Slip and Fall Claims Involving Back Injuries
Back injuries are the most disputed category in premises litigation, because degenerative change appears on imaging in most adults. That does not defeat the claim, and knowing why is the difference between settling low and settling properly.
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What a fall actually does to a back
Landing on the tailbone transmits force up the spine, producing compression fractures in the vertebral bodies and axial loading of the discs. Twisting as the legs go from under someone adds a rotational component that ligaments and discs tolerate poorly.
The injuries range from muscular strain, through facet joint injury, to disc herniation with nerve root compression, to vertebral fracture.
The degeneration argument, and why it is not a defense
Disc degeneration is present on imaging in a large majority of adults over forty, and in a substantial share of younger people, most of whom have no symptoms at all. An occupier will point to it and argue the findings pre-date the fall.
Texas takes claimants as it finds them. Aggravation of a pre-existing condition is compensable, and the recoverable claim is the difference between the condition before the fall and after it. Whether the disc was already there is not the question.
What actually proves the aggravation
Prior medical records showing no complaints, or a documented level of activity. Prior imaging where any exists, for direct comparison. Employment records showing the physical work being done before.
Then the treating history: symptom onset in relation to the fall and progression afterwards. And specific before-and-after evidence from the claimant, family and colleagues, which is frequently more persuasive than the scan because imaging shows anatomy rather than function.
Radiculopathy changes the claim
Where a disc compresses a nerve root, symptoms radiate into the buttock, leg and foot, and the injury becomes objectively demonstrable through examination and nerve conduction studies.
That removes the subjectivity argument almost entirely, which is why radiating symptoms should be reported explicitly rather than described as back pain.
Compression fractures, and age
In older claimants, a fall can produce a vertebral compression fracture where bone density is reduced. Occupiers argue the fracture was caused by osteoporosis rather than the fall.
The same principle answers it: a defendant takes the claimant as it finds them. A vertebra that would not have fractured but for the fall is a fall injury, whatever its baseline density.
Treatment escalation is the value signal
Therapy alone produces a contained claim. Escalation to injections shows conservative care failed. Escalation to surgical consultation and then to fusion or decompression changes the claim substantially.
Fusion in particular alters spinal mechanics permanently and transfers load to adjacent levels, carrying a real risk of further surgery later. That future risk is recoverable where medical opinion supports it.
Summary
| Factor | Effect | Evidence |
|---|---|---|
| Radiating symptoms | Removes the subjectivity argument | Exam, nerve conduction |
| Prior records showing function | Establishes aggravation | Medical and employment records |
| Escalation to injections | Conservative care failed | Treating records |
| Fusion or decompression | Substantial increase | Operative report, future risk |
| Compression fracture | Objective, though age is argued | Imaging |
| Return to physical work | Largest capacity variable | Vocational evidence |
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Frequently asked questions
Yes. Degeneration appears on imaging in most adults, the majority of whom have no symptoms. Texas compensates aggravation of a pre-existing condition, so the recoverable claim is the difference between your condition before the fall and after it.
Prior records showing an absence of complaints or a documented level of activity, prior imaging for comparison where it exists, the treating history showing onset and progression, and specific before-and-after evidence about function.
Because nerve root compression is objectively demonstrable through examination and nerve conduction studies, which removes the argument that symptoms are self-reported. Report radiating pain, numbness or weakness explicitly rather than describing only back pain.
No. A defendant takes the claimant as it finds them, so a vertebra that would not have fractured but for the fall is a fall injury whatever its baseline bone density.
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