Any workplace injury can be difficult to deal with. However, a shoulder injury can be particularly devastating, as it can affect your ability to work. Shoulder injuries often require serious surgery, ongoing medication, and medical therapy.
Rotator cuff injuries are debilitating due to their critical role in shoulder stability and mobility. Comprising four muscles and tendons, they enable arm movement and overhead activities. Damage leads to pain, weakness, and limited function, affecting daily life and often requiring extensive rehabilitation or surgery for recovery.
Lost wages and medical costs can add up quickly. The good news is that many people in this situation can file a workers’ compensation claim to help ease their financial worries.
Still, it can be difficult for injured workers to understand how workers’ comp settlements work and how much they might expect to receive from their claim. Settlement amounts vary wildly from case to case and are often based on several factors and legal agreement types.
If you’ve been injured at work, the best thing you can do is to educate yourself about what variables might affect your case. If you do this, you’re more likely to have the knowledge needed to ensure you receive a fair settlement covering expenses and bringing peace of mind.
Types of Shoulder Injury Settlements
Not all shoulder injury settlements are created equal. Before you consider pursuing a workers comp settlement for torn rotator cuff, you must understand the scenarios you may encounter and know how each might play out.
Stipulated Award
These types of settlements involve creating an ongoing agreement between the injured worker and the insurance company, ultimately bypassing the need for a court hearing. The insurance company and the victim agree that benefits are due and that the insurance company is liable for and must pay them. Usually, this agreement results in the insurance company paying for:
- Disability benefits
- Ongoing medical bills
Stipulated awards can be beneficial because they allow victims to receive lifetime medical care without worry. These agreements also make provisions for reopening the case and renegotiating the settlement if the injury worsens over time.
However, there are a few disadvantages to stipulated awards. The injured party will not be able to receive a lump-sum payment to cover any lost wages. Instead, you’ll receive periodic payments over time. It’s also possible that your overall monetary compensation may be lower with a stipulated award settlement.
Compromise and Release
Most workers’ compensation rotator cuff injury settlements fall into this category. Insurance companies often prefer these types of agreements because, unlike stipulated awards, there is no ongoing obligation for compensation. Instead, the insurance company offers a set amount of money in exchange for your agreement to close the case. You reap the benefit of a lump sum payment and freedom from the legal process.
Compromise and release agreements are named such because they can result in an injured worker being released from permanent disability stipulations. You will also be terminated from employment, as the deal requires this as a provision. If your physical condition allows, you can start another career, open a business, or pursue other income growth opportunities.
The caveat with compromise and release settlements is that there is very little chance that you will be able to reopen your case once it is closed, as this can only be done in limited circumstances. You could be out of luck if your settlement doesn’t cover your needs. For this reason, it’s essential to consult with an experienced workers’ compensation attorney who can thoroughly evaluate your case and adequately calculate your damages.
What Is the Typical Settlement for a Rotator Cuff Injury at Work?
Regarding the average workers’ comp rotator cuff injury settlement, many different numbers get tossed around on online websites and forums. Some say you can expect about $20,000 for medical expenses and additional damages such as lost wages and diminished work capacity. Other sources indicate that victims could receive upwards of six figures. Who is correct when it comes to typical settlement amounts?
So what is the average workers’ comp shoulder injury settlement? The typical settlement for rotator cuff injury at work is between $20,000 and $150,000. However, it’s important for victims and their families to realize that rotator cuff injuries don’t have an average settlement amount attached to them. Settlements depend on many factors and are as diverse as the people who receive them.
What Factors Affect the Average Compensation for Rotator Cuff Injury?
Because every rotator cuff injury differs, various factors will influence the payout someone might receive from a settlement with the insurance company. Your employer’s insurer will consider these factors when deciding how much they should offer you and how far they will go in negotiations.
Severity of Injury
Not all rotator cuff injuries are the same. You may develop:
- Tendonitis: The cuff tendon becomes irritated or inflamed
- Bursitis: The fluid-filled sac becomes inflamed
- Tears: Tendons tear partially due to overuse or entirely due to sudden injury
While all of these can result in some degree of pain, some (such as a complete rotator cuff tear) will result in severe pain that stops you from sleeping, loss of strength and mobility, and debilitating arm weakness, resulting in total shoulder disability. More severe injuries will result in higher compensation levels because they are likely to result in an inability to work and the need for serious surgery or ongoing treatment.
Previous Injuries
You may not realize that having a previous injury in the same shoulder you hurt this time can diminish the size of your settlement offer. That is because the insurance company will often attempt to blame your current injury on the pre-existing condition. You will need to solicit help from a medical expert to prove otherwise.
Lost Wages
A more severe shoulder injury that requires corrective surgery and results in chronic pain, weakness, and loss of full range of motion will have more of an impact on your ability to work than a partial injury. Because serious injuries cause people to take more time away from work or result in their inability to work altogether, they often command higher settlement offers to cover a greater level of lost wages.
Current and Future Medical Expenses
Sometimes, an injury is so severe that it requires immediate surgery, ongoing rehab, and physical therapy. The insurance company will factor in the cost of your medical care both now and in the future when crafting their workers’ comp settlement for torn rotator cuff. The more ongoing care you need, the likelier you will be offered a higher compensation to cover the costs.
Disability Benefits
Many disability insurance policies have offset clauses that affect the amount of workers’ compensation you are entitled to. Consequently, it is often legal for your torn rotator cuff workers’ comp settlement to be reduced because you are receiving disability benefits. In some cases, a judge must determine which benefit source should take precedence in your case.
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The Workers’ Comp Settlement Process
The workers’ compensation process is highly complex and time-consuming. However, it’s necessary to recover damages for those who injure their rotator cuffs on the job. If you’ve suffered a severe shoulder injury at work, these are the steps you should expect to take if you’ll be pursuing compensation:
- Notify your employer of your injury immediately
- Seek medical care from an employer-approved provider
- File the appropriate paperwork for a workers’ compensation claim
- Give your employer time to file a claim with their insurer
- Wait for the insurance company to approve or deny your claim; appeal if denied
- Wait for the insurer to make an offer of compensation
- Decide whether to accept the offer or negotiate with the insurer
- Agree on a settlement amount or have the case heard and decided by an Administrative Law Judge
- Return to work. Alternately, your employer might release you from your position according to the settlement terms
Because of the length and complexity of rotator cuff injury cases, it’s a good idea to speak with an attorney about your case before proceeding with a lawsuit. An experienced workers’ compensation attorney can evaluate your evidence, medical records, and settlement offer and help you determine the best next step. If you decide to negotiate your offer, they’ll battle the insurer on your behalf.
FAQs
Is Torn Rotator Cuff Surgery Covered by Workers’ Comp?
Typically, torn rotator cuff surgery is covered by workers’ comp. If your torn rotator cuff is deemed a workplace injury, you are likely entitled to compensation, including payment for the diagnosis, treatment, and repair of your shoulder injury. There’s no doubt that torn rotator cuff surgery is meant to be a reparative procedure.
Therefore, when it comes to torn rotator cuff surgery, workers’ comp settlements do cover it. They also cover the pre and post-surgical doctor’s visits, x-rays and labs required for diagnosis, medications you may need to take, and physical therapy for ongoing treatment. If it constitutes injury-related medical care, it’s covered.
What Is the Average Payout for a Rotator Cuff Injury?
The typical settlement for rotator cuff injury at work is between $20,000 and $150,000. There is a good reason for the wide range of estimates: every shoulder injury is unique to the person experiencing it. Additionally, every person has different mitigating factors, such as previous shoulder injuries and whether the damage warrants ongoing physical therapy or another type of medical care.
With that said, giving an average rotator cuff injury settlement amount is too tricky, and most attorneys won’t attempt it. Instead, having a workers’ compensation lawyer evaluate your case and determine what damages you may be entitled to is best.
How Do You File a Workers’ Compensation Claim for a Torn Rotator Cuff?
The first step in filing a workers’ compensation claim is to tell your employer about your injury. Your boss should document what happened and provide a list of approved doctors and medical professionals for you to see. Once you have sought medical care, you and your employer must file the appropriate paperwork. You must list supporting evidence, such as when and where the injury occurred.
Once all the paperwork has been filed, you’ll sit back and wait for the insurance company’s answer so that you can know whether to appeal, accept, or negotiate the insurer’s decision.
Do Insurance Companies Typically Offer Partial Rotator Cuff Tear Settlements?
The short answer is yes. However, workers’ compensation settlements are a little more complex than that. Even though a partial rotator cuff tear may cause severe pain and weakness or limit your arm’s full range of motion, it is still considered a “lesser” injury than a complete tear.
If your injury doesn’t alter your daily life or lead to a partial disability, your settlement will likely be much smaller than you probably anticipated.
Secure Pre-Settlement Funding With Oasis Financial
Undoubtedly, waiting for a workers’ compensation settlement can be an agonizing process. While the injury may be causing you and your family significant frustration, you also have to worry about mounting bills and the cost of keeping a roof over your head. Having to be involved in the legal process only makes things worse.
That is where Oasis Financial can step in to help. We offer pre-settlement funding for workers’ compensation cases in Illinois, Missouri, New Mexico, Ohio, and South Carolina. Because we help people regain control and avoid disaster under challenging circumstances, you can rest assured that receiving your funds will be as straightforward as possible, unlike personal injury loans.
Our team will evaluate your case based on information provided by your attorney. Approved applicants may have the opportunity to receive up to $100,000 in as little as 24 hours. You’ll repay the money from your settlement, not your already-stretched pockets.
Instead of spending your time and energy worrying about your medical bills and living expenses, fill out our no-obligation application today and see if we can help you get the financial relief you need to help you recover from your injuries.
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Oasis provides pre-settlement funding, also known as consumer litigation funding, to its customers through different products depending on their state of residence or cause of action. Many consumers will be provided pre-settlement funding in the form of a purchase agreement, which assigns a portion of the pending proceeds from their legal claim. Other consumers, such as those in SC and CO will be offered a funding in the form of a pre-settlement loan, sometimes referred to as a lawsuit loan. These transactions have important differences, therefore, consumers should carefully review and be aware of the type of transaction that is offered to them by any funding company.