How Is Pain and Suffering Calculated in a Personal Injury Claim?

Thirty-seven states, along with four territories, have medical liability damage caps on at least one type of damage. According to the NCSL, most states have medical liability damage caps on at least one type of damage.

Several states that passed caps later watched their own supreme courts strike them down. That disagreement reflects the most honest answer available. Nobody agrees on what this category of loss is worth, including the legislatures writing the rules about it.

Pain and suffering doesn’t come with an invoice. The valuation of this type of claim is heavily contested and eventually determined either by settlement or by a jury. Often, there is no set value, but the claim is assessed using a commonly understood factor called a pain and suffering multiplier. Keep in mind that the result is not legally binding. 

Let’s look at how this is calculated.

The Two Methods Everyone Cites

Medical bills and lost income are just a couple of the expenses used to estimate loss under the multiplier method, which calculates the economic loss as medical expenses plus lost earnings. The sum is then multiplied by a certain multiplier meant to represent the severity of the injury. 

Most minor soft tissue injuries would result in lower multipliers. A fusion surgery with permanent restrictions draws a high one. The size of that multiplier is not a fact anyone looks up. It is the entire argument, dressed as arithmetic.

The per diem method assigns a daily dollar figure and multiplies it by the days between the injury and maximum medical improvement. Typically, the injured party’s earnings are used to determine the value of a day of work. In the same way, the value of a day of suffering is used. The defense attorney attacks the logic used to come up with the numbers and doesn’t bother challenging the math since it’s so easy.

Neither method has been written into law, and neither binds adjusters nor juries. They have been tolerated because they fulfill the need for some sort of language during settlement negotiations. No better alternatives have yet replaced them.

What Actually Moves the Number

Practitioners tend to be more candid about their work than the formula articles are. Figures for pain and suffering in personal injury claims are described by Arizona Injury Law Group as difficult to arrive at, and no formula is given.

Documentation holds the most weight in establishing case values. Evidence is key and is evaluated based on the length of treatment, the presence of surgery, the presence of an impairment rating, and restrictions. All these factors establish the gap between activity levels before and after the injury and can only be assessed by individuals other than the injured person.

Venue and Credibility

Beyond the method of valuation used, two factors affect the final settlement amount, and both are neglected in any formulas. These factors are both beyond the control of the valuation methods, and yet, the injured person’s level of credibility affects the overall compensation. A credible injured person can sit for a deposition, explain treatment gaps, and avoid social media posts that contradict the complaint.

The second is geography. The same facts settle for different sums in adjoining counties, and carriers price that difference openly. A claim evaluated for a case that would be tried in a plaintiff-friendly venue carries a premium that has nothing to do with the medicine.

Caps, and the States That Refuse Them

Caps on damages are most common in cases involving medical negligence, but limits do not apply to all injury cases. In some states, caps are even banned. There is also no statutory cap on damages in Arizona, since the constitution bans all laws that limit the amount of damages someone can be awarded for death or injury, though the constitution includes one narrow exception for felony-related claims against crime victims.

The practical consequence is that a figure quoted from another state, or from a settlement a friend received four years ago, carries almost no information about a current claim somewhere else. For Connecticut residents, a Waterbury personal injury lawyer can apply the state’s modified comparative negligence rule, which reduces an award by the injured person’s share of fault and bars recovery when that share exceeds the combined fault of the defendants.

The economic side of a claim documents itself. Bills arrive, wages stop, and records accumulate. The other side leaves no paper unless somebody generates it, which is why the number so often lands lower than the injured person expected. What a file contains about the months after an injury, rather than what happened during those months, is what ends up being worth something.