Back or neck injury after an accident: how a herniated disc claim really works

What symptoms matter after a back or neck injury?

This page is about claims and is not medical advice. MedlinePlus says to contact your provider right away for back pain after a severe blow or fall, or loss of control over urine or stool. It also lists any numbness, loss of movement, weakness, or bowel or bladder changes. Those signs should not wait.

A disk can move out of place or break open from injury or strain. With a lower back herniation, you may have sharp pain in one part of the leg, hip or buttocks, with numbness in other parts. With a neck herniation, pain may move to the upper arm, forearm and fingers.

Pain that spreads down a limb is one reason to ask for a closer look. Much of it improves: the pain or numbness often goes away or improves a lot over weeks to months. When it lasts longer than 12 weeks and occurs daily, it is called chronic.

What does a doctor need to document for a back or neck claim?

The insurance company says my back problem was already there. Now what?

Expect this argument. Disk wear is common. One large review found disk degeneration in 37 percent of people age 20 with no symptoms and 96 percent of those age 80. MedlinePlus says most people show signs of neck wear on x-ray by age 60. NIAMS says back pain becomes more common with age. An adjuster will read those words on your MRI and call it degenerative.

That argument cuts both ways. If so many people have wear and no pain, then wear alone does not explain why you hurt only after the crash. The key evidence is what changed.

Were you working full duty before? Did you ever see a doctor for your back? Did pain start or get worse after the accident? Old records often help you, because they show you were not treating.

An older problem does not end a claim. In Texas, the state's highest court has said that it is well settled that a wrongdoer takes a plaintiff as he finds him.

The defense may still argue that some of your condition would have happened anyway. Arizona law also allows claims for aggravation in general, but we did not verify an Arizona court quote for this page, so ask a lawyer how it applies there.

Be honest with every doctor about your history. Hiding a prior injury is far worse than having one. Insurers often find old records, and a claim can fall apart over a single denied visit.

Why do gaps in care and delayed pain hurt these claims?

Adrenaline can hide pain, and stiffness often builds over days. That is common, but insurers still use it. A person who waits three weeks to see a doctor will hear that something else must have caused the pain.

A person who stops physical therapy for two months will hear that they healed. If you have a real reason, such as no insurance, childcare or a job you could not leave, write it down and tell your doctor so it appears in the record.

1. Get seen soon after the accident and name every area that hurts.
2. Say plainly how the accident happened and when the pain began.
3. Follow the plan, and tell the office if cost or work keeps you from coming.
4. Ask for your records and read them for mistakes.
5. Tell the doctor how pain limits work, sleep, lifting and driving.
6. Ask your doctor to state in writing whether the accident caused or worsened the condition.

What can a back or neck injury claim cover?

Future surgery is a common fight. A doctor needs to say it is more likely than not, what it will cost and why. Lost earning capacity matters most for physical jobs, where a permanent lifting limit can end a career even though you can still work somewhere.

How much is a herniated disc settlement worth?

No official source publishes an average, and pages that claim a range are guessing. The value depends on the treatment you needed, whether you had surgery, whether the condition is permanent, fault and the insurance available.

Example only, not a prediction: imagine provable losses of $40,000 and a jury finds you 20 percent at fault. In Arizona, your award would be reduced to $32,000. Texas also reduces by your share, but at 51 percent you would recover nothing. Lawyer fees, medical liens and repayment to your health plan come out of what you receive.

Who pays, and how long does it take?

Usually the at-fault driver's insurer or a business's liability insurer. Your own medical payments coverage, health plan or underinsured coverage may also apply. If you were hurt on the job, workers' compensation has separate rules. A hospital or provider may also have a claim on your recovery.

Claims with only therapy may resolve within months after treatment ends. Claims with injections or surgery take longer, and a suit can add a year or more. No agency publishes an average. Insurers often wait for treatment to end before making a serious offer, because that is when the numbers are known. Your filing deadline keeps running.

What is different in Arizona and Texas?

Mistakes that hurt back and neck claims

• Saying "I'm fine" at the scene, then saying nothing to a doctor for weeks.
• Hiding a past back problem.
• Trusting a clean x-ray.
• Doing heavy work or posting gym videos during treatment.
• Settling before you know whether you need injections or surgery.
• Signing a broad medical release that covers your whole life.

Questions