Seat Belt Injuries in Car Accidents

On this page, our lawyers look at injuries caused by seat belts in auto accidents. We discuss how seat belt injuries occur and different types of seat belt injuries. We also explain how much compensation you can expect in a seat belt injury lawsuit based on the type of injury. We look analyze actual settlements and verdicts in cases involving seat belt injuries.

Seat belts were invented in the 19^th Century but didn’t make their way into American cars until the 1950s. The first recorded seat belt injury was diagnosed in 1956. Since then, medical researchers have coined the term “seat belt syndrome” to describe the distinct pattern of injuries that accompany seat belt use.

Seat belts have been an important development for safe transportation, preventing ejection from the vehicle and decreasing the severity of impact during an accident – it is estimated that up to 80 percent of all car accident fatalities could have been prevented by seat belt usage. But to keep the wearer restrained even in the most forceful collisions, seat belts must be rigidly strong. So this lifesaver paradoxically can cause very serious injuries.

When a vehicle comes to a sudden stop, as it would in a motor vehicle accident, the occupants’ torsos slam against the belt strap. Our lawyers see many cases where this force protect the occupant but still causes harm. The injuries caused by seat belts might be different from the injuries seen in unrestrained drivers. (Again, seat belt injuries are almost always significantly less severe.)

Even so, seat belt injuries in high-velocity accidents can be devastating. It is worth underscoring that victims of seat belt injuries probably would have had far more serious injuries without wearing a belt. But that does not change the fact that these injuries can be brutal.

Given the psychological sense of security that seat belts offer, combined with the fact that many seat belt-related injuries have delayed symptoms, some traffic accident victims will refuse medical attention at the scene of the accident, only seeking help after the pain sets in, sometimes hours or even months following the crash. Early recognition and treatment can be the key to ensuring that seat belt syndrome chest and abdominal injuries do not become permanently debilitating or fatal.

Types of Seat Belt Injuries

Up to 80 percent of serious blunt chest injuries result from motor vehicle crashes, among restrained and unrestrained car occupants alike. Historically, the four leading causes of fatalities resulting from fatal injuries have been:

1. ruptures of the aorta (37%)
2. ruptures of the heart (28.4%)
3. bilateral lung contusions (31.1%)
4. lung lacerations (15.5%).

These are usually high-speed accidents with great force that involve not so much the seat belt but the steering wheel striking the victim and causing damage to internal organs in the chest.

Everyone knows the use of seat belts saves lives. But even though seat belt restraint causes much less severe damage than ejection or impact with the dashboard, blunt chest trauma caused by seat belt usage can lead to a wide range of injuries. Seat belt wearing drivers and passengers will only experience bruising and soreness after a crash. But high-velocity impacts can cause serious injury even for restrained occupants.

Skin Abrasions are commonly found across the lower abdomen or extending diagonally across the chest and neck. The classic “seatbelt sign,” marked in bruises or lacerations, can indicate internal injuries in 30 percent of cases, with abrasions in different locations indicating different internal injuries.

Abdominal abrasions can be symptomatic of soft tissue injuries in the peritoneum, bowel perforation, hematoma, or particular kinds of spinal fractures. Our car accident lawyers do not see many serious crashes where the victim does not have a hematoma from the force of the crash. Often the worse the bruising, the worse the injuries from the crash would have been. In terms of settlement value, if the only injury is a hematoma from the seat belt after accident, that would be a case on the lower end of the compensation range. A seat belt bruise is particularly important if the property damage is not significant and you are claiming other injures. Because that seatbelt bruise is a sign of a meaningful force transfer that insurance adjusters (and juries) find meaningful.

Chest abrasions are often associated with rib, sternum, or clavicle fractures and heart or lung injuries. Neck abrasions may indicate injury to the carotid artery, larynx, and cervical spine. Any appearance of the “seat belt sign” after an auto accident should prompt an immediate and thorough search for related internal injuries.

Skeletal Injuries are the most common traffic accident damages, with motor vehicle crashes accounting for 90 percent of all sternum fractures. While rib, sternal, or clavicle fractures are not particularly severe injuries in and of themselves, because of their location near the heart and lungs, chest fractures can potentially cause more serious visceral injuries if left untreated. Spinal fractures are also common seat belt injuries, particularly for passengers wearing lap belts. These “Chance” fractures are characterized by their horizontal direction.

Soft-Tissue and Visceral Injuries such as torn tendons and muscle fibers in the shoulder or abdominal perforations can also result from seatbelt restraint. Soft tissue injuries are rarely fatal, but they can cause decreased mobility. They will appear red in the first few hours after impact, rather than the more typical black-and-blue seat belt bruising. In the most serious cases, blunt force trauma to the chest can cause bruising of the heart or lungs. These are rough bruises but most patients rebound well from these injuries.

Tears, ruptures, and perforations in the abdominal area are the most common significant injuries caused by seat belts. They often occur directly beneath the site of the lap portion of the seatbelt and can be made significantly worse when the seat belt is not worn appropriately.

When positioned properly, the lap belt strap should lay across the bony part of the wearer’s pelvis, and the shoulder strap should run diagonally over the torso without cutting against the neck.

Obesity, slouching, or moving the shoulder strap under the arm can cause much more significant damage to the liver and abdominal cavity. Abdominal soft tissue or visceral injuries are often asymptomatic at first, making it all the more important for a rapid and thorough medical evaluation even if the crash victim doesn’t report any on-site pain.

Vascular Injuries are rare consequences of seat belt use. In some cases, the force of the collision can cause thoracic aortic tears (a rip in the body’s largest artery). Most of the time, the shoulder strap will control chest deceleration well enough that the shearing force on the aorta won’t be strong enough to cause a tear. Aortic injuries can still occur for seat belt wearers in the most forceful collisions.

Post-Accident Signs and Symptoms of Seat Belt Injuries

Often, seat belt wearing crash victims will feel tenderness around their chest area, including soreness when breathing, laying down, or moving their arms. Such pains may result from deep bruising, which could last for days or weeks after an accident without requiring medical attention. It is, however, always a good idea to have any pains evaluated by a doctor to make sure they are not indicative of something more serious.

The most tell-tale sign of injury is seat-belt-shaped bruising across the chest, stomach, and neck, and should always motivate a visit to the emergency room. Sometimes more subtle symptoms such as chest pain, stiffness, or difficulty breathing will appear long after the initial crash. In the hours, days, even years after an accident of any severity, be on the lookout for the following symptoms.

• Changes in the ability to urinate or move the bowels, including blood in the urine or stool
• Coughing or vomiting blood
• Dizziness, weakness, or pale, wet skin could be symptomatic of severe internal bleeding and shock
• Leg weakness could indicate abdominal, lower back, or spinal nerve injuries
• Labored or painful breathing and chest or back pain may be associated with lung, heart, or vascular injuries
• Neck pain or stiffness, often resulting from whiplash

What Is Seat Belt Syndrome?

Seat belt syndrome is a medical term used to describe a unique collection of external and internal injuries caused by the impact of a seat belt during a car accident. Seat belt syndrome injuries include skin abrasions in a seat belt pattern, chest and shoulder fractures, shoulder tendon and muscle damage, and deeper internal injuries.

The challenge in diagnosing seat belt injuries early is due to the delayed onset of more severe symptoms. Despite initial stable vitals and minimal pain, the internal injuries—such as mesenteric tears or intestinal ischemia—can progress over time, as demonstrated in these cases. The presence of the seat belt sign significantly increases the likelihood of internal damage, even when initial scans are inconclusive. Delayed diagnosis can result in more extensive surgical intervention and complications, underscoring the importance of close monitoring and repeated imaging when seat belt injuries are suspected.

How Much Are Seat Belt Injuries Worth in a Lawsuit?

The settlement value of seat belt injuries in car accident lawsuits varies greatly depending on the type and severity of the damage caused by the seat belt. Minor seat belt injuries, such as skin abrasions, don’t require medical treatment and will typically have a settlement value in the $5,000 to $10,000 range.

Common skeletal injuries such as sternal, clavicle, or rib fractures are more serious and have average settlement values between $30,000 and $60,000. Soft tissue and visceral injuries can be more serious and therefore have a slightly higher average settlement value. The most serious seat belt injuries, such as vascular tears and spinal fractures have very high potential settlement values, are often worth more than $100,000.

How Much Can I Claim for Bruised Ribs in a Car Accident?

Insurance companies do not generally view bruised ribs as a significant injury, so they usually have a low settlement payout of under $10,000. Fractured ribs have a much higher settlement value.

Sample Seat Belt Injury Settlements and Verdicts

While the following list of seat belt related verdicts and settlement payouts may not be particularly useful for predicting the outcome of a future car accident case, they can help to paint a broader picture of how the severity of a seat belt injury, along with the jurisdiction and the extent of economic loss, can factor into victim compensation. Our website has information about the impact of the type of injury or type of accident and the settlement compensation you can expect.

• 2023, Texas, $917,874 Verdict. The plaintiff was traveling westbound on a highway when a vehicle driven by defendant exited a parking lot and struck his vehicle on the passenger side, causing it to flip over several times. The plaintiff suffered multiple fractured ribs from his seat belt during the rollover, as well as a fractured hip requiring replacement surgery.
• 2022, Washington, $64,641 Verdict. The defendant allegedly collided head on with the plaintiff after losing control of his vehicle and going into oncoming traffic. The plaintiff suffered a fractured sternum and lateral right fifth and sixth rib fractures (presumably from his seat belt). Verdict included $15,000 in medical expenses and around $40,000 for pain and suffering.
• 2022, Pennsylvania, $39,051 Arbitration. The plaintiff was a passenger in a vehicle that was rear-ended by the defendant. The plaintiff allegedly suffered fractured ribs on the right side and cervical, lumbar, and thoracic sprain and strain. Case was resolved in arbitration.
• 2021, Indiana, $140,000 Verdict. The plaintiff claimed to suffer four fractured ribs, a grade II liver laceration, and neck pain radiating down her right shoulder, when, while she was stopped a gas pump at a service station, an underinsured driver backed into her. She sought UIM benefits under her auto policy with Allstate.
• 2020, California, $50,000 Settlement. A woman was rear-ended by an intoxicated driver who fled the scene. Her son and daughter were passengers. She suffered soft-tissue back and neck injuries as well as headaches. She visited a chiropractor for three months. Her son suffered a right clavicle abrasion, approximately around his shoulder belt’s position during the accident. He also suffered headaches as well. The plaintiff’s daughter suffered a lip laceration and a soft-tissue neck injury. All three experienced emotional distress caused by the hit-and-run collision. The settlements totaled $50,000.
• 2019, Washington, $43,824 Arbitration Award. A woman was rear-ended while stopped and waiting for traffic. Her two-year-old twins were passengers. She suffered soft tissue left ankle and bank injuries as well as whiplash Her treatment consisted of chiropractic therapy and a massage therapist for six months after the accident. A massage therapist is never a great sign of a serious injury case in the experience of our car accident lawyers. Her twins who were in booster seats were shaken up and sustained neck welts. But, thankfully, they did not suffer serious injuries. The Arbitration Award totaled $43,824 for all three.
• 2019, Virginia, $962,000 Settlement. The defendant attempt a left-turn. Her vehicle struck the plaintiff’s vehicle, which went off-road and struck a traffic signal pole. The victim suffered fractures to her right heel, wrist, and ankle. Her belt also caused chest bruises and abrasions. She underwent open reduction surgery of her heel, consisting of screws and plate insertion. The plaintiff stayed in the hospital for ten additional days. She then underwent surgical removal of her plates and screws. Her wrist pain healed, but not her ankle pain. She would receive steroid injections to her ankle. The plaintiff also noted that she might need ankle surgery in the future to resolve her issues. The case settled for $962,000. Was the majority of this woman’s out-of-court settlement based on her chest injury from the belt? No. But it underscores that if you suffer a serious seat belt injury you probably suffered other significant injuries in the crash.
• 2019, Texas, $15,599 Verdict. The front-seat passenger suffered back, neck, and shoulder injuries after the defendant motorist struck her husband’s pickup truck. She did not go to the emergency department or seek any further medical care for five weeks. She then saw a chiropractor, complaining of shoulder, neck, and back pain. That is a long delay and it is likely a key reason why the jury’s verdict was as low as it was. She testified that suffered a shoulder bruise around where her shoulder seat belt was positioned. Her chiropractor diagnosed her with soft-tissue cervical, lumbar, and shoulder injuries. She underwent chiropractic and physical therapy for seven months. Her neck and shoulder pain resolved, but not her back pain. She then underwent steroid injections to her back. Her back pain resolved after two months. The jury awarded the plaintiff $15,599 in damages.
• 2019, Washington, $40,362 Arbitration Award The defendant struck the plaintiff’s vehicle as they were stopped behind traffic. The victim suffered a mild concussion and soft-tissue injuries to her neck, back, and ribs. She also suffered chest contusions and abrasions caused by her seatbelt. She sought treatment through her primary care physician, chiropractor, and massage therapist. The Arbitration Award totaled $40,362.
• 2019, Texas, $244,500 Verdict. The plaintiff broadsided a vehicle after she drove past a green light. She suffered disc tears and protrusions in her neck and back. The plaintiff also noted that one of her breast implants was damaged by her seat belt. She had been undergoing chiropractic adjustments for years before the accident, which she continued to do after the collision. The plaintiff underwent steroid injections to her neck as well. She also saw a plastic who recommended surgery to repair her breast implant. The plaintiff claimed that she can no longer ski or carry heavy items. She also noted that she cannot carry her grandchildren for extended periods. Her pain management doctor suggested a cervical rhizotomy and shoulder injections. Certainly a tough case given the prior history. But this accident lawyer did his job and the jury awarded $244,500.
• 2019, Virginia, $500,000 Verdict. A man’s SUV was rear-ended by the defendant. He initially claimed left shoulder and clavicle bruising caused by his seatbelt. He also suffered lower right-side bruising and tenderness. He did not seek medical attention and these injuries resolved about one month later. However, the plaintiff noticed floaters in his right eye, which he disregarded because he has experienced this about four years ago. He saw his ophthalmologist, who found nothing wrong. The plaintiff then viewed what he perceived to be a smudge in his right eye’s field of vision. He lost much of his right eye’s vision shortly after. His ophthalmologist then diagnosed him with a retinal detachment and tear. He underwent surgery, which resolved some of his vision. However, the plaintiff’s vision was permanently at 20/30, which was at 20/20 before the accident. He now experienced difficulty with viewing a computer screen while at work. He was also no longer able to ride a motorcycle. The jury awarded the plaintiff $500,000.
• 2019, Washington, $28,814 Verdict. A man’s pickup truck was rear-ended by the defendant. He suffered a head injury that suggested concussion. The plaintiff also suffered a soft-tissue neck, back, and thorax injuries. His seatbelt also caused blunt abdominal trauma and a mid-back contusion. The collision’s impact shattered his rear window, causing her to sustain cuts from shattered glass. The jury awarded $28,814 in damages.

Medical and Legal Aid

It is important to seek medical evaluation quickly after an accident, whether or not you were in pain at the crash scene. Many complications of seat belt syndrome, even if they don’t cause immediate pain, can become much more severe, even fatal, if not treated soon after the initial injury.

Car accident victims with bruises or lacerations from their seat belts should be tested for more serious internal injuries without exception. Patients with suspected chest trauma should expect to have a chest X-ray or a chest CT.

If your seat belt syndrome or other car accident injuries were caused by the negligence of another driver, call Miller & Zois at 800-553-8082 or get a free no obligation Internet consultation.

Sources:

• Seat Belt Injuries: Radiologic Findings and Clinical Correlation
• Seat Belt Injuries of the Spine and Abdomen
• Seat Belt Sign and Its Significance