By Michael Shemtoub, trial attorney, Beverly Law. Updated November 2026.
Spinal cord or back injury after an accident?
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Start with the cost of care
In most spinal cord injury claims, the cost of care is the backbone of the damages. The National Spinal Cord Injury Statistical Center (NSCISC) at the University of Alabama at Birmingham publishes average care costs by severity. Its 2026 data sheet gives these figures, with yearly costs in 2025 dollars (NSCISC 2026):
| Severity | First year | Each later year | Lifetime, injured at 25 | Lifetime, injured at 50 |
|---|---|---|---|---|
| High tetraplegia (C1-C4), AIS A-C | $1,446,827 | $251,246 | $6,419,617 | $3,528,112 |
| Low tetraplegia (C5-C8), AIS A-C | $1,045,459 | $154,128 | $4,690,573 | $2,885,122 |
| Paraplegia, AIS A-C | $705,131 | $93,409 | $3,139,165 | $2,060,139 |
| Motor functional at any level, AIS D | $472,190 | $57,353 | $2,144,693 | $1,513,784 |
The lifetime column is discounted at 2%, and the sheet does not state its dollar year. Treat them as averages of care costs across many people; they say nothing about what any claim will settle for. They also leave out lost wages, which the sheet reports separately as indirect costs. If you are not sure where an injury falls on the AIS scale, see what qualifies as a spinal cord injury.
The life care plan turns averages into your numbers
Damages are measured for one person, by the care that person will need. In California, the jury instruction on future medical expenses asks the plaintiff to prove “the reasonable cost of reasonably necessary medical care” the person “is reasonably certain to need in the future” (CACI 3903A).
That proof usually comes from a life care plan, a report that projects future care needs and their cost, often built from the treating doctors’ recommendations: attendant care, equipment, home changes, medications, therapy, and the cost of treating complications. Life expectancy drives the total, and research from the spinal cord injury model systems has reviewed the methods planners use to estimate it (Krause, MSKTC). NSCISC’s 2026 tables show why it matters. For a person injured at 40 who survives the first year, estimated remaining life expectancy is 29.1 years with paraplegia and 20.8 years with high tetraplegia, compared with 40.7 years for someone without a spinal cord injury (NSCISC 2026).
Lost earnings and earning capacity
NSCISC reports that indirect costs, such as lost wages, fringe benefits and productivity, averaged $97,787 per year in 2025 dollars, and that its care figures above leave those losses out (NSCISC 2026). In a real case, the claim is built from the person’s own work history, pay records, age and what the injury now prevents. Our page on lost wages after a car accident covers the paperwork.
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State rules that change the number
The same injury can produce a different recovery depending on where the case is filed.
| Rule | California | Texas | Washington |
|---|---|---|---|
| Your share of fault | Reduces damages, never bars them (Li v. Yellow Cab) | Barred if more than 50% at fault (CPRC 33.001) | Reduces damages, never bars them (RCW 4.22.005) |
| Noneconomic damages limits | Only in professional negligence claims against health care providers: $350,000 in 2023, rising $40,000 a year to $750,000 (Civ. Code 3333.2) | $250,000 per claimant in health care liability claims against physicians and providers (CPRC 74.301) | The state’s statutory limit was struck down as violating the jury right (Sofie v. Fibreboard) |
| Punitive damages | Allowed on clear and convincing proof of malice, oppression or fraud (Civ. Code 3294) | Allowed for fraud, malice or gross negligence (CPRC 41.003), with a cap (41.008) | Not allowed without express statutory authority (Dailey) |
Medical bills are counted differently too. In California, a plaintiff whose care was paid by private insurance can recover no more than the amounts actually paid by the plaintiff or the insurer, plus amounts still owed, and the discount between the billed and paid amounts is not recoverable (Howell v. Hamilton Meats). Texas limits recovery of medical expenses to the amount “actually paid or incurred by or on behalf of the claimant” (CPRC 41.0105). For a spinal cord injury, that rule mostly shapes the past bills, while the future care claim rests on the life care plan.
Insurance often sets the real ceiling
A verdict is only worth what can be collected. The at-fault party’s liability policy, any employer or company coverage, and your own underinsured motorist coverage decide how much money is actually there. A trucking company or other business may carry its own coverage, which is one reason truck crashes are handled differently; see what drives the value of a truck accident settlement and making a UIM claim.
What this means for your case
Value is built from records. Keep every bill and explanation of benefits, ask your rehabilitation team for written recommendations on equipment and attendant care, and keep proof of your income before the injury. Avoid settling before your doctors can describe your long-term needs, because future care can cost far more than the bills already paid. Whoever paid for your care may claim repayment from the recovery. Medicare, for example, must be repaid for conditional payments when a beneficiary receives a settlement or judgment (CMS). Our page on medical liens explains how that works. Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou. For the steps and filing deadlines, see how to sue for a spinal cord injury.
Common questions
What is the average spinal cord injury settlement?
We do not use averages, because they hide the facts that decide a case: the injury level and grade, age, earnings, fault and insurance. The NSCISC cost tables measure care costs, not settlements.
Does a higher injury level mean a higher value?
Care costs rise with the level and severity of the injury, as the NSCISC table shows. The value of a claim still depends on proof of fault and on the money available to pay it.
Can I recover for care I will need years from now?
Yes, if it is proven. In California, future medical costs must be reasonably certain to be needed, which is why a life care plan and testimony from treating doctors carry so much weight.
Does it matter that my insurance paid less than the hospital billed?
In California and Texas, yes. Past medical damages are generally measured by what was paid or incurred, not by the full billed amount.
Are punitive damages part of the value?
Only in some cases. They require proof of serious misconduct, Texas caps them, and Washington does not allow them without a statute that authorizes them. Beverly Law offers a free case review in English or Spanish at (310) 552-6959. You owe no fees or costs unless we win. Browse more answers in our injury law FAQs.
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Related pages
Sources
- NSCISC at UAB, Traumatic Spinal Cord Injury Facts and Figures at a Glance (2026 SCI Data Sheet) (sites.uab.edu)
- MSKTC (SCI Model Systems), Krause, Accuracy of life expectancy estimates in life care plans (Topics in Spinal Cord Injur (msktc.org)
- CACI No. 3903A, Medical Expenses, Past and Future (justia.com)
- Howell v. Hamilton Meats & Provisions, Inc. (2011) 52 Cal.4th 541 (law.justia.com)
- Tex. Civ. Prac. & Rem. Code § 41.0105 (statutes.capitol.texas.gov)
- Tex. Civ. Prac. & Rem. Code § 41.003 (statutes.capitol.texas.gov)
- CMS, Non-Group Health Plan Recovery (Medicare conditional payments) (cms.gov)
- Tex. Civ. Prac. & Rem. Code § 41.008 (statutes.capitol.texas.gov)
- Tex. Civ. Prac. & Rem. Code § 74.301 (statutes.capitol.texas.gov)
- Tex. Civ. Prac. & Rem. Code § 33.001 (statutes.capitol.texas.gov)
- Cal. Civ. Code § 3333.2 (leginfo.legislature.ca.gov)
- Cal. Civ. Code § 3294 (leginfo.legislature.ca.gov)
- Li v. Yellow Cab Co. (1975) 13 Cal.3d 804 (scocal.stanford.edu)
- RCW 4.22.005 (app.leg.wa.gov)
- Sofie v. Fibreboard Corp. (1989) 112 Wn.2d 636 (law.justia.com)
- Dailey v. North Coast Life Ins. Co. (1996) 129 Wn.2d 572 (law.justia.com)
Important: This page is general information, not legal or medical advice, and reading it does not create an attorney-client relationship. Every case is different; talk to a lawyer about yours. Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou. Last reviewed: November 7, 2026.