One study found that the adjusted mean cost for spinal stenosis surgery was $38,434 (in today’s dollars, adjusted for inflation). This is not the average workers’ comp settlement for spinal stenosis. A workers’ compensation settlement reflects many different types of compensation available, with the award in an individual case depending on several factors.
Horton & Mendez Injury Attorneys discusses the average workers’ comp settlement for spinal stenosis.
Understanding Spinal Stenosis and Its Impact on Workers
Spinal stenosis is the narrowing of the spinal column and may occur with or without symptoms.
Vertebrae are stacked in a column, making up the back. The spinal cord sits within the spinal column within the space between the vertebrae. When this space is narrowed, it is called spinal stenosis.
Cause
Spinal stenosis in the workplace may be the result of sudden trauma, such as a fall or explosion. It may also occur because of improper lifting.
Symptoms
Spinal stenosis can cause several symptoms, including the following:
- Muscle weakness, especially in arms and hands
- Leg heaviness, cramping
- Numbness, especially in the lower body
- Back pain, shoulder blade pain
- Burning, tingling
- Walking and balance difficulty
- Excretory, sexual dysfunction
Symptoms may be delayed and can worsen over time. Other injuries, including spinal contusion, may also be present.
Diagnosis
Spinal stenosis is diagnosed by scans, including x-ray, MRI, and CT scans. The examining physician will take a patient’s history and evaluate symptoms. Electrical and nerve tests can measure activity and stimulation.
Treatment
Treatment for spinal stenosis may include:
- Physical therapy
- Medication (steroids and anti-inflammatory)
- Surgery (making more space in the spinal column)
- Posture correction
- Exercise, weight management, quitting smoking
Factors Affecting Workers’ Compensation Settlement Amounts
Timing of the settlement
Has surgery already happened or does the cost need to be included in the settlement? How much more medical care is likely to come? The timing of the settlement, and how much medical care is needed in the future, can factor into the final settlement.
Type of settlement
There are multiple options when it comes to structuring a workers’ compensation award.
A clincher agreement may end employer liability for future medical care. Future medical care may be left open. As the person claiming benefits, you can negotiate the settlement that is best for your situation. In cases of spinal stenosis, this largely depends on whether the condition is expected to worsen in the future.
Average weekly wage
Someone with moderate or severe spinal stenosis symptoms will probably miss work. Missed work is calculated from the person’s average weekly wage. Income before injury will be a factor in determining a settlement amount for spinal stenosis.
Permanent disability and disfigurement
North Carolina workers’ compensation awards permanent disability payments for loss of the use of the back. Anything more than 75% is compensated for total loss of use of the back. Permanent work restrictions may be assessed to determine disability pay.
All injuries
If a person has other injuries because of an incident or accident in the course of employment, all injuries may be a part of the workers’ compensation settlement.
Total and permanent disability
North Carolina recognizes situations where it may not be appropriate to cap temporary total disability benefits at 500 weeks. When a person has severe injury, including spinal cord injury resulting in paralysis or other debilitating conditions, their case may be an exception to the 500-week rule. To qualify, an injury must be extreme.
Strength of the case
The other side may be more willing to litigate through appeals if they believe there is a chance they may win their case. A settlement offer may be lower if there are factual or legal questions about the case.
Challenges in Workers’ Comp Settlements for Spinal Stenosis
Many North Carolina workers’ comp cases for spinal stenosis center on whether the workplace injury is the cause of the spinal stenosis.
Insurance companies like to point to other medical conditions that may be a cause of the medical condition. The plaintiff has the burden of proof, so they must be prepared to address the issues raised by the defense.
In Stewart v. Goulston Techs, Inc. (N.C. Ct. App. 2022), the plaintiff was working with chemicals.
They fainted and fell down the stairs. Medical scans confirmed spinal stenosis and contusion of the spinal cord.
The insurance company questioned whether the injury arose from employment. They cited the person’s other health conditions like diabetes and obesity.
The court said that an idiopathic condition does not preclude compensation if the injury is associated with any risk of employment. It was reasonable, the court said, to conclude that the award was justified.
In Schneeman v. Food Lion LLC (N.C. Ct. App. 2018), a grocery store produce sales associate was lifting watermelon out of a deep bin.
He experienced sharp arm pain that worsened over the next week. An MRI showed spinal stenosis. A doctor testified to causation, and workers’ compensation was awarded.
In Carr v. Dept. of Health and Human Services 218 N.C. App. 151 (2012), a workplace fall resulted in spinal stenosis. Benefits were upheld because of sufficient testimony of a causal relationship.
Maxim post hoc, ergo propter hoc
A phrase you may hear in the context of workers’ comp for spinal stenosis is maxim post hoc, ergo propter hoc. The phrase means, after this, because of this. It’s a phrase the insurance company may use to allege that spinal stenosis has a different cause. If the insurance company raises the issue of maxim post hoc, ergo propter hoc, you must be prepared to respond.
Steps To Take if Your Spinal Stenosis Claim Is Denied
If your spinal stenosis claim is denied, you may seek another medical opinion. You may file for a hearing or appeal a decision of the Commission to the court. A lawyer can represent you at all stages of the case.
Contact an Experienced Wilmington Workers’ Compensation Lawyer
If you have been hurt at work, we invite you to contact an experienced Wilmington workers’ compensation lawyer. You may receive a settlement for spinal stenosis. Contact Horton & Mendez Injury Attorneys to get help now.
