Disc Bulge vs. Herniated Disc at L4-L5 and L5-S1: Illinois Workers’ Compensation Guide for Sciatica, Injections, and Back Surgery
A disc bulge or herniated disc at L4-L5 or L5-S1 is one of the most common and most heavily disputed injuries in Illinois workers’ compensation cases. These lumbar spine injuries often cause sciatica, nerve compression, radiculopathy, numbness, weakness, and lifting restrictions that prevent injured workers from returning to physically demanding jobs like construction, nursing, warehouse work, delivery driving, factory work, and baggage handling. Depending on severity, treatment may range from physical therapy and epidural steroid injections to lumbar microdiscectomy surgery, laminectomy, spinal fusion, or even a spinal cord stimulator. Under Illinois workers’ compensation law, injured workers may be entitled to medical care, TTD benefits, permanent disability compensation, and future medical coverage — but insurance companies frequently argue that the condition is “degenerative” or “just a strain.” No two back injury cases are the same, and disc injuries are never one-size-fits-all.
If you want a deeper breakdown of settlement value and case variables, read our guide on Illinois back injury settlements here:
https://mcharguelaw.com/workers-compensation/how-much-is-a-back-injury-worth-in-an-illinois-workers-compensation-case/
How Disc Bulges and Herniated Discs Happen at Work
Most lumbar spine injuries happen because the job requires repetitive physical stress. Many workers can pinpoint the exact moment they felt the injury. Others develop worsening pain over time.
Common work-related causes of disc bulges and herniated discs include:
• Lifting heavy objects improperly
• Twisting while carrying weight
• Repetitive bending or squatting
• Pushing or pulling carts or pallets
• Sudden jerking motions
• Falls from ladders or scaffolding
• Slip-and-fall accidents
• Loading trucks, packages, or baggage
• Lifting or repositioning patients
These injuries are extremely common in workers such as:
Construction workers:
https://mcharguelaw.com/workers-we-represent/construction-workers/
Factory and industrial workers:
https://mcharguelaw.com/workers-we-represent/factory-workers/
Delivery drivers (Amazon, UPS, FedEx, and others):
https://mcharguelaw.com/workers-we-represent/delivery-drivers/
Nurses and healthcare workers lifting patients:
https://mcharguelaw.com/workers-we-represent/nurse-healthcare-workers-compensation-lawyers/
Airline and airport employees handling luggage:
https://mcharguelaw.com/workers-we-represent/airline-airport-employees/
Disc Bulge vs. Herniated Disc: What’s the Difference?
In a workers’ comp case, the language on your MRI matters.
A disc bulge means the disc is protruding outward beyond its normal boundary. The outer layer is usually intact.
A herniated disc (also called disc extrusion or disc protrusion) means disc material has pushed through the outer layer and may compress nearby nerves.
Both conditions can cause serious symptoms, including:
• Sciatica (pain radiating down the leg)
• Burning or shooting pain
• Numbness or tingling in the legs or feet
• Weakness (foot drop in severe cases)
• Pain when standing, walking, or sitting
• Loss of ability to lift, bend, or twist safely
A key point: a “disc bulge” can still be disabling if it is pressing on a nerve root.
Why L4-L5 and L5-S1 Injuries Are So Common
L4-L5 and L5-S1 are the two most common lumbar levels involved in Illinois workers’ compensation claims.
That is because these levels absorb a huge amount of stress from:
• lifting
• twisting
• bending
• prolonged standing
• repetitive motion work
Many workers experience pain in the low back that spreads into the buttock, thigh, calf, or foot. That pattern often signals radiculopathy or sciatica caused by disc involvement.
Back Injuries Can Be Repetitive Trauma (Even Without One Accident)
A major mistake workers make is assuming they do not have a claim because there was no single accident.
Illinois workers’ compensation law allows claims for repetitive trauma injuries, including disc bulges and herniations caused by years of lifting, bending, and twisting.
This is especially common in construction, factory, nursing, delivery, and airport baggage jobs.
If your back pain gradually worsened over time, you may still have a valid case. Learn more here:
https://mcharguelaw.com/workers-compensation/how-do-you-prove-a-repetitive-trauma-injury-in-illinois-workers-comp/
You can also read our guide on cumulative injuries here:
https://mcharguelaw.com/workers-compensation/what-are-cumulative-injuries/
Common Symptoms of a Herniated Disc or Disc Bulge With Sciatica
A disc injury can feel very different from a simple strain.
Signs that your back injury may involve L4-L5 or L5-S1 disc problems include:
• pain that radiates down the leg (sciatica)
• numbness or tingling in the foot
• weakness climbing stairs or walking
• inability to sit for long periods
• symptoms that worsen with bending forward
• pain when coughing or sneezing
• muscle spasms and guarding
• reduced range of motion
If you have progressive weakness or loss of bowel/bladder control, seek emergency treatment immediately. These symptoms can indicate serious nerve compression.
Treatment Options: PT, Epidural Injections, and Surgery
Workers’ compensation back injury cases usually follow a predictable treatment progression.
However, not all workers respond the same way. Some recover fully. Others develop chronic pain and instability.
Physical Therapy and Conservative Treatment
Many disc bulges improve with:
• physical therapy
• stretching and strengthening
• anti-inflammatory medication
• modified work restrictions
• time off work
If symptoms resolve, the case may still have value depending on lost wages and restrictions — but the claim is usually less severe than a surgical case.
Epidural Steroid Injections (ESIs)
Epidural injections are common when symptoms persist after PT.
Insurance companies often fight injections because they are expensive and can be repeated over time.
Some workers get significant relief. Others only get temporary improvement, leading to surgery recommendations.
Microdiscectomy Surgery
A lumbar microdiscectomy is commonly performed for herniated discs causing radiculopathy.
It is often recommended when:
• leg pain does not improve
• weakness is worsening
• conservative treatment fails
Many workers do well after a microdiscectomy. But sometimes symptoms return due to re-herniation or instability.
Laminectomy Surgery
A laminectomy removes part of the vertebral bone to relieve pressure on nerves. It is often used in stenosis cases or complex disc compression cases.
Lumbar Fusion Surgery
A fusion is one of the most serious lumbar spine surgeries. It is usually performed when:
• the spine becomes unstable
• discs collapse or degenerate
• multiple surgeries fail
• chronic radiculopathy persists
• there is spondylolisthesis or instability
Fusion cases often involve permanent restrictions and future medical concerns, which can significantly impact settlement value.
Spinal Cord Stimulator
In some severe cases, workers experience persistent pain even after surgery. A spinal cord stimulator may be recommended for chronic nerve pain.
This can dramatically increase the long-term value and complexity of a case.
What If the First Surgery Fails? (Failed Back Surgery Syndrome)
Unfortunately, some injured workers experience failed back surgery syndrome, where pain continues even after a microdiscectomy or laminectomy.
In some cases:
• scar tissue forms
• nerve pain persists
• instability develops
• a second surgery becomes necessary
• fusion becomes the next step
A back injury that begins as a “disc bulge” can evolve into a lifelong condition if complications arise.
Does Surgery Increase a Workers’ Comp Settlement in Illinois?
In many cases, yes.
Surgery often increases settlement value because it creates:
• permanent impairment
• permanent restrictions
• higher future medical risk
• long-term work limitations
• wage loss exposure
However, surgery alone does not automatically guarantee a high settlement. The insurance company will still analyze:
• your wages (average weekly wage)
• job demands
• ability to return to work
• permanent restrictions
• future medical needs
• credibility and medical documentation
We explain this in detail here:
https://mcharguelaw.com/workers-compensation/does-surgery-increase-the-value-of-my-workers-comp-case-in-illinois/
Future Medical Concerns: Why Disc Injury Cases Should Not Settle Too Fast
Disc injuries are not like broken bones. Even if pain improves, many workers face future medical risks.
Common future medical concerns include:
• recurring sciatica
• repeat epidural injections
• worsening degenerative disc disease
• adjacent segment breakdown after fusion
• permanent lifting restrictions
• flare-ups requiring new treatment
• spinal instability over time
This is why many back injury cases should not settle quickly, especially when surgery has been recommended or injections are ongoing.
Light Duty Work and Back Injury Restrictions
After a disc injury, most doctors place injured workers on restrictions such as:
• no lifting over 10–20 pounds
• no repetitive bending or twisting
• no prolonged standing
• limited walking
• no climbing ladders
• sit/stand as tolerated
These restrictions often eliminate a worker’s ability to return to construction, factory work, delivery driving, or nursing.
If your employer offers “light duty,” you need to be careful. Some employers pressure workers into tasks that violate restrictions, which can worsen the injury.
Read our complete guide to Illinois workers’ comp light duty rules here:
https://mcharguelaw.com/workers-compensation/light-duty-work-in-illinois-workers-compensation-a-complete-legal-guide/
Functional Capacity Evaluations (FCEs) and Permanent Restrictions
Many serious back injury cases involve an FCE, which is designed to measure what you can safely do.
FCE results often become critical evidence in:
• permanent restrictions
• wage differential cases
• settlement negotiations
• trial
Learn how permanent restrictions impact your case here:
https://mcharguelaw.com/workers-compensation/how-fces-and-permanent-restrictions-affect-workers-compensation-settlements-in-illinois/
Independent Medical Exams (IMEs): The “Back Strain” Trick
Insurance companies frequently send injured workers to an IME doctor.
A common IME tactic is to downplay a disc injury by calling it:
• “lumbar strain”
• “degenerative disc disease”
• “pre-existing condition”
• “age-related changes”
Even if your MRI shows an L4-L5 or L5-S1 herniation, the IME doctor may claim it is unrelated to work.
We have taken cases to trial where the IME said “strain only,” and we won surgery approval.
Learn more about IMEs and how they are used against injured workers here:
https://mcharguelaw.com/workers-compensation/imes-in-illinois-workers-compensation-what-injured-workers-need-to-know/
What If Workers’ Comp Denies My Injections or Back Surgery?
Denials are extremely common in disc injury cases because injections and surgery are expensive.
Common denial arguments include:
• “You have degenerative disc disease.”
• “The MRI shows pre-existing changes.”
• “You can return to work without surgery.”
• “Your symptoms are exaggerated.”
• “Your injury is unrelated to work.”
If surgery is denied, you may still be able to fight it through litigation, medical evidence, and trial.
Read our guide here:
https://mcharguelaw.com/workers-compensation/workers-comp-denied-my-surgery-in-illinois-what-to-do-next-fast/
What Benefits Can You Receive for a Disc Bulge or Herniated Disc?
Illinois workers’ compensation benefits for a back injury may include:
• medical treatment (MRI, PT, injections, surgery)
• Temporary Total Disability (TTD) benefits
• Temporary Partial Disability (TPD) benefits
• permanent disability benefits
• wage differential benefits
• vocational rehabilitation benefits
You can read about the full range of benefit types here:
https://mcharguelaw.com/workers-compensation/types-of-workers-comp-benefits-in-illinois/
For a breakdown of how weekly checks are calculated (TTD, TPD, maintenance), read this guide:
https://mcharguelaw.com/workers-compensation/how-much-does-workers-comp-pay-in-illinois-ttd-tpd-maintenance-aww-explained-2025-guide/
How Much Is a Disc Bulge or Herniated Disc Settlement Worth in Illinois?
There is no single “average” settlement value for a disc bulge or herniated disc at L4-L5 or L5-S1.
However, back injury settlements in Illinois tend to follow a general reality:
• mild disc bulges treated conservatively may resolve in the mid five figures
• herniated discs with radiculopathy requiring injections often resolve higher
• surgical cases involving microdiscectomy or laminectomy can reach high five figures or more
• fusion cases with permanent restrictions, wage loss, or inability to return to work often reach six figures and beyond
The biggest settlement drivers are:
• your wages
• job duties
• permanent restrictions
• whether surgery was required
• future medical exposure
• credibility and medical support
For a full breakdown, read our Illinois back injury settlement guide here:
https://mcharguelaw.com/workers-compensation/how-much-is-a-back-injury-worth-in-an-illinois-workers-compensation-case/
You can also review our Illinois settlement chart overview here:
https://mcharguelaw.com/workers-compensation/illinois-workers-comp-settlement-chart-how-much-is-your-case-worth/
External Resource: Overview of Back Injuries in Illinois Workers’ Compensation
For additional perspective on back injury claims and how insurers often dispute them, you can also review this Illinois workers’ compensation overview article here:
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Why You Should Speak With a Lawyer About a Disc Injury Claim
Disc injury cases are some of the most complex workers’ compensation claims in Illinois because they often involve:
• repetitive trauma disputes
• degenerative disc disease defenses
• IMEs minimizing the injury
• denied injections or surgery
• permanent restrictions
• light duty conflicts
• future medical risk
• wage differential exposure
A worker may have a sprain with a small bulge that resolves. Another worker may have a herniated disc with radiculopathy that progresses to injections, surgery, and permanent disability. Some workers have a microdiscectomy that fails and later require fusion or spinal cord stimulator treatment.
Because the range of outcomes is so wide, you should talk with an experienced workers’ compensation attorney before accepting a settlement or returning to work too soon.
FAQ: Disc Bulge, Herniated Disc, and Sciatica Workers’ Comp Claims in Illinois
Does Illinois workers’ compensation cover a disc bulge?
Yes. Illinois workers’ compensation covers a disc bulge if your job caused it or aggravated it. Even if you had degenerative disc disease before, you may still qualify for benefits if work activities contributed to the condition.
Does Illinois workers’ compensation cover a herniated disc at L4-L5 or L5-S1?
Yes. A herniated disc at L4-L5 or L5-S1 is one of the most common lumbar spine injuries in Illinois workers’ compensation claims. Benefits may include medical treatment, wage loss benefits, and permanent disability compensation.
What is sciatica in a workers’ comp case?
Sciatica is radiating pain that travels from the low back into the buttock, leg, or foot. In Illinois workers’ compensation cases, sciatica is often caused by a disc bulge or herniated disc compressing a nerve root.
What is the difference between a disc bulge and a herniated disc?
A disc bulge is when the disc protrudes outward but the outer wall remains intact. A herniated disc occurs when disc material pushes through the outer layer, often causing more severe nerve compression and sciatica symptoms.
What is the average settlement for a herniated disc in Illinois workers’ comp?
There is no true “average” settlement. Illinois herniated disc settlements depend on treatment, surgery, restrictions, wages, and future medical needs. Conservative cases may resolve lower, while surgical cases involving fusion or permanent restrictions can reach six figures or more.
Can repetitive lifting cause a herniated disc at work?
Yes. Repetitive lifting, bending, and twisting can cause or worsen disc injuries. Illinois law recognizes repetitive trauma workers’ compensation claims even without one specific accident.
Do epidural steroid injections increase settlement value?
Often, yes. Epidural steroid injections can increase settlement value because they indicate a more serious disc injury and increase future medical exposure. However, the impact depends on whether symptoms improve and whether permanent restrictions remain.
Does a microdiscectomy increase the value of a workers’ comp case?
Yes, in many cases. A microdiscectomy is a surgical procedure and typically increases the value of a workers’ compensation case because it reflects significant injury, impairment, and future medical risk.
Does lumbar fusion surgery increase settlement value?
Yes. Lumbar fusion is a major surgery and often results in permanent restrictions and long-term medical concerns. Fusion cases frequently have higher settlement values because the injury can permanently limit a worker’s ability to return to heavy labor.
What if workers’ comp denies my back surgery?
Surgery denials are common in Illinois workers’ compensation cases. You may still be able to challenge the denial through litigation, medical evidence, and hearings before the Illinois Workers’ Compensation Commission.
What is an IME and why do they call it a strain?
An IME is an Independent Medical Examination arranged by the insurance company. IME doctors often minimize disc injuries by labeling them as a “lumbar strain” or blaming them on degenerative disc disease to justify denying injections, surgery, or disability benefits.
Can I work light duty with a disc bulge or herniated disc?
Sometimes. Many workers can return on restrictions, but heavy labor jobs often cannot be safely performed with disc injury limitations. If your employer cannot accommodate restrictions, you may be entitled to benefits.
Should I talk to a lawyer about a disc bulge or herniated disc claim?
Yes. Disc injury claims are often disputed, involve IMEs, denied surgery, permanent restrictions, and future medical exposure. Speaking with an experienced Illinois workers’ compensation lawyer can help protect your medical care and maximize your benefits.
