Quick answer: There is no standard settlement amount for an L4-L5 or L5-S1 disc injury. In California, the value depends on your permanent disability rating under the AMA Guides, adjusted for your age and occupation, plus whether you had surgery or nerve involvement, how much disability is apportioned to non-work causes, and the cost of future medical care. Fusion surgery and documented radiculopathy generally produce higher ratings than a strain that resolves.
The L4-L5 and L5-S1 levels are the two lowest motion segments of the lumbar spine. They carry the most load during lifting and bending, and they are where most work-related disc herniations occur. Searching for an average settlement is understandable, but California calculates permanent disability through a formula, and the inputs to that formula vary widely from one worker to the next.
How a Lumbar Disc Injury Is Rated
Whole person impairment
The evaluating physician rates the spine under the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, which California uses by statute. For most lumbar injuries, the doctor assigns a Diagnosis-Related Estimate (DRE) category. The lumbar DRE categories run from 0% whole person impairment (WPI) for a condition with no significant findings, through roughly 5% to 8% for non-verifiable radicular complaints, 10% to 13% for documented radiculopathy, 20% to 23% for loss of motion segment integrity or surgically treated conditions with residual findings, and 25% to 28% for the most severe cases. Fusion surgery commonly places a worker in the higher categories.
Adjustments under the rating schedule
The WPI is then adjusted for diminished future earning capacity, your occupation and your age to produce a permanent disability percentage. A heavy-labor occupation and an older age both increase the final rating. The percentage converts to a set number of weeks of permanent disability payments.
Rebutting the standard rating
Under the Almaraz-Guzman line of decisions, a physician may use another chapter or method within the AMA Guides when the standard rating does not accurately reflect the impairment. This can matter for failed back surgery, chronic pain and complex nerve injuries.
Factors That Change the Value
- Surgery: discectomy, laminectomy and especially fusion.
- Radiculopathy: nerve compression confirmed by imaging and EMG or nerve conduction studies.
- Apportionment: how much of the disability the doctor attributes to pre-existing degeneration or other causes.
- Future medical care: injections, medication, pain management and possible future surgery.
- Average weekly wage: which sets the weekly rate for permanent disability.
- Return to work: whether your employer can accommodate permanent restrictions, which affects the $6,000 Supplemental Job Displacement voucher.
Settlement Options
A Stipulations with Request for Award pays permanent disability over time and keeps future medical treatment open for the back injury. A Compromise and Release pays a lump sum and usually closes future medical care, so the amount must account for that care. For workers on or near Medicare, a Medicare Set-Aside may be required. Compare these options before signing anything. See workers’ comp settlements for back injuries.
Protecting the Value of a Disc Injury Claim
- Report the injury promptly and describe the lifting or event that caused it.
- Make sure your MRI findings and nerve symptoms are documented.
- Do not settle before you reach permanent and stationary status.
- Prepare for the QME evaluation, where apportionment is often decided.
See also overexertion injuries and back and neck injury representation.
Talk to a Certified Specialist at No Cost
Dennis A. Dascanio is certified by the State Bar of California Board of Legal Specialization as a specialist in workers’ compensation law and has represented injured workers since 1987. Consultations are free, and attorney fees are approved by the judge and paid only from benefits recovered. Call the office nearest you: Santa Ana 714-550-7002, Ontario 909-460-6900, or San Diego 619-338-8399. Se habla español.
This page provides general information, not legal advice for your situation. Every claim depends on its own facts.