Getting Workers' Compensation Benefits for Back Pain

Workers’ comp covers back pain stemming from accidents as well as repetitive motion. The challenge is proving that the pain is work-related.

By , Attorney · UCLA School of Law

Back injuries are among the most common workplace injuries, according to a survey by Martindale-Nolo. Whether your back injury is the result of an accident or repetitive strain over time, the resulting pain can be debilitating, making it hard or even impossible to perform your job duties. Back pain is a leading cause of work-loss days as well as work limitations for employees in the U.S.

If you sustained a back injury while on the job, workers' comp will probably pay for your medical expenses and a portion of any wages you lose as a result of being unable to work. There are a number of hurdles to overcome, however, before you'll be entitled to any benefits.

The most significant of these is proving that your injury really is related to your work, and not—as insurance companies and employers often argue—the result of a pre-existing condition or something you did on your personal time.

Types of Back Injuries Covered by Workers' Comp

In addition to back injuries sustained during on-the-job accidents, such as falling from a ladder, back pain at work is often caused by repetitive stress or strain. These types of injuries typically result from repetitive lifting, lowering, or twisting, but can even be caused by standing or sitting for long periods of time.

Employees who perform physical labor, such as factory workers, construction workers, and healthcare workers, are at increased risk for both accidents and repetitive strain injuries. For example, a factory worker could sustain a spinal fracture when she is struck by a piece of equipment, or a nurse could strain his back as a result of repeatedly lifting and moving patients.

But workers whose jobs are primarily sedentary can also be at risk. For example, long-haul truckers sit for hours at a time, during which they are not using their back muscles, only to arrive at their destination and unload heavy cargo, which puts extra stress on the spine. Even office workers can experience back injuries as a result of poor posture while sitting at a desk all day.

Proving That Your Back Pain Is Work-Related

To recover workers' comp benefits for back pain, you need to show that your pain is "work-related." An injury generally is considered work-related if you were doing something for the benefit of your employer when it happened. The injury doesn't need to happen at your worksite, but it must take place during the course of your employment.

Insurer Claims of Pre-Existing Conditions

Workers' comp insurers may claim that your back pain is not work-related, but is instead the result of a pre-existing condition. For example, they may point to a car accident that happened while you were off duty, an old sports injury, or simply the effects of aging on the spine.

Even if you have a prior injury, your new injury may still be covered by workers' comp if it aggravated the old one (but you might not receive as much compensation). In the case of other claimed pre-existing conditions, such as the effects of aging, you may be able to demonstrate that it was performing your job duties—not getting older—that actually caused your back pain.

To increase your odds of recovering workers' comp benefits, make sure to tell your medical providers that you believe your back injury is work-related, and explain how and why.

Evidence to Show That Your Injury Is Work-Related

Evidence that can help you prove that your back injury was caused by your job, rather than by a pre-existing condition, includes:

  • signed doctors' notes stating your diagnosis and that your back injury is work-related
  • statements from coworkers and other people who saw the accident occur or who witnessed you engaging in the same repetitive motions day after day
  • security footage from your workplace that shows the accident or the conditions that caused your back injury, and
  • prescriptions and treatment plans provided by your physician.

What to Do When You Experience Work-Related Back Pain

Back injuries that result from a traumatic event such as a fall are usually obvious, but repetitive stress or strain injuries may be harder to spot. They may show up slowly, in the form of numbness or tingling, aching muscles, or pain down your leg. If you are experiencing symptoms of a back injury, seek treatment immediately. Unlike common ailments such as colds that go away on their own, back pain tends to get worse if not treated.

In addition, workers' comp insurers are more likely to find your claim credible if you address it promptly. If you wait, insurers can claim your injury wasn't that serious, or that it was caused by non-work-related activities that you participated in during the intervening time period.

You'll also need to report your injury to your employer as soon as you can. This begins the workers' comp process. Deadlines for reporting vary from state to state, but in some states you only have a few days to report your claim or you risk forfeiting it completely.

Your employer will then provide you with the workers' compensation claims forms to fill out (or in some cases, the employer will fill them out for you). Again, states strictly limit the amount of time employees have to file workers' comp claims, so file your claim as soon as you can.

Hiring a Workers' Comp Lawyer

Although most workers with back injuries eventually receive compensation, many initially have their claims denied and need to file an appeal. The appeal process can be time-consuming and complex. Hiring a workers' comp lawyer to help you through the process can result in you receiving much more in compensation than employees who don't hire a lawyer.

Workers' comp lawyers typically charge what's known as a "contingency fee," which is a certain percentage—usually about 15%—of your overall settlement or award. This means that you don't have to pay anything up front, and if you lose you only have to pay expenses such as copying costs and filing fees, not hourly attorney fees.

Even after accounting for the contingency fee, workers who have a lawyer to guide them through the workers' comp process still generally take home more in compensation than those who don't hire a lawyer.

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