Back and Neck Injuries

This section explains out how back and neck injuries that are caused or aggravated by a person’s job are handled in the Iowa Workers’ Compensation system.

The human back is divided into three sections. The neck section is referred to as the cervical region. The middle section of the back is referred to as the thoracic region. The lower section of the back is referred to as the lumbar region.

Most people have 7 discs in the neck region, 12 in the middle back, and 5 in the lower back. We have had clients with different numbers of discs and that can make things confusing. The discs serve several functions. They act as shock absorbers between vertebrae and help hold the vertebrae together. The discs also assist with the flexibility of the spine.

Discs can be damaged and the core can begin to leak out. This decreases the disc’s ability to work as a shock absorber and can also hinder flexibility. The leakage of the disc can also press on the nerves that run through the spine and cause pain. The back and neck also have an intricate system of tendons, ligaments and muscles which support the back and allow us to bend and twist. These muscles, tendons and ligaments can also be injured.

In the most severe injuries the nerves running through the spine can also be damaged. This can lead to seriously impaired body function, and even paralysis.

Frequently, back and neck injuries can be successfully treated with a combination of physical therapy and medication. Epidural injections can help many people. In other situations back or neck surgery may be necessary. In some cases injured workers may need a spinal stimulator and/or long-term medication. Unfortunately, after a back injury many people will end up with some amount of decreased physical function and permanent work restrictions.

Back and neck injuries can be caused by a single traumatic event or cumulative trauma from work over an extended period of time.

Back and neck injuries frequently develop from a combination of pre-existing problems that are aggravated by work activities. Jobs that require a lot of bending, twisting, and lifting tend to be the most frequent cause of an on-the-job back or neck injury.

However, some back and neck injuries are caused by relatively simple work activities such as an isolated incident of bending over to pick up a light object.

A fair amount of Iowa Work Comp back or neck injuries also arise out of motor vehicle accidents while a person is driving as part of their job.

Under Iowa workers’ compensation law an employee is entitled to be paid for a back or neck injury if work activities were a substantial cause of the injury. In many back and neck cases there is a controversy over whether work was really a substantial cause of the injury; or whether the injury was actually caused by pre-existing problems. In Iowa, workers are entitled to work comp benefits for aggravations of pre-existing problems as long as work was a substantial aggravating factor, and the work aggravation resulted in a permanent and substantial increase of the pre-existing condition.

Employers and insurance carriers will sometimes dispute whether an injury was caused by work. If the employer or insurance carrier rejects a claim, then the worker does not receive medical benefits or weekly workers’ comp payments. However, an injured worker is entitled to contest a denial of his claim by filing a lawsuit with the Iowa Workers’ Compensation Commissioner. Every liability dispute is different and our strategy in each case is tailored to the specifics of the case. However, the section of our website on “Benefits of Hiring our Lawyers” gives a general overview of how we litigate causation disputes on behalf of our clients.

Back and neck injuries fall under the category of unscheduled injuries. This means that the amount of compensation a worker should be paid for a back or neck injury is based on how much the injury impairs the worker’s potential future earning capacity. The main factors that need to be analyzed in determining the loss of potential earning capacity from a back or neck injury are:

1. Age of the Worker. Older workers generally receive higher awards for the same injury than a younger worker. The reasoning is that many employers would prefer to hire younger employees. Therefore, an older worker with restrictions and limitations from an injury is going to have a harder time getting hired.
2. Extent of Education. An injured worker with less education will generally receive more work comp money than a worker with a higher level of education. This rule is based on the idea that workers with less education generally have to rely on their physical abilities more. Therefore, a back or neck injury that impairs a worker’s ability to do physical labor is going to be a bigger problem for a less educated worker. A worker with higher education has a better chance of being able to get a job that does not require putting stress on their back or neck.
3. Skills. As a general matter a worker with lower skills is going to receive a higher workers’ compensation award than a worker with more skills. The basis for this difference is that employers are always more interested in hiring highly skilled workers than lesser skilled workers.
4. Work History. A worker who has only performed one job in his life is going to generally receive a higher award than a worker who has been successful in a broad variety of jobs. The reasoning is that a worker who has shown an ability to be successful in a wide variety of jobs has a better chance of being able to succeed despite a physical disability from a back or neck injury.
5. Motivation. A worker who does not work hard at their rehabilitation after an injury is generally going to receive less money in an Iowa work comp case. Similarly, a worker who does not try to return to their old job or seek out new employment is also going to be penalized. By contrast, injured workers who make their best efforts to heal as well as possible and get back to work are generally treated more generously by the Iowa Workers’ Compensation Commissioner.
6. Loss of Actual Earnings. Under Iowa law a worker whose earnings stay the same or even go up after an injury can still be entitled to receive workers’ compensation benefits. However, if a back or neck injury results in lower earnings for a worker, this decrease in earnings will help lead to a higher workers’ compensation award.
7. Impairment Ratings. After an injured worker heals as well as they are able to, the treating doctor and later an independent medical exam doctor can issue an impairment rating to help describe the extent of the injury. The Iowa Workers’ Compensation Commissioner prefers that doctors use the AMA Guides to the Evaluation of Permanent Impairment (5th Edition). The AMA Guides set out very detailed standards for how different types of injuries, including back and neck injuries, should be evaluated, and what percentage of impairment should be assigned. Back and neck injuries are rated as an impairment of the body as a whole. Generally, a higher impairment rating will lead to larger workers’ compensation payments in the Iowa system.
8. Functional Capacity. After an injured worker completes his treatment for a back or neck injury he may go through a functional capacity evaluation. The specifics of a functional capacity evaluation (FCE) can vary greatly. However, the goal of all functional capacity evaluations is to test the physical abilities of the injured worker through a series of carefully designed and monitored tests. After a functional capacity evaluation is completed the tester will generally issue a report setting out detailed findings on the amount and types of work the injured employee can perform. A worker with a lower level of functional capacity will generally receive a larger work comp award than a worker with a higher level of functional capacity.
9. Work Restrictions. After a worker has gone through all of their treatment the doctors may issue permanent work restrictions. A worker might also be given permanent work restrictions from a doctor who conducts an independent medical exam. The more that the work restrictions limit the ability of a worker to do their regular job, the more money the worker will generally end up being awarded for their injuries.
10. Ability to Engage in Employment for Which the Worker is Suited. If a worker can return to their prior job they can still receive workers’ compensation benefits, but it will generally be on the lower side of the possible range. By contrast, an employee who can’t return to their old job because of their injuries is generally going to receive a higher workers’ compensation award as a result of their back and neck injuries.
11. Continued Employment versus Termination. If the employer fires or terminates the worker after the back or neck injury that will generally lead to more workers’ compensation money for the worker. By contrast, if the employer is willing to accommodate the worker’s limitations from the injury, then the worker will generally receive a lower work comp award.

No one factor controls how a worker’s back or neck injury will be compensated. Determining how much a back or neck injury is worth is much more complex than entering numbers into a formula. All of the relevant factors have to be considered and analyzed to determine how much the back or neck injury has reduced the injured worker’s potential future earning capacity.

In some work comp cases the major dispute is how much money the injured worker is entitled to receive. Sometimes when clients come to see us they have already been told by the insurance carrier or adjuster that they will be paid a certain amount of money for their injury. Our law firm does not take an attorney fee out of the weeks of benefits that the defendants have promised to pay. We only receive a fee out of additional money we are able to recover for our clients above and beyond what they have already been promised.

The starting point for determining the dollar amount of compensation an injured worker is entitled to receive is always to figure out their weekly rate. As an example, we will assume that an injured worker has a weekly workers’ compensation rate of $500.

Generally the maximum amount of permanent partial disability benefits that a worker can receive for a back or neck injury is 500 weeks.

Therefore, if a worker is awarded 10% loss of potential earning capacity he is entitled to receive 10% of 500 weeks. Therefore, the worker would be entitled to receive 50 weeks of permanent partial disability benefits, or $25,000. (50 weeks x $500 = $25,000).

If a worker receives a 20% award, that works out to be 100 weeks of permanent partial disability benefits or $50,000 (100 weeks x $500 = $50,000).

If a worker receives a 50% award, that works out to be 250 weeks of permanent partial disability benefits or $125,000 (250 weeks x $500 = $125,000).

If a worker receives 75% award, that works out to be 375 weeks of permanent partial disability benefits or $187,500 (375 weeks x $500 = $187,500).

An exception to the maximum compensation of 500 weeks of benefits for a work comp back or neck injury is if the injury results in permanent total disability. Permanent and total disability is generally expressed as follows:

1. The injury must completely disable the worker from performing the work that their experience, training, education, intelligence and physical capabilities would otherwise permit them to perform.
2. Total disability does not mean that a worker is absolutely helpless.
3. The fact that the injured worker could perform some work despite the physical and educational limitations does not rule out an award of permanent total disability.

If a worker is found to be permanently and totally disabled then they are entitled to receive their weekly disability amount for the rest of their life. The weekly payment of permanent total disability does not stop when a worker reaches age 65.

Our lawyers have 90 years of combined experience in all types of Iowa work comp cases including back and neck injuries. See the section of our website on “Benefits of Hiring our Lawyers” that explains some of the biggest ways that our lawyers help our clients.

Call or email us now, and our lawyers would be happy to talk to you about your back or neck injury case, and answer any questions you have without charge or obligation.