A broken sternum from a car accident typically settles based on three moving parts: your documented medical costs, the wages you lose during roughly ten weeks of recovery, and a pain-and-suffering figure calculated as a multiple of those economic damages. Simple non-surgical treatment can run under $1,000, while hospitalization pushes costs past $8,000, and surgery climbs higher still. Apply a multiplier between 1.5 and 5 to your economic losses for pain and suffering, then subtract any share of fault assigned to you, health insurance and medical liens, and attorney fees of 33 to 40 percent. What lands in your account is often meaningfully less than the headline number.
The Components That Add Up to Your Settlement
Every sternum fracture claim is built from the same categories. The size of each depends on your specific injury, your job, and how well you document what happened to you.
Medical Costs
Medical expenses form the floor of the claim. A simple sternal fracture diagnosed and treated without hospitalization can cost under $1,000. Once ambulance transport, emergency room care, hospitalization, and follow-up visits enter the picture, the total moves into the thousands quickly. Because roughly 90 percent of sternal fractures result from car accidents, most claimants carry emergency transport and ER charges on top of the fracture treatment itself.
Future medical costs belong in the demand as well. If your physician projects ongoing pain management, follow-up imaging, or possible corrective surgery, those projected expenses are part of what the at-fault driver’s insurer should pay.
Lost Income
Most people recover from a broken sternum in roughly ten to eleven weeks, so a two-month wage loss is a realistic minimum.1National Institutes of Health. Long-Term Morbidity in Patients Suffering a Sternal Fracture If your work involves lifting or any activity that stresses the chest, expect longer. Pay stubs, employment records, and tax returns support the claim; self-employed claimants use profit-and-loss statements and client contracts.
When the fracture causes lasting limitations that reduce future earning capacity, an economist or vocational expert can project those losses over your remaining working years. That projection is where cases shift from modest to substantial.
Pain and Suffering
Pain and suffering compensates for physical discomfort, lost sleep, inability to exercise or lift your children, anxiety about re-injury, and general disruption that doesn’t show up on a bill. Insurers and attorneys commonly use a multiplier method: total economic damages multiplied by a factor between 1.5 and 5, with the multiplier tied to severity and life impact. A clean fracture that heals on schedule sits near the bottom of that range. A fracture requiring surgery, with chronic pain afterward, pushes toward the top.
Evidence carries real weight here. A daily journal recording pain levels, sleep disruption, and activities you can no longer perform gives the multiplier something concrete to attach to. So does testimony from a mental health professional if the accident triggered anxiety, depression, or post-traumatic stress.
Permanent Impairment Ratings
If your fracture leaves lasting limitations, a physician can assign a permanent impairment rating using the AMA Guides to the Evaluation of Permanent Impairment. The American Medical Association describes a properly completed rating as “the gold standard for documenting permanent impairment to support insurance and legal proceedings.”2American Medical Association. AMA Guides to the Evaluation of Permanent Impairment Overview The rating is assigned after you reach maximum medical improvement and gives adjusters a concrete number to anchor the long-term component of your damages. It matters most when complications like pseudarthrosis or chronic pain are involved, because it translates subjective complaints into an objective medical finding.
How Surgery and Complications Change the Number
A sternum fracture is not one injury with one price tag. If the bone fails to heal properly, a condition called pseudarthrosis can develop, essentially a false joint that causes ongoing pain and may require surgery to correct. Older adults, people with diabetes, and those taking steroids face higher risk. Patients over 50 also report symptoms lasting longer than the typical window.
When surgery is needed, recovery extends well past the standard ten-week timeline, and the total cost of treatment climbs substantially. A sternum treated with open reduction and internal fixation tells a fundamentally different story to an adjuster than one treated with rest and pain medication. The operative report becomes one of the most valuable documents in the file, and it typically pushes both the medical costs and the pain-and-suffering multiplier higher.
How Shared Fault Reduces Your Payout
If you share any responsibility for the accident, your settlement is reduced accordingly. Nearly every state applies some form of comparative negligence, and the rules vary in ways that meaningfully change the math.3Justia. Comparative and Contributory Negligence Laws 50-State Survey
- Pure comparative negligence lets you recover even if you were 99 percent at fault, but your award is reduced by your percentage. On $100,000 in damages with 30 percent fault assigned to you, you receive $70,000.
- Modified comparative negligence bars recovery once your fault crosses a threshold. Roughly ten states set the bar at 50 percent, and about twenty-five states set it at 51 percent.
- Contributory negligence, still the rule in one state, bars any recovery if you contributed to the accident to any degree.
Adjusters know these rules and look for evidence you contributed, whether by speeding, distraction, or not wearing a seatbelt. Police reports, dashcam footage, and witness statements are what push back on those arguments.
Why Settling Too Early Costs You Money
One of the most expensive mistakes in a sternum fracture case is settling before you know what your injury is worth. The reference point is maximum medical improvement, the moment your doctor determines that your condition has stabilized and no further significant improvement is expected. Reaching it doesn’t mean you’re pain-free. It means your condition is as good as it’s going to get.
Until then, neither you nor your attorney can accurately calculate the full claim. If you settle at week six of what turns into a longer recovery, and then develop pseudarthrosis requiring surgery, you’ve already released your right to compensation for that complication. You get one negotiation. Accepting early means accepting a number built on incomplete information.
A typical timeline runs like this: treat and recover for two to four months, reach maximum medical improvement, obtain any needed impairment rating, then assemble a demand package and negotiate. Negotiations themselves take weeks to months. Most personal injury cases settle before trial, but a credible willingness to file suit strengthens your position at the table.
What Gets Deducted Before You See a Check
The settlement figure on paper is not the amount that reaches your account. Several parties may have a legal right to be paid first.
Health Insurance Liens
If your health insurance covered treatment for the fracture, the insurer has a right to be reimbursed from your settlement. Employer-sponsored plans governed by the federal Employee Retirement Income Security Act tend to have particularly strong recovery rights. Your attorney may be able to negotiate the lien down, arguing that the plan should share in legal costs or that you weren’t fully compensated, but the plan’s own language often controls how much room there is.
Medical Provider Liens
Hospitals and doctors who treated you can place liens against the settlement for unpaid bills. Many states allow these liens, and in some cases the provider must be paid in full before you receive any portion of the money. Medical liens are enforceable regardless of the outcome, so they don’t vanish if the case falls apart.
Attorney Fees
Most personal injury attorneys work on contingency, taking a percentage of the settlement rather than charging upfront. The standard range is 33 to 40 percent, with the lower end typical for cases that settle before a lawsuit is filed and the higher end for cases that go to trial. Combine attorney fees with health insurance reimbursement and medical liens, and the net amount you receive can be substantially less than the headline number. Working that math early keeps expectations realistic.
What the IRS Takes
Federal law excludes from gross income any damages received on account of personal physical injuries or physical sickness, other than punitive damages.4Office of the Law Revision Counsel. 26 USC 104 Compensation for Injuries or Sickness For a broken sternum from a car accident, the bulk of the settlement, including medical expenses, lost wages, and pain and suffering, is not taxable.
Several portions can be taxable:
- Punitive damages are always taxable as income, because they punish the defendant rather than compensate you. These awards are rare; only about five percent of verdicts include them, and they generally require proof of intentional wrongdoing or reckless conduct like drunk driving.5Internal Revenue Service. Tax Implications of Settlements and Judgments
- Interest on the settlement, including prejudgment interest, is taxable and reported as interest income.6Internal Revenue Service. Settlements Taxability Publication 4345
- If you previously itemized and deducted medical expenses related to the injury, the portion of the settlement covering those costs may be taxable to the extent the deduction gave you a tax benefit.
- Emotional distress damages that stem directly from the physical injury remain excluded, but emotional distress not tied to a physical injury is not treated as a physical injury under the statute.4Office of the Law Revision Counsel. 26 USC 104 Compensation for Injuries or Sickness
Legal fees on a personal injury case cannot be deducted on your federal return. That doesn’t change the tax-free status of the compensatory portion, but the 33 to 40 percent your attorney receives is not something you can write off.
The Deadline You Cannot Miss
Most states allow two to three years from the date of the accident to file a personal injury lawsuit, though some allow as little as one year and others up to five or six. Miss your state’s statute of limitations and the court will dismiss your case regardless of its strength. Filing an insurance claim does not stop the clock. Only filing the actual lawsuit does.