Does Surgery Increase Workers’ Comp Settlement

Understanding the  Potential Impact of Surgery on Workers’ Compensation Settlements

Below, we share some insights into specific circumstances in which surgery might affect workers’ compensation settlements and how our dedicated team can help drive beneficial settlement negotiations.

What Is Workers Compensation?

Workers’ comp in Georgia is a state-mandated program that provides monetary benefits to employees who suffer work-related injuries or illnesses. The system is designed to ensure that injured employees receive prompt medical care and financial support without the need for lengthy litigation.

Through workers’ compensation insurance, injured workers can get financial compensation that covers

• Medical expenses
• Rehabilitation costs
• Lost wages 
• Permanent disabilities
• Death benefits (in the case of a fatal workplace incident).

Injured workers generally receive workers’ compensation benefits at legally approved intervals, but sometimes, they may receive lump sum settlements that cover their current and future needs/expenses. This article is written from the perspective of such settlements.

How Surgery May Influence Workers’ Compensation Settlement 

In the aftermath of a work injury, the injured worker may require surgery as part of their medical treatment.

Surgery is a complex medical procedure that can increase medical care costs. It can also lead to other health implications. But will this translate to an increase in the injured worker’s eventual settlement? That may depend on several factors, including the following:

If the  Surgery Already Occurred

If the surgery has already occurred before filing the workers’ compensation claim, it will likely be considered when determining the final compensation amount. The fact that it was speedily done might be used to indicate that the surgery was critical to the worker’s recovery. 

Remember that for medical treatment to be covered by workers’ compensation, it must be handled by an authorized physician. So unless your surgery (if you’ve already had it) was handled by such a physician (in which case your employer’s insurance company would have already paid for it), you might not be able to recover compensation for the surgery unless it was done in an emergency.

But, if the surgery has not yet occurred, the insurance company might question the necessity of the surgery and whether an alternative treatment plan would yield similar results. If the surgery is only a recommendation, it is unlikely to impact the proposed settlement.

The Type of Surgery 

While surgery can be a lifesaver, it could also lead to permanent disability or long-term rehabilitation, depending on its nature. For example, an injured worker who has to have a part of their limbs amputated might be unable to work or might need a different kind of job role after recovery.

Therefore, before a settlement where surgery is a factor, it is important to determine whether the surgery would likely lead to a full recovery or result in long-term restrictions and physical therapy needs. In the latter case, the impact of the surgery on the injured worker’s ability to work and earn a living and the need for ongoing medical regal might be considered and could lead to an increased settlement.

In a nutshell, surgery can lead to an increased settlement if it is necessary and leads to prolonged recovery periods or permanent disability. In such cases, the worker’s average weekly wage and potential future earnings should be calculated when reaching a settlement. This holistic approach ensures that all potential expenses are covered, providing comprehensive disability benefits for the injured worker.

The Importance of Medical Evidence and Documentation

Supporting Claims for Benefits

Detailed medical records are essential for calculating the benefits owed to the injured worker. This includes temporary disability benefits during recovery, permanent disability benefits if the surgery results in lasting impairment, and compensation for any additional medical treatments required post-surgery.

Monitoring Recover and Rehabilitation 

Post-surgery, detailed medical documentation is essential for tracking the worker’s recovery progress and any possible complications. This ensures that the worker receives appropriate follow-up care and rehabilitation, which is crucial for a successful return to work or for determining further compensation if the worker cannot return to their previous job.

Evidence in Legal Proceedings

In cases where a workers’ compensation claim is disputed or requires litigation, thorough medical documentation serves as critical evidence. Detailed records from healthcare providers can substantiate the claim and support the injured worker’s case in court or during settlement negotiations.

However, having these medical documents is not enough; you also need to know how to use them effectively to get the maximum compensation possible. This is where having legal assistance becomes critical.

Negotiating Your Workers’ Compensation Settlement: How The Dressie Law Firm, LLC Can Help

Negotiations for a workers’ compensation settlement can be complex. Knowing the right tactics and details can significantly affect your final settlement amount.

When negotiating, it’s crucial to highlight the impact of the surgery on your wages. Multiple surgeries and extended recovery periods can lead to more significant wage losses, which should be factored into the settlement. Future medical care costs are essential to consider.

At The Dressie Law Firm, LLC, we understand that a lump sum settlement must take all these factors into account to be beneficial, especially when surgery is involved. We can represent you throughout the negotiation process and fight to ensure that any settlement reached covers all aspects of your needs.

With our experience in personal injury and workers’ compensation claims, we can assist you in gathering and presenting medical evidence that strengthens your claim. Surgical procedures often signal severe injuries, which can significantly impact your settlement. In such instances, we can also ensure that the crucial information is properly documented and submitted to the workers’ compensation insurer.

Our goal, in any case, is to help maximize our clients’ compensation. So whether you’re dealing with catastrophic injuries such as traumatic brain injury, scarring, permanent disability, or less severe injuries, you can trust us to advocate fiercely on your behalf using our knowledge of how employers and insurance companies operate to your advantage.

We know that enduring a surgical procedure can be life-altering, and we strive to secure the support you need for your rehabilitation and future well-being.

Contact us today for more guidance on how surgery could influence your claim and future care needs.  Let us help you understand your rights and options and determine the best way forward.