How Pain and Suffering Is Valued in Missouri

After an accident, the hospital bill tells one story. The number on your paycheck stub tells another. But neither captures what it feels like to lie awake at night because your back will not stop burning, or to watch your kids play in the yard from a window because you cannot join them anymore.

Missouri law recognizes that these experiences — the pain, the limitations, the emotional weight — deserve compensation. But how does a jury put a dollar figure on something so personal? The answer lies in how you build and present the evidence of your suffering.

Missouri Does Not Use a Pain and Suffering Formula

Some states and insurance companies rely on multiplier formulas — take the medical bills, multiply by three or five, and call it a day. Missouri does not work that way. There is no statutory formula, no mathematical shortcut.

Instead, Missouri juries receive broad discretion to determine fair compensation based on the evidence they hear at trial. This means your pain and suffering award depends entirely on how effectively your story is told and documented.

This is both a risk and an opportunity. Without a formula, a poorly presented case might recover far less than it deserves. A well-documented case with compelling testimony can recover significantly more than any formula would suggest.

The Four Dimensions of Pain and Suffering

Missouri juries evaluate pain and suffering across four dimensions. Understanding each one helps you and your attorney build the strongest possible case.

Nature of the Pain

Not all pain is the same. A sharp, stabbing pain in your knee every time you climb stairs is different from a dull, constant ache across your lower back. Nerve pain that radiates down your leg feels different from the throbbing of a healing fracture.

Specificity matters. A jury understands "a burning sensation that starts at my lower back and shoots down to my left foot every time I stand for more than ten minutes" far better than "my back hurts." The more precisely you describe your pain, the more real it becomes to the people deciding your case.

Extent of the Pain

Extent measures how broadly the pain affects your body and your life. An injury to your dominant hand does not just affect your hand — it affects your ability to cook, write, dress yourself, hold your child, and do your job.

Missouri juries consider the ripple effects. A shoulder injury that prevents a carpenter from working also prevents him from maintaining his home, playing catch with his son, and sleeping through the night. Each of these consequences is part of the extent of his suffering.

Duration of the Pain

How long will the pain last? An injury that resolves in six weeks is valued differently from one that a doctor says will persist for the rest of your life.

Future pain carries enormous weight in damages calculations. If you are 35 years old and your doctor testifies that your chronic pain condition is permanent, the jury must consider decades of continued suffering. Medical testimony about prognosis becomes critical here.

Intensity of the Pain

A pain scale number alone does not tell the full story, but it provides a starting point. What matters more is how the pain manifests in your daily life. Can you sleep? Can you concentrate at work? Does the pain cause you to withdraw from social activities, lose your temper with your family, or avoid physical contact with your spouse?

The intensity of pain is best demonstrated through its consequences on your behavior and your relationships.

Evidence That Strengthens a Pain and Suffering Claim

Juries are skeptical by nature. They need evidence beyond your testimony alone. Here is what makes a pain and suffering claim compelling:

Medical records with detailed notes. Doctors who document your pain complaints, your functional limitations, and your emotional state create a contemporaneous record that carries significant weight. Ask your doctor to note how your injury affects your daily activities, not just your diagnosis.

A personal pain journal. Write down your pain levels, what triggers them, what you cannot do, and how you feel each day. Entries like "could not attend my daughter's school play because standing for 45 minutes causes my back to seize" are powerful evidence.

Testimony from family and friends. Your spouse can describe how you have changed since the injury. Your coworker can explain how you used to carry heavy equipment and now cannot lift a box of paper. Your friend can testify that you stopped coming to weekly dinners because sitting in a restaurant chair for an hour is too painful.

Photographs and video. Images of your injuries over time tell a visual story. Photographs of surgical scars, swelling, bruising, and assistive devices all document your physical reality.

Mental health records. If your injury has caused depression, anxiety, PTSD, or other psychological conditions, treatment records from a therapist or psychiatrist corroborate the emotional component of your suffering.

What Insurance Companies Argue to Reduce Pain and Suffering Awards

Insurance companies deploy predictable strategies to minimize non-economic damages:

"The gap in treatment proves the pain is not that bad." If you missed physical therapy appointments or waited weeks between doctor visits, an insurer will argue that your pain was not severe enough to warrant consistent treatment. Follow your treatment plan meticulously.

"Pre-existing conditions caused the pain." If you had any prior complaints about the same body part, expect the defense to attribute your pain to the pre-existing condition rather than the accident. Your doctor can help distinguish between old and new symptoms.

"Social media shows they are not suffering." A photograph of you smiling at a family gathering can be presented to suggest your pain is exaggerated. Adjusters and defense attorneys routinely review social media profiles. Be cautious about what you post during your case.

"There is no objective evidence of pain." Some injuries — soft tissue damage, nerve pain, chronic pain syndromes — do not always show up on imaging studies. Defense attorneys may argue that if it cannot be seen on an MRI, it does not exist. This is where detailed medical records, pain journals, and witness testimony become essential.

The Role of Expert Witnesses

In cases involving significant pain and suffering damages, expert witnesses play a critical role:

Treating physicians explain your diagnosis, the treatment you have received, and your prognosis. Their testimony connects your reported pain to an objective medical condition.

Pain management specialists can testify about the nature and expected duration of chronic pain conditions, the medications required to manage them, and the limitations those conditions impose.

Mental health professionals document the emotional and psychological impact of your injury — depression, anxiety, sleep disturbances, and changes in personality that your family has observed.

Life care planners outline the future medical care, therapy, and support services you will need, painting a picture of the long-term reality of living with your injury.

Why Settling Too Early Can Cost You

Insurance companies make early settlement offers for a reason: they want to close your claim before the full extent of your pain and suffering becomes clear. Many injuries worsen over time. A herniated disc that seems manageable at three months may require surgery at six months. A concussion that appeared minor may develop into persistent post-concussive syndrome.

Accepting an early settlement means giving up your right to seek additional compensation later, even if your condition deteriorates. Your attorney can help you understand when your medical condition has stabilized enough to accurately value your pain and suffering claim.

FAQ

Is there a cap on pain and suffering damages in Missouri?

Missouri does not impose a cap on non-economic damages in most personal injury cases. However, in medical malpractice cases, RSMo § 538.210 limits non-economic damages. For standard personal injury claims such as car accidents and premises liability, there is no statutory cap.

How do juries decide a specific dollar amount for pain and suffering?

Juries consider the totality of the evidence — medical records, testimony, photographs, and the injured person's description of how the injury has affected their life. There is no formula. The amount reflects the jury's collective judgment about what constitutes fair compensation.

Can I recover pain and suffering damages without going to trial?

Yes. The vast majority of personal injury cases settle before trial. However, the settlement value of your pain and suffering is influenced by what a jury would likely award if the case went to trial. Strong documentation and preparation for trial improve your settlement leverage.

What if my pain gets worse after I settle?

Once you accept a settlement and sign a release, you generally cannot reopen your claim, even if your condition worsens. This is why it is critical to wait until your medical condition has stabilized and to consult with an attorney before accepting any settlement offer.

Do I need a lawyer to recover pain and suffering damages?

You are not legally required to have a lawyer, but cases involving significant pain and suffering are substantially more complex than simple property damage claims. An experienced attorney understands how to document, present, and argue for the full value of your non-economic damages.

If you've been injured, you deserve someone who fights for you. Contact OTT Law at (314) 794-6900 for a free consultation.

This article is for informational purposes only and does not constitute legal advice. Every case is different. Contact OTT Law at (314) 794-6900 for a free consultation specific to your situation.