Scarring and Disfigurement Settlement: How It Is Valued

Most injury damages are about pain and function: how much it hurt, what you can no longer do. Disfigurement is about appearance and identity, and the law in most states treats it separately. Jury instructions in many states list disfigurement as an element the jury may compensate, distinct from pain and suffering and from loss of enjoyment of life, and some states' no-fault thresholds and damage cap exceptions name 'significant and permanent scarring or disfigurement' expressly. The separate category exists because a scar's harm continues after the pain has stopped and the function has returned.

The harm is social and psychological. A visible scar changes how a person is seen and how they see themselves, affects confidence, relationships and in some occupations employability, and for a child becomes part of growing up. The law compensates that, measured over the person's life expectancy, which is why age is a major factor: a facial scar on a twenty-year-old is carried for sixty years.

The injuries that produce compensable scarring are lacerations from glass and metal in crashes, burns, dog bites, particularly to children's faces, road rash from motorcycle and bicycle crashes, and the surgical scars from fracture repair and other treatment, which are compensable as a consequence of the injury even though the surgery was necessary.

Location first. Facial scars, and scars on the neck, hands and forearms, which are visible in daily life, are valued highest. Scars on the torso, upper arms and legs that clothing covers are valued lower, though they matter for people whose work or life exposes them. Scars that affect function, a contracture that limits movement, a scar across a joint, carry additional damages for the limitation.

Size, character and permanence second. A fine, flat, pale line that has faded is at the bottom; a wide, raised, discolored or keloid scar, a scar that distorts a feature, or an area of grafted skin is at the top. Whether the scar is permanent, and whether revision surgery can improve it and to what degree, is a plastic surgeon's opinion and the central medical evidence. The cost of revision, often performed in stages after the scar has matured over a year or more, is claimed as future medical expense.

The person third. Age, because a younger person lives with the scar longer; sex, because juries and insurers have historically valued facial scarring on women higher, a bias that attorneys on both sides are aware of and that courts do not endorse; occupation, for people in public-facing or appearance-related work; and the documented effect on the person's life, including psychological treatment where it was sought.

Suppose your daughter, 14, was a passenger in a car struck broadside, and glass from the window lacerated her cheek from the corner of her eye to her jaw. The laceration was closed in the emergency room with 31 sutures. Medical bills were $9,400. A year later, the scar had matured as a raised, pink line four inches long, visible across a room.

A plastic surgeon examined her and reported that the scar was permanent, that a revision procedure after she finished growing could narrow and flatten it but not remove it, and estimated the revision at $12,000 with a second procedure possible. Photographs at three-month intervals documented the scar's course. Her parents and her school counselor described the change in her: withdrawn, refusing photographs, declining activities she had enjoyed.

The claim was presented with the disfigurement as its principal element: a permanent, visible facial scar on a fourteen-year-old, with sixty years of life expectancy, the surgeon's opinion that revision would improve but not eliminate it, the future revision cost, and the documented psychological effect. It settled for a figure many times the medical bills, within the at-fault driver's policy, approved by the court and held for her until adulthood. All figures are hypothetical; the pattern of a disfigurement claim exceeding the medical bills many times over is typical for a facial scar on a child.

Scars change for a year or more after the injury, and the documentation has to follow them.

• Photograph the wound at the start and the scar at regular intervals, in consistent lighting, with a ruler for scale and from the same angles; the series shows the scar's course and its permanence.
• Keep the emergency room and wound care records, including the length and depth of the laceration and the number of sutures.
• Consult a plastic surgeon once the scar has begun to mature, for an opinion on permanence, revision options and cost; this is the central evidence.
• Follow the wound care instructions, sun protection and scar treatment the doctors recommend; failure to do so is argued as a failure to mitigate.
• Record the scar's effect: comments from others, changes in activities, clothing choices, work effects, and seek counseling if the effect is significant, which both helps and documents.
• Do not settle before the scar has matured and the surgeon has given an opinion; an early settlement values a scar whose final appearance is unknown.
• For a child, expect court approval of the settlement and funds held until adulthood, and plan revision surgery for after growth is complete.

Most states' jury instructions list disfigurement as a separate element of damages, and some state statutes name it; a few fold it into pain and suffering or loss of enjoyment of life, which affects how the claim is presented rather than whether it is compensated. Damage caps on non-economic damages, where they exist, apply to disfigurement, and some caps have exceptions for permanent and substantial disfigurement, which is an argument for the higher limit.

In no-fault states, significant and permanent scarring or disfigurement is a threshold injury in Florida, Michigan, New York and New Jersey, among others, meaning a person with such a scar may claim against the at-fault driver for non-economic damages even if no other injury meets the threshold. The threshold language and the case law on what 'significant' means differ by state.

Workers' compensation systems pay scheduled benefits for disfigurement in many states, usually for scars on the face, head, neck and hands, at fixed amounts that are far below civil damages, which is one reason a third-party claim against someone other than the employer matters for a worker disfigured on the job. Deadlines are the state's injury statute, one year in Tennessee and Kentucky, two in Texas, California, Florida and Georgia, three in New York and North Carolina; for a child, usually extended until adulthood.

Burn scars are the most extensive and the most disfiguring, with grafted areas, contractures and color change over large parts of the body, and burn claims are built on the burn center's records, the grafting and reconstruction history, and a plastic surgeon's or burn specialist's projection of future procedures, which can continue for years. The disfigurement element of a serious burn claim is often the largest.

Dog bites to the face, which disproportionately injure young children, produce scars that strict liability dog bite statutes in many states compensate without proof of the owner's negligence, paid by the owner's homeowner's policy, and the plastic surgery and the child's lifetime with the scar are the claim. Road rash from motorcycle, bicycle and scooter crashes produces grafted areas and permanent discoloration on arms and legs, compensated as disfigurement alongside the underlying injuries.

Surgical scars from the treatment of a crash injury, an incision for a plate on a fractured arm, an abdominal scar from internal injury surgery, are compensable as consequences of the crash, and their visibility and extent are included in the claim even though the surgery was necessary and well performed.

A scarring claim is valued on the scar's location, character and permanence and on the life of the person carrying it, proven by photographs over time, a plastic surgeon's opinion and evidence of the effect, and it should not be settled before the scar has matured. The questions to answer early are whether the photographic record has begun, when a plastic surgeon should be consulted, and whether the state treats disfigurement as a separate element or a threshold injury. Most personal injury attorneys work on contingency.

Ask Legal Matters is a free claim-review request service, not a law firm. Requests may be shared with independent attorneys and legal services partners who handle inquiries in your state, and an attorney must evaluate the facts before anyone can say what the claim is worth. If you or your child were left with a scar by someone else's negligence, you can request a free claim review.

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• Medical Malpractice Claims: Standard of Care, Deadlines and Damages
• Accident in a Borrowed Car: Whose Insurance Pays
• Accident on Icy Roads or in Bad Weather: Who Is at Fault
• Airbag Did Not Deploy in a Crash: Can You Sue, and Whom?
• Amputation Injury Claim: Prosthetics and Lifetime Costs
• At Fault in a Car Accident? Comparative Negligence Explained
• What Is the Average Car Accident Settlement? What Sets the Value

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