A healthy shoulder joint is essential to many of the activities we do every day. Because shoulder injuries often are painful, require significant medical care, and might be at least partially disabling, they can have substantial settlement value as part of a personal injury insurance claim or lawsuit.
If you've suffered a shoulder injury after an accident that was someone else's fault, you're probably wondering how your claim is valued by insurance adjusters, attorneys, and others.
A shoulder injury involves damage to the structures—usually the bones, tendons, or ligaments—in and around the shoulder joint. The shoulder joint consists of three bones: The shoulder blade ("scapula"), collarbone ("clavicle"), and upper arm bone ("humerus"). Let's look at some common shoulder injuries and how they often happen.
In any personal injury claim, injuries drive case value. Shoulder injuries that cause long-term or permanent disabilities will, not surprisingly, be valued higher than those that heal quickly and leave no residual impairment.
Here are some of the most important factors that influence settlement value.
As a rule, what are sometimes called "hard injuries"—broken shoulder bones, a dislocated shoulder, or torn tendons or ligaments—are worth more than soft tissue injuries like ligament sprains or muscle or tendon strains. Fractures, dislocations, and tears show up on an X-ray or a CAT scan. Injuries that are easy to see are easy to relate to: Everyone knows that a broken bone is painful, requires medical care, and takes time to heal.
Soft tissue injuries, by contrast, tend to be easier to dismiss as minor, or something that will get better quickly. To convince an insurance adjuster that your sprain or strain has real value, you'll need to work harder to describe the mechanism and severity of your injury.
Severe shoulder injuries can lead to long-term or permanent disability. Quite often, for instance, shoulder separations or dislocations, or tears to the rotator cuff lead to decreased or painful range of motion. Age also takes a toll on the shoulder, so any injury-related disability sets the stage for more physical limits as time goes by. If your doctor has told you to expect permanent impairment from your injury, you'll want to be sure and highlight that in your communications with the insurance adjuster.
A shoulder injury case can also include compensation for pain and suffering, emotional distress, disability and disfigurement, and loss of enjoyment of life. Because these are "intangible" losses, they can be difficult to value. We'll talk more about valuing them in "Your Medical Expenses and Damages," below.
The injuries you've suffered will dictate the medical treatment you receive. Minor shoulder sprains or strains typically heal with little or no medical intervention. Moderate or severe injuries, by contrast, are likely to require specialized care. You may need surgery to repair broken bones or torn tendons or ligaments.
With many types of shoulder injuries, your doctor will order physical or occupational therapy, along with home exercises that will help you to regain shoulder strength and range of motion. Be sure to complete all treatments ordered by your doctor. If you don't, the insurance adjuster will argue that you weren't really hurt, or weren't hurt as badly as you claim.
If your doctor has told you to expect future problems, that increases the odds you'll also need future medical care. Be sure to talk with your doctor about future care needs, and ask that those needs be documented in your medical records. The settlement value of your shoulder injury claim should include payment for necessary future medical treatment.
Valuing future medical care in a personal injury case can be complicated. If your shoulder requires significant future care—like a shoulder replacement—you'll want an experienced attorney to guide you through the process.
Medical expenses play an important role in calculating the damages you can recover, so they are a critical factor in valuing your shoulder injury claim. Here's why.
In a typical shoulder injury case, you can recover two kinds of damages. The first is called "economic" (also called "special") damages. Your medical expenses, along with other easily quantifiable losses such as lost income and pharmacy charges, are examples of economic damages. Especially in serious shoulder injury cases, your medical expenses will be the single largest item of economic damage.
In addition, you can recover "noneconomic" (also called "general") damages. Noneconomic damages compensate you for "intangible" injuries like pain and suffering, emotional distress, and disability and disfigurement. In some cases, insurance adjusters and attorneys will use a multiplier to arrive at an estimate of these losses. Your medical expenses play an important role here, too.
Here's how it works. Your total medical expenses (past and future) are multiplied by the multiplier to arrive at a value for your noneconomic damages. In a typical shoulder injury case, the multiplier might be three times medical expenses. If your medical expenses are $25,000 and the multiplier is 3, then your noneconomic damages are $75,000. Note that medical expenses covered by health insurance or another insurance policy still get included in the calculation of your noneconomic damages.
A few states have laws that put a limit, or "cap," on noneconomic damages. Because noneconomic damages often are the largest part of a shoulder injury settlement or jury verdict, damage caps can significantly reduce the value of your case. Check your state law for specifics.
Lost income is part of your economic damages. In many shoulder injury cases, you'll need to calculate both past and future lost income. Figuring past lost income usually is easy. But calculating future lost income—sometimes called "loss of earning capacity"—is more difficult.
You're entitled to compensation for your past lost income, as well as any vacation, sick days, or paid time off you used to cover your time away from work. Get a letter from your employer's payroll office to prove the value of your past lost earnings and benefits.
Depending on the kind of work you do, a shoulder injury can limit your ability to work in the future. For example, if you work in construction or your job requires frequent, repetitive shoulder movement, a serious rotator cuff injury or shoulder dislocation might make it much harder for you to work in the future.
If you need training that will qualify you for a new line of work, or if your work life expectancy is decreased because of your injury, you should be fairly compensated for those injuries. In that case, you'll need witnesses—both medical and vocational rehabilitation experts—to prove your inability to work and calculate your future lost earnings or loss of earning capacity, including any vocational training costs. An experienced attorney can help with these witnesses.
The value of your shoulder injury settlement or verdict is likely to be influenced by several of your personal characteristics.
Your age and your life expectancy will be important in determining future damages, including medical care, loss of earning capacity, and noneconomic damages for things like pain, suffering, and emotional distress. The longer you're expected to live, the greater these damages likely will be.
Your occupation drives your future earning potential. The more money you earn, the higher that potential will be.
These factors will be considered in determining your life expectancy. But if your overall health prior to the accident was poor or you have a long and problematic medical history, an insurance company or jury often will give these things additional weight or consideration.
This shouldn't be a factor but often is. A likable person will generate more sympathy from a jury (if the case goes to trial).
In order to hold someone responsible for your injuries and damages, you must prove that person was legally at fault for what happened. In most cases, this will mean showing that the other party was negligent. If you, too, are partly to blame for the accident, in most states your share of the fault will reduce the value of your claim.
For instance, suppose that all of your damages, both economic and noneconomic, total $100,000. If the other party was 100% to blame for what happened, then the value of your case is $100,000. But if you're 20% at fault, that will likely reduce the value of your case by $20,000, for an adjusted value of $80,000.
Note that in a few states, if you share any fault for the accident, that will destroy your claim entirely. If you're concerned that your own fault might reduce the value of your case, consult with an experienced personal injury attorney.
These examples are provided only for illustrative purposes. You should not view these settlements or verdicts as indicative of the value of shoulder injury cases in general, or of your case in particular. Keep in mind, too, that big settlements and verdicts get publicized while the smaller ones often go unmentioned.
Thinking about filing an insurance claim or lawsuit after a shoulder injury? Your best first step might be to hire an experienced personal injury lawyer. You can also use the features on this page to connect with an injury lawyer in your area.