Workers’ Compensation for Back Injuries

Back injuries are among the most frequent causes of work absences. Back injuries at work account for almost 20% of workers’ compensation claims. They are also among the claims that insurance companies most commonly contest.

Federal law requires workers’ compensation benefits to be provided to longshoremen, harbor workers, employees injured in offshore drilling activities, employees of defense contractors who are injured in a foreign country, and certain other workplace injury victims. Most other employees are covered by state law that mandates the payment of workers’ compensation benefits.

Back injuries are problematic because doctors must often base a diagnosis on subjective reports of pain. Soft tissue injuries, including stretched or torn muscles, are difficult to identify by objective testing. An MRI might provide evidence of a soft tissue injury, but insurance companies are reluctant to pay for an MRI. In any event, a normal MRI result does not prove the absence of pain.

Workers’ compensation lawyers help victims of workplace back injuries obtain full workers’ compensation benefits. Lawyers are the first line of protection against insurance companies that deny workers’ compensation claims. Asking for legal advice soon after an injury occurs is the best way to protect against insurance companies that want to maximize their profits by minimizing the payment of benefits that injured workers deserve.

Causes of Workplace Back Injuries

Lifting heavy objects is a typical cause of work-related back pain. Ideally, employers will provide employees with appropriate lifting and safety equipment to minimize the risk of back strain. However, even in the absence of an employee’s negligent failure to protect employees from harm, an injured employee is entitled to compensation for work-related back injuries.

Other potential causes of back injuries at work include:

• Pushing, pulling, or dragging heavy loads
• Repetitive bending
• Carrying objects with an awkward grip
• Stretching, reaching, or twisting beyond the range of comfort
• Prolonged sitting in an uncomfortable position
• Prolonged sitting in a chair that is not ergonomically designed
• Operating heavy equipment without sufficient rest breaks
• Collisions with other workers or equipment that impact the back
• Vehicle collisions while traveling for an employer

Previous back injuries, whether or not they are work-related, increase the risk of a back injury at work. If a previous injury is exacerbated or aggravated at work, the injured employee may be eligible for workers’ compensation benefits regardless of the cause of the earlier injury.

Insurance companies often look for an excuse to reject claims for workers’ compensation. Lying about a previous injury may be a legitimate reason to deny a claim. Employees should always be honest about their medical history. If a workers’ compensation insurer denies a claim because of a preexisting injury, the injured employee should seek immediate legal advice. A delay may jeopardize the opportunity to receive benefits that the employee is entitled to receive.

Workers’ Compensation Medical Benefits for Back Injuries

Applicable federal and Florida workers’ compensation laws require an employer to provide medical treatment for a work-related back injury. Employers generally meet that obligation through insurance plans.

In cases covered by Florida’s state workers’ compensation law, employees are usually required to obtain medical treatment from a designated provider. The employer or its insurance representative will provide the employee with information about where to report for treatment of a back injury. Prior advance approval is generally required for any specialized treatment, including physical therapy. Chiropractic care is covered if it is approved by the treating physician, but the maximum number of treatment sessions or weeks of treatment for which workers’ compensation will pay is limited by Florida law.

In cases covered by federal workers’ compensation laws, injured workers are generally entitled to choose their own physician. A change of treating physician, however, may require the employer’s approval. Chiropractic treatment may be covered if treatment is limited to adjustments of the spine to correct misalignments that are shown on an x-ray. 

Treatment under state or federal law can include office visits, x-rays and other diagnostic tests, hospitalization, surgery, physical therapy, and medications. Referrals to specialists, including physical therapists, must generally be made by the treating physician. 

Absence from Work Due to Back Pain

When work absences are caused by a work-related back injury, employees may be entitled to compensation. In a case that is covered by Florida law, an employee who cannot work at all, or who cannot earn the same wage after the injury, is entitled to a temporary disability benefit if the inability to work lasts more than seven days.

If the disabling back injury lasts more than 21 days, the insurer must pay the benefit for all missed days of work, including the first 7 days. If the employee returns to work within the first 21 days, the employee is not paid for the first 7 days of work absences.

Under Florida law, an employee who is unable to work at all will receive two-thirds of their average weekly wages until they return to work, subject to a minimum and maximum benefit. Employees with the ability to work at a reduced wage will receive a benefit that is calculated according to a formula. Severely disabled workers may be entitled to a higher benefit. If the employee does not return to work, the benefit ends after 104 weeks or when the injury has reached its maximum extent of healing, whichever occurs first.

Federal law also requires employers to pay two-thirds of average wages when a back injury prevents an employee from working. However, there is usually no limit to the number of weeks that compensation must be paid. When an employee is capable of working at a reduced wage, however, compensation is limited to a five-year period and is based on two-thirds of the difference between the former wage and the reduced wage.

Permanent Disabilities Caused by Back Injuries

If an employee cannot make a complete recovery from a back injury, the employee may be entitled to permanent partial disability benefits under Florida law. Disability benefits based on muscle and other soft tissue injuries can be difficult to calculate. The calculation depends on an impairment rating assigned by a physician.

Insurance companies try to minimize the payment of permanent disability benefits. Arguments about impairment ratings often result in settlements. A lawyer who is armed with an understanding of back injuries and how impairment ratings should be determined is in the best position to advocate in favor of a fair disability benefit.