send it to your L&I claim manager, or you may file an online appeal with the Board of Industrial Insurance Appeals. Until the end of June 2021, the Board of Industrial Insurance Appeals will hold all hearings via Zoom.

Pensions

An L&I pension provides a lifetime income when you can’t work due to a permanent total disability. You automatically qualify for a pension if you have one of the following disabilities: loss of use of both arms, both legs, or one arm and one leg, or total vision loss. When you qualify for a pension, you receive an amount that’s equal to your lost-time benefit. The amount you receive depends on your salary, marital status, your average wage when you sustained an on-the-job injury, and other factors.

You must certify your disability annually unless you have a specified disability, and you may receive periodic cost of living adjustments. Depending on the payment option you select, your family may receive survivor’s pension benefits after your death.

Contact a Worker’s Compensation Attorney

If you believe you qualify for a worker’s compensation settlement, consult with a workers’ compensation attorney before you begin negotiations. Attorneys negotiate with the Department of Labor & Industries on your behalf. If you have already received a low offer, a workers’ compensation attorney can help you through the appeal process. Most attorneys offer a free initial consultation where you have an opportunity to discuss your case and get the help you need.

What Is a TBI?

It’s easy to tune out a doctor who starts tossing out medical jargon. However, if your physician tells you that you have a TBI, you must pay attention, ask questions, and insist on getting answers. Physicians realize that patients don’t always ask the questions they should. They tell you the basics, and if you don’t ask for more information, they often leave it at that.

Healthcare providers don’t always have time for a Q&A so they simplify their protocols. They provide a diagnosis, give you at-home care instructions, and prescribe medication. If you don’t require hospitalization, they send you home and schedule you for follow-up care. When a doctor says you have a TBI, what they say next is likely critical to your recovery.

A TBI Is a Brain Injury

TBI is the traditional abbreviation for traumatic brain injury. This condition occurs when your brain sustains damage during a traumatic event. Brain injuries don’t always happen the way you think they do. They don’t always require a direct blow to the head.

They don’t always bleed, and they occur because of:

  • A head bump or blow;
  • A penetrating or crushing head wound; or
  • A severe jolt or body trauma.

Penetrating wounds open up the skull, causing direct, highly-visible brain damage. Severe jolts, bumps, and blows may cause closed head wounds. They leave the skull intact but damage your brain by twisting it and slamming it within the skull’s interior. These brain traumas are common during vehicle crashes, contact sports, falls, workplace incidents, and other accidents. Traumatic Brain Injury Data Systems found that vehicular crashes caused 50 percent of the brain injuries in their database. Falls caused 28 percent of TBI injuries and violence caused 11 percent.

Types of Traumatic Brain Injuries

The Centers for Disease Control and Prevention cite TBI as a “serious public health concern.” They estimate that 150 people die each day from TBI-related injuries. Doctors generally diagnose traumatic brain injuries as mild, moderate, or severe.

All three types manifest four categories of symptoms:

  • Physical: Blurred vision, nausea, balance difficulties, and other physical disturbances.
  • Thinking/Cognitive: Problems with thinking, concentration, memory, and other cognitive issues.
  • Sleep Issues: Changes in sleeping habits, either less sleep or more than usual.
  • Emotional Issues: Irritability, sadness, anxiety, nervousness, and other emotional disturbances.

Mild Brain Injuries

The CDC and healthcare professionals have only recently begun acknowledging that a concussion is, in fact, a mild traumatic brain injury (mTBI.) When you sustain a mild brain injury, you have the potential to make a full recovery. Your progress depends on getting the treatment you need and following your doctor’s instructions. But some mild traumatic brain injuries have lasting consequences. In particular, multiple unresolved concussions sometimes cause cumulative damage.

Concussion treatment requires that you withdraw from routine activities and rest. Often, that’s all it takes to return to regular activities within a few weeks. If you try to bounce back too quickly, you don’t always complete the healing process. If you sustain another concussion before the initial brain injury heals, you subject your brain to additional damage. This dynamic often occurs in organized sports. It also happens with vehicle accidents, falls, and other physical activities.

Patients suffering from a mild brain injury sometimes develop related conditions, such as:

  • Post concussion syndrome: A condition where symptoms last for several months beyond the estimated recovery time.
  • Second impact syndrome: A rare, sometimes fatal condition where the brain swells when an injured person resumes normal activities too soon.
  • PTSD: A disorder that produces continuing pain, anxiety, sleep disturbances, and other symptoms.
  • Chronic traumatic encephalopathy: A condition where the brain structure gradually changes in response to multiple, unresolved concussions or microtraumas.

Moderate to Severe Brain Injury

When you sustain a moderate to severe brain injury, the symptoms are usually more disruptive. You won’t necessarily lose consciousness if you have a mild TBI, but it’s more likely when you sustain moderate to severe brain damage.

Every brain injury requires timely treatment.

The CDC emphasizes that these and other advanced symptoms are “danger signs“ that a brain injury requires immediate intervention:

  • Worsening, continuous headache;
  • Vomiting or nausea;
  • Loss of strength or numbness;
  • Slurred speech;
  • One pupil dilated;
  • Convulsions; and
  • Difficulty recognizing people or places.

Observable Symptoms

If you have a moderate to severe brain injury, you might not recognize the symptoms. If you lose consciousness or sustain an open wound, it’s easier for others to recognize your need for medical attention.

If you remain conscious, but can’t recognize or explain your symptoms, those around you should ask and answer these questions:

  • Does the injured person appear dazed?
  • Do they readily respond when you ask a question?
  • Do they remember the circumstances?
  • Do you observe any personality changes?
  • Does the person easily forget what you tell them?

When young children sustain head injuries, they don’t always have the vocabulary to explain what they’re feeling.

You must remain watchful for these symptoms:

  • Any of the danger signs listed above.
  • The child can’t stop crying.
  • The child doesn’t want to eat or nurse.

Living With a Moderate to Severe TBI

When you sustain a moderate to severe brain injury, you may require inpatient care and rehabilitation. Brain injury victims often deal with a range of complications, from a temporary loss of consciousness to vegetative states. Moderate to severe brain injury patients sometimes deal with physical, emotional, cognitive, and other issues. While some return to driving, working, and other activities, others deal with lifelong impairments and lifestyle changes.

The National Institute for Disability, Independent Living, and Rehabilitation Research monitors thousands of patients with moderate to severe brain injuries. They have determined that recovering patients were 50 times more likely to have seizures and 11 times more likely to suffer from an accidental drug overdose. They were also six times more likely to contract pneumonia.

The organization also found these five-year patient trends:

  • Patients’ medical conditions worsened: 30 percent
  • Conditions remained the same: 22 percent
  • Conditions improved: 26 percent
  • Patients died: 22 percent

The Brain Injury Association of America recognizes that severe TBI is a progressive disease that often leads to other conditions. Some TBI patients deal with cognitive decline, seizures, Parkinson’s disease, dementia, and other chronic conditions.

Contact a Brain Injury Attorney for More Information

When you sustain a brain injury, it often turns your life upside down. Whether you’re dealing with the Department of Labor & Industries or a liability insurance carrier, never handle a claim on your own. When you choose to work with a brain injury attorney, they can use their resources to protect your legal interests. They work hard to produce the best claim outcomes possible for each client they take on. Contact Boohoff Law for a free initial consultation.