Damages Estimate Worksheet

When you suffer injuries that you believe are the fault of another party (or parties), you may file a claim for "damages." In legal terms, damages are the costs associated with an injury. They are claimed when filing a lawsuit. If the defendant is found liable for your injuries, then you will be awarded damages. Many personal injury attorneys work on a contingency basis, which means they don't get paid unless you win your case and are awarded damages.

Damages are not always easy to calculate. In many cases, your attorney will be able to point out additional damages that are indirectly related to the claim. Examples of what would qualify as additional damages are the costs associated with travel to physical therapy clinics, and loss of wages. Also, you may require long-term or even lifelong medical assistance stemming from the injury. See Economic Recovery for Accidents and Injuries for a more complete list with detailed explanations. You could also review FindLaw's Injury Damages section for more articles and resources.

The following worksheet is intended to help you see how damages include easily identifiable costs in an effort to place a dollar value on your physical person and the way in which your life has changed since you were injured. Beyond an inventory of known costs, it does not attempt to calculate the value of your physical self or the quality of your life as it was before the injury.

This worksheet should give you a general idea of the damages involved in your case. But to get a complete understanding of the strength of your claim and damages involved, you should consult a lawyer. Fortunately, you can do so by contacting an experienced personal injury attorney for a free claim evaluation.

Damages Estimate Worksheet

I. Out-of-Pocket Damages (also known as “Special Damages")

Damages Present Amount Spent or in Case (U) Estimated:

• Doctors' bills _____________ $_________________
• Ambulance bill _____________ $_________________
• Hospital bills _____________ $_________________
• Private nurses _____________ $_________________
• Medicines/Drugs _____________ $_________________
• Medical supplies _____________ $_________________
• Travel/lodging arising from need for medical treatment _____________ $_________________
• Wheelchairs, walkers, prostheses, handicapped-accessible vehicle, other special implements _____________ $_________________
• Future medical expenses _____________ $_________________
• TOTAL MEDICAL DAMAGES $_________________
• Household help _____________ $_________________Lost wages _____________ $_________________
• Other work losses _____________ $_________________
• Future losses _____________ $_________________
• Loss of earning capacity _____________ $_________________
• Increased cost of living _____________ $_________________
• Special training/occupational therapy _____________ $_________________
• Property damage _____________ $_________________
• TOTAL OUT-OF-POCKET DAMAGES $_________________

To get a sense of how an insurance company might value your case, make the following calculations:

• Method No. 1: Multiply your total by three (3) $________________
• Method No. 2: Multiply your “medical" damages by five (5) $________________

II. Damages for Physical Injury

Check all that apply, then rate the severity of each checked injury on a scale of 1 (not serious) to 5 (catastrophic). Don't worry about dollar amounts for these items:

General Damages for Physical Injury

• Pain and suffering _____________ 1 2 3 4 5
• Future pain and suffering _____________ 1 2 3 4 5
• Total disability _____________ 1 2 3 4 5
• Partial disability _____________ 1 2 3 4 5
• Future disability _____________ 1 2 3 4 5
• Loss of enjoyment of life _____________ 1 2 3 4 5
• Your spouse's loss of your services _____________ 1 2 3 4 5

Damages for Lost Limbs

Again, check all that apply, then rate the severity of each checked injury on a scale of 1 (not serious) to 5 (catastrophic). Again, don't worry about dollar amounts for these items:

• Dominant hand/arm _____________ 1 2 3 4 5
• Nondominant hand/arm _____________ 1 2 3 4 5
• Foot _____________ 1 2 3 4 5
• Leg below knee _____________ 1 2 3 4 5
• Leg mid-thigh _____________ 1 2 3 4 5
• Leg at hip _____________ 1 2 3 4 5

Damages for Lost Organs

Again, check all that apply, then rate the severity of each checked injury on a scale of 1 (not serious) to 5 (catastrophic). Again, don't worry about dollar amounts for these items:

• Kidney _____________ 1 2 3 4 5
• Lung _____________ 1 2 3 4 5 
• Back/Neck injury _____________ 1 2 3 4 5
• Head injury/brain damage _____________ 1 2 3 4 5
• Other: _________________ _____________ 1 2 3 4 5

III. Intangibles--How Your Life Has Changed

The following questions are intended to help you get a feel for the kinds of facts that a jury may consider when deciding what to award in damages:

• Which of your injuries are visible? Which are invisible?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
• What physical pain did you experience when you were first injured?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
• What physical pain did you experience as you recovered from your injury?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
• Do you still feel physical pain from your injury? _______Yes _______No
• If you answered “Yes" to Question 5, please elaborate. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

6. When you think about your injury and how it has affected you, what/how do you feel?(check all that apply)?

• Sorrow _______
• Anxiety _______
• Humiliation _______
• Anger _______
• Fear _______
• Frustration _______
• Defeated _______
• Resigned _______
• Other _______

7. What physical activities and hobbies did you enjoy that now cause you pain?

• Participating in sports _______ 
  • If so, which sport(s)?________________________
• Gardening _______
• Woodworking/Crafts _______
• Sewing/Embroidery/Needlework _______
• Playing a musical instrument _______ 
  • If so, which instrument(s)?_____________________
• Playing with children _______
• Cooking _______
• Other _______

8. What household chores now cause you pain?

• Cooking _______
• Laundry _______
• Cleaning _______
• Ironing _______
• Washing the car _______
• Yard work/Snow removal _______

9. What social activities have you had to reduce or abandon? 

• Entertaining guests _______
• Club activities _______
• Charitable/social organizations _______
• Dancing _______
• Concerts/plays _______
• Going to museums _______
• Going out with friends _______

10. Are you still able to help people when they need help? For example, can you still babysit your grandchildren? Can you still visit people from your church, temple, or mosque who were sick and unable to attend services? Take a few minutes to think about this question and then write a little bit about these sorts of changes:

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

11. What plans for the future have you had to modify or abandon?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

12. Are there any other changes in your day-to-day life resulting from your injury?______________________________________________________________________________________________________________________________________

Learn More About Your Claim by Contacting an Attorney

Putting a dollar amount on your injuries is not as simple as adding up your medical care receipts. Injuries typically affect both your life and finances in direct and indirect ways as well. To be sure you're able to harness the law to your advantage, contact an experienced personal injury attorney to learn more about your claim.