Pain and Suffering Damages: How They’re Calculated

Last reviewed: October 2026 · How we research: How We Research

Medical bills and lost paychecks come with receipts. Pain doesn’t. Yet in many injury claims, “pain and suffering” is the largest part of the compensation, sometimes several times larger than everything else combined. It is also the part most fought over, because there is no invoice to point to. This guide explains what pain and suffering covers, the two methods insurers and lawyers use to put a number on it, what makes the figure go up or down, and how to document your own experience so it is taken seriously.

What “pain and suffering” actually covers

Legally, pain and suffering is part of non-economic damages: losses that are real but don’t have a market price. Depending on the state and the case, it can include:

Pain and suffering sits alongside economic damages such as medical bills, lost wages and property damage. For the full list of what you can claim, see every type of damage you can claim.

The two ways pain and suffering is calculated

No law sets a formula. Juries are told to award a reasonable amount based on the evidence and their own judgment. In practice, though, most claims settle long before a jury sees them, and lawyers and insurance adjusters rely on two rough methods as a starting point.

1. The multiplier method

Add up the economic damages (mainly medical bills and lost income) and multiply by a number, usually between 1.5 and 5. A minor soft-tissue injury that heals in a few weeks sits at the low end. A serious injury with surgery, a long recovery or permanent effects sits at the high end. In rare, catastrophic cases the effective multiplier can be higher.

The weakness of this method is that it ties suffering to medical spending. Someone who had little treatment, perhaps because they couldn’t afford it, can end up with a low figure even if they suffered a great deal.

2. The per diem (per day) method

Assign a dollar amount to each day you lived with the injury, then multiply by the number of days until you reached maximum medical improvement. The daily figure is often based on your daily earnings, on the reasoning that living with the pain is at least as hard as a day’s work. This method is easy to explain, but it works poorly for permanent injuries, where there is no end date. Some states also limit when lawyers can argue per-day figures to a jury.

A worked example

Illustrative example. Maria breaks her wrist in a rear-end crash. She needs surgery with a plate and screws, misses six weeks of work, and recovers fully after about six months. Her medical bills are $16,000 and lost wages $4,000, so her economic damages total $20,000.

• Multiplier: surgery and a six-month recovery suggest a multiplier around 2 to 3. That gives $40,000 to $60,000 for pain and suffering.
• Per diem: 180 days at $150 a day, roughly her daily take-home pay, comes to $27,000.

The two methods give different answers, and that is normal. Her lawyer would likely open negotiations near the top of the range and support it with evidence of how the injury affected her daily life. The insurer would argue for the bottom. Try your own numbers below.

Pain and suffering calculator

To turn pain and suffering into a full settlement estimate, including fault, lawyer fees and liens, use our personal injury settlement calculator.

What pushes the number up or down

Many large insurers also use claims-evaluation software to score injuries based on diagnosis codes and treatment records. These programs rely heavily on what is written in your medical records, so if your doctor never noted that you couldn’t sleep or lift your child, the software may not count it.

How to prove pain and suffering

Because suffering is invisible, the claim depends on evidence that makes it visible. The strongest sources are:

1. Medical records. Tell every provider about your pain levels, sleep, mood and what you can’t do. If it isn’t in the chart, it’s harder to prove.
2. A pain journal. A short daily note is surprisingly powerful, because it records details you would otherwise forget by the time you negotiate.
3. Photos and video of injuries, casts, scars and equipment, taken over time.
4. Statements from people who know you: a spouse, friends or co-workers describing how you’ve changed.
5. Mental health treatment records, if you saw a counselor or psychologist after the accident.

State caps on pain and suffering

Most states don’t cap pain and suffering in ordinary injury cases such as car accidents. A minority do. Examples include Mississippi ($1 million in most civil cases), Tennessee ($750,000, or $1 million for catastrophic injuries), Colorado ($1.5 million for most claims arising from 2025) and Ohio, which limits non-economic damages in most tort cases unless the injury is permanent and severe. Several others, including Alaska, Idaho, Hawaii and Maryland, have general caps with their own formulas and exceptions.

Caps are more common in medical malpractice cases. See our guide to malpractice settlements and damage caps. In practice, the bigger limit in most car accident claims isn’t a cap at all but the at-fault driver’s insurance policy limit.

Is pain and suffering taxable?

Generally no, when it comes from a physical injury or physical sickness. Under Internal Revenue Code section 104(a)(2), compensation for physical injuries, including the pain and suffering that goes with them, is excluded from federal income tax. Emotional distress damages without a physical injury are generally taxable, except to the extent of medical costs for treating it. Punitive damages and interest are taxable. Ask a tax professional about your settlement.

Frequently asked questions

Can I get pain and suffering without a lawyer?

Yes, for small claims you can negotiate it yourself. But adjusters know that unrepresented claimants rarely push back on non-economic damages, and this is where the gap between represented and unrepresented outcomes is usually widest. See whether a lawyer is worth the cost.

Does pain and suffering apply in no-fault states?

In no-fault states, your own personal injury protection (PIP) coverage pays medical bills and lost wages but not pain and suffering. You can usually claim pain and suffering from the at-fault driver only if your injury passes a threshold, such as a serious or permanent injury, or medical bills above a set amount, depending on the state.

Does shared fault reduce pain and suffering?

Yes. In comparative fault states, your total damages, including pain and suffering, are reduced by your share of the fault. In the few states with contributory negligence, any fault can bar recovery entirely.

Sources

• Cornell Law School, Legal Information Institute: Pain and suffering
• 26 U.S. Code § 104, Compensation for injuries or sickness
• IRS Publication 4345, Settlements: Taxability
• Ohio Revised Code § 2315.18

This guide is general information, not legal or tax advice. Calculator results are illustrations based on common negotiation methods and do not predict any outcome. Damage rules and caps vary by state and change over time; consult a personal injury lawyer licensed in your state.