Someone’s negligence may cause your rotator cuff tear in a Florida car accident. If so, you may have a case.
What is the Rotator Cuff?
The rotator cuff is a group of muscles and tendons that keep the shoulder steady. The four muscles of the rotator cuff are the Supraspinatus, Infraspinatus, Teres minor, and the Subscapularis.
The supraspinatus can be seen in the above image.
What is a Rotator Cuff Tear?
A rotator cuff tear occurs when one of the tendons is torn from overuse or injury.
A rotator cuff tear weakens the shoulder, which makes it harder or more painful to engage in your activities of daily living, such as putting on your clothes, brushing your hair and more.
How is a Rotator Cuff Tear Diagnosed?
A rotator cuff tear will not show up on an x-ray. In addition to a physical exam, a magnetic resonance imaging (MRI) or ultrasound may help to determine if there is a rotator cuff tear.
These studies can better show soft tissues like the rotator cuff tendons.
These studies can show the rotator cuff tear, as well as where the tear is located inside the tendon and the size of the tear. Larger tears may have a higher full value of the pain and suffering component.
With a larger tear, there is an increased chance that the defense doctor will admit that there is a tear.
If the tear is very small, there is a chance that the defense doctor will deny that a tear exists. This may decrease the value of the case.
An MRI can also give your doctor a better idea of whether the tear is old or new because it may show the quality of the rotator cuff muscles.
Cause of Rotator Cuff Tear and How it Affects Your Injury Case
The two causes that make up the majority of rotator cuff tears: injury and degeneration.
If you fall down on your outstretched arm or lift something that weighs too much and make a jerking movement, you can tear your rotator cuff.
Assuming that someone’s carelessness caused your fall, the strongest case is when an orthopedic doctor states that the person’s fall or other type of accident caused him or her to tear their rotator cuff.
If someone’s carelessness caused your to fall down and suffer a rotator cuff tear in Florida, you may have a case to get your damages (e.g. medical bills, lost wages, pain, suffering, mental anguish, inconvenience, etc.).
Most rotator cuff tears happen due to the tendon being worn out, which happens slowly over time. The injured person’s doctor is therefore a key witness in a rotator cuff case.
If the doctor says that the rotator cuff tear was acute, this would tend to increase the full value of the case because the doctor is saying that the accident caused the tear.
If the treating orthopedic doctor says that it is a degenerative tear, this would decrease the full value of the case. However you may still be entitled to receive compensation for an aggravation of a pre-existing rotator cuff tear.
If the injured person files a lawsuit against the negligent party, the latter will have a chance to have a doctor of their choosing examine the claimant. This doctor will often say that the tear was degenerative.
What Factors Contribute to Degenerative or Chronic Rotator Cuff Tears?
Repetitive Stress. If someone does the same shoulder motions over and over, it can stress the rotator tendons and muscles.
Some sports activities can increase the likelihood that you have an overuse tear, which decreases the value of a case.
Some examples of sports such as rowing, weightlifting, tennis and baseball can make you at risk for a tear. There are also other jobs and routine activities that can cause overuse tears.
This article focuses on car and truck accident claims where someone’s negligence caused your shoulder injury. I wrote a separate article on shoulder injuries caused by slip and falls in Florida or on cruises.
Passenger Gets $138,433 for Rotator Cuff Tear from Car Crash
She had shoulder surgery following a car accident in Bonifay, North Florida. My client lived outside of Florida.
The shoulder surgery was unsuccessful so she later underwent a manipulation under anesthesia (MUA).
She was a nurse practitioner. The adjuster argued that my client’s tear was degenerative and caused by her job.
Her job involved lifting patients to and from a bed or chair. I argued that the crash’s heavy impact caused the acute tear.
Nationwide Insurance Company was the uninsured motorist (UM) liability insurer for the host vehicle.
My client also had an auto insurance policy with Nationwide. She had $300,000 in UM liability coverage on that policy.
Nationwide paid $138,433 to settle the case. $8,433 of the settlement was from Medpay Coverage.
The claims adjuster for the trucking company sent my client’s medical records to an orthopedic surgeon, who stated that this injury was caused from overuse prior to since my client would often have to lift heavy objects as part of his job.
Tip: Always check and see if the defense doctor talks about shoulder injuries on his or her website. There may be statements that can help your case.
The injured person should immediately present these statements to the liability claims adjuster.
I argued that the heavy impact caused the acute tear.
Other factors that contribute to chronic, or degenerative rotator, cuff tears are lack of blood of supply or bone spurs. Both of these factors may decrease the full value of the case.
Review Your Medical Records Prior to Accident
You should review all of your prior medical records and look for the lack of treatment, lack of complaints, and lack of symptoms that usually accompany a rotator cuff tear. Point these out to the claims adjuster.
Doctor May Say That Accident Caused Rotator Cuff Tear But it is Healed
Sometimes a defense doctor, or even a treating doctor, will say that the rotator cuff tear was caused by the car crash or other accident but it has completely healed.
I settled a tear surgery case for $210,000, where the treating workers compensation surgeon said that the shoulder pain should have resolved within four to six weeks after the truck crash.
The doctor therefore claimed that my client’s shoulder was healed and the pain was not related to the accident.
Check Post-Incident Records for Continued Problems
The injured person should check all of the medical records including, but not limited to, physical therapy records which state that there is a limited range of motion, lack of strength or pain. Point these out to the claims adjuster immediately.
Physical therapists often will spend much more time than the doctor with the injured person. Physical therapist’s notes are often much more detailed, particularly as to limitation of motion, lack of strength and complaints of pain.
Even if your shoulder tear existed before an incident or accident, in Florida you are still entitled to get damages for an aggravation of a shoulder tear or other pre-existing injury.
Younger Injured Victims May Have an Easier Time Proving Acute Tear
If you are young and you are diagnosed with a rotator cuff tear after an accident, you have a strong argument that an incident or accident caused the tear.
For example, if you are 15 years old and you have rotator cuff surgery following an accident then it generally will be tough for a claims adjuster to make the argument that you had this tear before the incident or accident.
If you are older, your case may be tougher because a shoulder tear may come with age and repetitive use. This is especially true if you worked in the construction or a similar field which required hard use of your shoulder.
Sometimes the radiologist will say in his report that the tear “may” have been related to a motor vehicle accident or other incident.
A doctor who looks the MRI may say that you have a pre-existing rotator cuff tear based on calcification, which may lower the value of your case.
Advantage of Getting Workers Compensation Benefits for your Shoulder Surgery Personal Injury Case
If you were injured while working, one of the advantages is that you may get benefits from your employer or their insurer.
Disadvantage of Using Workers Compensation Insurance for a Shoulder Surgery Case.
The biggest disadvantage to using workers compensation insurance is that a doctor who is paid by a workers compensation insurer may say that shoulder tear was old and unrelated to the accident than a doctor who is a patient advocate.
An orthopedic doctor who treats shoulders and is more “patient friendly” is more likely to relate your surgery to the accident.
This is because the doctor being paid by the workers compensation insurer:
a. Knows that if he doesn’t relate the injury to the accident or minimizes your injury then the workers compensation insurer will send him more patients.
b. May be believed by the jury if he or she says that he did not see a tear when he operated on you.
Example of Settlement for a Shoulder Surgery Case if you were working but someone Other than your Employer caused your Accident
Let’s assume that you are working for a company in Florida. Perhaps you are a truck driver. While you are driving your company’s truck you were rear ended by another 18 wheeler.
The other truck driver receives a ticket. You report the accident to your employer but you don’t go to the hospital because the pain is not bad enough.
A few days later you decide to go to your primary doctor because your shoulder pain has not gone away. You give that doctor your health insurance information.
You then receive a call from the workers compensation insurer for your employer. They refer you to a medical facility where you receive treatment.
A month later you receive an MRI and the report says that you have a tear, but the radiologist is unable to tell whether the tear if from the accident.
Your doctor – who you were referred to by your employer – continues to treat you. He then says that he will perform shoulder surgery on you if you would like.
You choose to have shoulder surgery. You then receive a little more treatment and the doctor tells you that you are as good as you are going to get.
The doctor then says that you have a permanent impairment of 2%.
Let’s assume that workers’ compensation gives you benefits. How much your case is worth against the driver that hit you?
The formula to figure this out is:
Injury Settlement = (Medical bills and lost wage paid by workers’ comp.) + Pain and Suffering + (Lost wages not paid by Workers Comp)
Sometimes Need Threshold Injury to Recover Pain and Suffering Damages
In certain Florida auto accident cases, the injured person must have a threshold injury to recover pain and suffering damages.
Then we would assign money for pain and suffering assuming that we could prove he has a threshold injury if he was in a Florida motor vehicle accident that required a finding of permanency.
On the other hand, there is Joe Blow who makes $500 a week and misses four (4) weeks because of the Florida car accident. He heals pretty well and he is back to work.
His lost earnings may be $2,000 or so if he misses four (4) weeks of work. Assume Joe treated for years for shoulder pain before the crash but never had an MRI. Now, an MRI shows that he has rotator cuff tear.
The bodily injury liability adjuster will argue that Joe’s rotator cuff tear is:
- a pre-existing injury or
- an aggravation of the prior rotator cuff tear.
Let’s also say that Joe was 50% or more at fault in the accident. The settlement value would then be sliced down more.
Let’s say Joe’s car and the careless driver’s vehicle show no damage. The settlement value may further be reduced.
Assume that Joe owned a car in Florida that was required to have PIP but he was driving without insurance. The value goes down even more.
You can see why it is impossible to say what the average rotator cuff tear is worth in a Florida injury case. Florida does not use a table that states that a rotator cuff tear is worth a certain amount.
I have settled torn rotator cuff cases from $10,000 (where there was limited insurance) all the way up to $210,000. It just depends on the facts of the particular case.
Now, the good news is that based on past Florida jury verdicts we can gather all possible data to see what past juries have awarded for rotator cuff tears in Florida accidents.
b. Pain and Suffering Value of Rotator Cuff Tear Without Surgery
The full value of the pain and suffering component for settlement purposes in Florida of a rotator cuff tear is between $40,000 and $70,000, and possibly higher depending on resultant disability.
The lower end of the range is for minimal treatment and little limitation. The higher end of the settlement range is for a longer period of treatment – such as one year or more – and a greater disability.
c. Where Surgery is performed
For a starting point, the settlement range for pain and suffering on a torn rotator cuff where surgery is performed is between $100,000 and $175,000. The low-end of the range is if you had little treatment, are left with limitations and disability after the surgery.
The higher end of the range is for longer treatment (over a year or more), when you left with a larger resultant disability, and your life has significantly been affected.
Above is a diagram of a full thickness rotator cuff tear with subsequent surgery.
Without surgery, the full value for pain and suffering is generally less for purposes of settlement. A lot of this article also does not apply to workers’ compensation cases in Florida, as you can generally not get pain and suffering in those cases unless you also have a claim against someone other than your employer.
But I do discuss settlements where you were injured while working and someone other than your employer was at fault.
4. How medical documentation and/or testimony affects your case.
You should provide your medical bills, records & diagnostic studies (e.g. MRI cd, CT scan, etc.) to an insurer as soon as possible. Often times the liability insurer will hire a radiologist to review all of your medical records that are in any way related to your claimed rotator cuff tear.
The defense radiologist may say that your injury existed before the incident. You want to make sure that you carefully select your orthopedic doctor.
Otherwise you may wind up with a doctor who does not want to help your case and may not be a patient advocate.
Even if the radiologist and treating orthopedic doctor say that they cannot determine the age of your shoulder tear, you still have the right to get a second opinion with a doctor of your choice.
This doctor may feel that the shoulder tear is related to the incident or accident. He will probably want to see the actual MRI films.
So how do you know how much your shoulder surgery case is worth if the doctors who treated you and reviewed the MRI have different opinions? Often times you have to cut the full value of your case by a certain percentage.
Rotator cuff tears are usually diagnosed by an MRI. An orthopedic doctor may also state that a shoulder tear cannot be caused by certain types of accidents.
Other factors affecting shoulder injury cases
How soon you complained of shoulder pain after the crash.
Some doctors may state that if an accident causes a rotator cuff tear, you would feel pain immediately following the incident.
$65,000 Settlement for Rotator Cuff Surgery from a Car Crash in Orlando
$57,000 Shoulder Surgery Settlement
I settled another shoulder surgery case for $57,000. It had liability issues. Progressive insured one car.
GEICO insured the other car.
Progressive paid its $10,000 BI liability policy limits. GEICO paid $47,000 from its BI liability coverage.
In some of those cases, the liability claims adjuster argued that my client’s rotator cuff tear was not caused by the car or truck accident due to minimal property damage.
The orthopedic doctor diagnosed my client with:
- shoulder impingement with rotator cuff tear
- shoulder posterior labral tear
- shoulder mid anterior labral fraying
GEICO’s claims adjuster argued that the rotator cuff tear was degenerative (old) and was due to age and overuse.
My case: $35,000 Settlement for a motorcyclist who had surgery to repair his rotator cuff (shoulder injury) after he was hit by another driver in Jacksonville, Duval County, Florida.
The negligent driver had a $10,000 liability insurance policy with Progressive.
The owner of the at fault car had a $25,000 bodily injury liability auto policy with State Farm.
An actual picture taken during my client’s rotator cuff surgery is below.
Man Gets $183,697 for Pain and Suffering from SLAP Tear in Car Crash
This is not my case. The claimant’s injuries were:
- a shoulder sprain
- multiple bruises to the left shoulder
- type 1 AC joint sprain
- a partial thickness articular sided tear
- a partial thickness tear of the subscapularis tendon
- shoulder impingement and fraying of the superior labrum and bicep with a type 1 SLAP lesion
- subsequent left shoulder arthroscopy with subacromial decompression, distal clavicle and SLAP repair, including insertion of 2 metallic screws and anchors.
The claimant settled at mediation with the other 3 defendants, one of which was an uninsured motorist (UM) insurance company.
The claimant, a 48 year-old employee of UPS, was driving home on a highway. He claimed that the another driver, Rodriguez, made a U-turn (where it was not allowed) and was driving 25 miles per hour below the speed limit.
He said that he attempted to avoid the other vehicle and tried to avoid the crash by driving into the grass median.
His truck flew in the air and landed on its side and ended up in the opposite lane of travel. The jury determined that the truck driver was driving a company car.
The verdict was in September 2011. The case is Kata vs. K.K. Car Co., Inc. and Ambassador Rent-A-Car.
My thoughts: I don’t know the amounts of the other settlements that the injured man made with the other defendants. Since there were additional settlements, the award for pain and suffering is larger than the $183,697 verdict for pain and suffering mentioned above.
The amount awarded for pain and suffering is above the average settlement range that I may use as a starting point for the pain and suffering component of a SLAP tear surgery case.
7. Calculating Projected Total Settlement
Let’s see how the value of pain and suffering affects the possible total settlement of your accident case where you have rotator cuff surgery. You can calculate your damages in any personal injury case by using the following formula:
Settlement = Out of pocket Medical Bills + Lost Wages + Pain and Suffering
You are passenger in a car in Bonifay (North Florida) or any city in Florida. The car that you are riding in is struck by another car. The other car receives a ticket for causing the accident.
The other car does not have bodily injury liability insurance, but you have $300,000 of uninsured motorist insurance (UM) available and the owner of the car that you are in has $100,000 UM/UIM with State Farm insurance.
You treat with doctors for 1 year or so and the doctor who sends you to get an MRI that shows that you have a rotator cuff tear. Physical therapy does not relieve you of your pain so you have surgery to repair your rotator cuff.
The orthopedic doctor says that you have a permanent injury. This allows you to make a claim for pain and suffering in a car accident case in Florida.
You are still able to work at the job that you had before the accident. Your out-of-pocket medical bills are $5,000.
Your health insurance company has paid $15,000 in medical bills and they may be entitled to be reimbursed. You have $2,000 in lost wages, mainly for the time that you could not work after the surgery.
Possible Settlement = Out of pocket Medical Bills + Lost Wages + Pain and Suffering
Because your life has been minimally affected after the surgery, taking the pain and suffering value from the lower end of the range, let’s plug in the numbers:
Possible Settlement = $20,000 + $2,000 + $100,000
Possible Settlement = $122,000
This example took some facts from my $147,000 settlement.
Let’s take the same facts as Example #1 except that you were driving the car and you were 50% at fault.
You and the other driver both say that each of you had a steady green light at the time of the accident. There are no witnesses.
In this case you would use the formula below:
Possible Settlement = (Out of pocket Medical Bills + Lost Wages + Pain and Suffering) x (% Other car’s fault)
Possible settlement = ($122,000) x (50%)
Possible settlement = $61,000
As you can see, if you change one fact to the case the value is cut in half. This is one of the reasons why you should be very careful when comparing your case to your friend’s case or other cases that you read or hear about.
Example #3 – Rotator Cuff tear – No Surgery
You are 18 years old and you are riding a motorcycle in Miami-Dade County – or any county in Florida – and you are stopped at a red light. A car hits you from behind. The impact of the crash causes you to fly of the motorcycle and land on your shoulder.
An MRI reveals that you have a torn rotator cuff. The orthopedic doctor that you are treating with states that your rotator cuff tear is related to the accident.
Your out-of-pocket medical bills are $6,000 and you have $500 in lost wages. Your total treatment with the orthopedic doctor is for 3 months.
To get an idea of the settlement range for your case, the formula to use is:
Possible settlement = Out of pocket medical bills + lost wages + pain and suffering
Because your treatment was rather short, and you are left with little if any disability, I will assign $40,000 (taken from the range mentioned above) for pain and suffering for settlement purposes.
Because you were on a motorcycle and you were hit by a truck (a motor vehicle), you do not need prove that you have a permanent injury in order to be entitled to money for pain and suffering. Now I will plug-in the medical bill and lost wage figures that I gave in the example into my settlement evaluation for this case:
Possible settlement = $6,000 + $500 + $40,000
Settlement = $46,500
Now let’s take the same facts from Example #3 except that you were speeding and the other car violated your right of way. To keep it simple, let’s assume that you are 50% at fault for the accident. The formula is:
Possible settlement is= (Out of pocket medical bills + lost wages + pain and suffering) x (% fault of other driver)
Possible settlement = ($6,000 + $500 + $40,000) X (50%)
Possible settlement = ($46,500) X (50%)
Possible settlement = 23,250
As you can see from this example, changing one fact to the case cuts the value of your case in half.
Did a driver’s carelessness cause your rotator cuff tear in an accident in Florida? Did you suffer another injury or another type of accident?
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