What is a 2-level ACDF workers comp settlement worth?

A two-level ACDF typically lands at an 18 to 25 percent whole-person impairment rating, and the PPD value scales with the state's weeks per percentage point and the worker's pre-injury wage. Two-level fusions consistently settle higher than one-level fusions for that reason.

What is a cervical fusion workers comp settlement worth?

A single-level cervical fusion (ACDF) typically lands at a 12 to 18 percent whole-person impairment rating. Multi-level fusions go higher. The settlement value depends on the rating, the worker's wage, the state formula, and whether future medical care is closed out as part of the settlement.

Is a cervical fusion permanent?

Yes, by definition. The fused segments no longer move, and the surrounding segments compensate. That permanent loss of motion is what produces the impairment rating and drives the PPD value of the claim.

Neck Workers Comp Settlement by State

A neck injury at work produces a different settlement in every state because each state's workers compensation statute assigns a different number of weeks of compensation for the loss. This page ranks every state with a neck schedule by the max payout at the current state cap, walks the surgery scenarios that drive most real settlements, and lays out the impairment-rating math for the states that do not schedule the neck separately.

Neck at a Glance

Impairment-rating states: 13

How common is a neck workers comp claim?

Neck injuries accounted for 1.1% of all days-away-from-work cases in the most recent Bureau of Labor Statistics survey (2024), or roughly 20,570 cases that kept a US worker out of work for at least one day. The national count across every body part is around 1.83 million DAFW cases per year, so this category is one of the larger slices.

Source: BLS SOII 2024 Table R2: Detailed industry by selected parts of body affected (Number) .

Neck medical context and impairment ratings

Cervical fusion is the most common surgery driving high-value neck-injury workers comp settlements. The C5-C6 and C6-C7 levels see the most pathology in working-age adults because they bear most of the rotational stress of head movement. A two-level ACDF, even when successful, leaves a permanent functional deficit that scales the PPD award substantially higher than a one-level case.

Diagnoses and terms searchers use: cervical spine, ACDF, anterior cervical discectomy and fusion, C5-C6, C6-C7, cervical disc herniation, cervical radiculopathy, whiplash.

Whole-person impairment rating ranges

Outcome	Whole-person impairment
Cervical strain, MMI without surgery	0 to 5% whole-person
Cervical disc herniation treated conservatively	5 to 10% whole-person
Single-level ACDF	12 to 18% whole-person
Two-level ACDF	18 to 25% whole-person
Three-level or more ACDF	25 to 35% whole-person

Ratings reference the AMA Guides to the Evaluation of Permanent Impairment. Most states use the 5th or 6th edition; your state hub names the version it follows.

Surgery is the lever that drives neck settlement values

Workers often ask whether having surgery helps or hurts the settlement number. Mechanically, surgery usually raises the permanent impairment rating, which raises the PPD value of the case under any state's scheme. It also extends time spent in temporary disability, which means more weeks of TTD before MMI and a later settlement conversation.

Procedure	What it does and how it lands
ACDF (single-level)	Anterior cervical discectomy and fusion at one level, most commonly C5-C6 or C6-C7. The most common neck surgery in workers comp. Recovery three to six months; impairment usually low to mid-teens whole-person.
ACDF (multi-level)	Fusion at two or more levels. Recovery six to nine months. Impairment rises with each level fused.
Posterior cervical fusion	Fusion approached from the back of the neck. Less common in workers comp; used for instability or trauma cases. Higher impairment than ACDF on average.
Cervical artificial disc replacement	Less common in workers comp because not every carrier authorizes it. Outcomes similar to ACDF for impairment rating purposes.
Microdiscectomy (cervical)	Removal of a herniated disc fragment without fusion. Recovery six to twelve weeks; impairment usually single digits if successful.

Neck recovery and MMI timeline

A successful single-level ACDF reaches MMI about nine to twelve months after surgery. Multi-level fusions take longer because the additional fused segments increase the time before the doctor can assess permanent restrictions.

The settlement conversation almost never starts until the doctor declares maximum medical improvement (MMI). Before MMI, the carrier normally keeps paying weekly TTD and medical bills. After MMI, the case can be valued against the schedule and the impairment rating.

How a neck workers comp settlement actually gets calculated

Numbers on the chart above are statutory ceilings. The settlement you sign almost never matches the ceiling exactly. Five things move the real number:

Your impairment rating. A doctor's percentage rating scales the schedule down. A 25 percent rating on a 200-week scheduled body part pays 50 weeks, not 200.
Your average weekly wage. Workers below the state cap collect two-thirds of their own wage; workers above the cap collect the cap. High-wage workers leave money on the table because of the cap.
Surgery, recovery, and the final impairment rating. A successful surgery often lowers the rating after recovery. A failed surgery or one with complications raises it. The settlement amount tracks the rating at MMI.
Open vs closed future medical. A settlement that leaves future medical care open is worth less in cash than one that closes it out, because the carrier loses control of future cost.
How easy the carrier finds the claim to defend. Strong causation evidence and consistent treatment records push the settlement closer to the schedule ceiling. Gaps, prior injuries to the same body part, or disputed causation push it down.

Impairment-rating states

These states do not use a body-part schedule. A doctor assigns a whole-person impairment rating after MMI, and the state pays a statutory number of weeks per percentage point. The PPD value depends on the rating and the state's weekly cap.

Alaska (max weekly $1,418.00): Alaska uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
California (max weekly $1,764.00): California uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
Kentucky (max weekly $1,277.99): Kentucky uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
Minnesota (max weekly $1,536.84): Minnesota uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
Montana (max weekly $1,004.00): Montana uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
Nevada (max weekly $1,364.15): Nevada uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
North Dakota (max weekly $1,535.00): North Dakota uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
Oregon (max weekly $1,943.41): Oregon uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
South Dakota (max weekly $1,067.00): South Dakota uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
Tennessee (max weekly $1,426.70): Tennessee uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
Texas (max weekly $1,271.00): Texas uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
Vermont (max weekly $1,839.00): Vermont uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.
Wyoming (max weekly $974.00): Wyoming uses an impairment-rating approach. Neck cases are valued by the doctor's whole-person impairment rating multiplied by the statutory weeks per percentage point.

Wage-loss states

These states pay based on actual wage loss after the injury, not a body-part schedule. The settlement turns on the gap between pre-injury wages and post-MMI earning capacity, capped at the state's maximum weekly rate.

District of Columbia (max weekly $1,799.31): District of Columbia pays based on actual wage loss after the injury, not a body-part schedule. Neck settlements here turn on the gap between pre-injury wages and post-MMI earning capacity.
Florida (max weekly $1,358.00): Florida pays based on actual wage loss after the injury, not a body-part schedule. Neck settlements here turn on the gap between pre-injury wages and post-MMI earning capacity.

States that schedule other body parts but not neck

The states below maintain a body-part schedule but do not list the neck as a separately scheduled member. Cases here normally get valued under the general impairment provision of the statute, with the doctor's whole-person impairment rating driving the number of weeks of PPD payable.

Alabama: Alabama schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Arizona: Arizona schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Arkansas: Arkansas schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Colorado: Colorado schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Connecticut: Connecticut schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Delaware: Delaware schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Georgia: Georgia schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Hawaii: Hawaii schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Idaho: Idaho schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Illinois: Illinois schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Indiana: Indiana schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Iowa: Iowa schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Kansas: Kansas schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Louisiana: Louisiana schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Maine: Maine schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Maryland: Maryland schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Massachusetts: Massachusetts schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Michigan: Michigan schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Mississippi: Mississippi schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Missouri: Missouri schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Nebraska: Nebraska schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
New Hampshire: New Hampshire schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
New Jersey: New Jersey schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
New Mexico: New Mexico schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
New York: New York schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
North Carolina: North Carolina schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Ohio: Ohio schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Oklahoma: Oklahoma schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Pennsylvania: Pennsylvania schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Rhode Island: Rhode Island schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
South Carolina: South Carolina schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Utah: Utah schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Virginia: Virginia schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
West Virginia: West Virginia schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.
Wisconsin: Wisconsin schedules other body parts but does not list neck separately. Most neck cases here are valued under the state's general impairment provision.

Common questions about neck settlements

What is a 2-level ACDF workers comp settlement worth?: A two-level ACDF typically lands at an 18 to 25 percent whole-person impairment rating, and the PPD value scales with the state's weeks per percentage point and the worker's pre-injury wage. Two-level fusions consistently settle higher than one-level fusions for that reason.
What is a cervical fusion workers comp settlement worth?: A single-level cervical fusion (ACDF) typically lands at a 12 to 18 percent whole-person impairment rating. Multi-level fusions go higher. The settlement value depends on the rating, the worker's wage, the state formula, and whether future medical care is closed out as part of the settlement.
Is a cervical fusion permanent?: Yes, by definition. The fused segments no longer move, and the surrounding segments compensate. That permanent loss of motion is what produces the impairment rating and drives the PPD value of the claim.

Neck settlement: taxes, timing, and what comes next

Workers comp settlements are not taxable at the federal level under IRS Publication 525 and IRC § 104(a)(1). That covers weekly checks and lump-sum settlements. State taxation follows the federal rule in every workers comp jurisdiction.

The check usually arrives two to four weeks after a judge signs the settlement. Structured settlements (where the money comes through an annuity instead of a lump sum) and cases involving Medicare set-asides take longer, often months. Outstanding medical liens from providers also slow disbursement because the attorney has to clear each lien before paying the worker.

Sources

BLS SOII 2024 Table R2: Detailed industry by selected parts of body affected (Number)
State statutes and workers comp board rate notices, linked from each state hub.
AMA Guides to the Evaluation of Permanent Impairment for whole-person impairment ranges.