Average Workers Comp Settlement For Surgery

If you have suffered an injury at work requiring surgery, you may wonder how this will affect the settlement you receive through workers’ compensation. 

The average workers’ comp settlement amount can vary greatly depending on the type of injury, the severity of the surgery, and other factors. 

This guide will provide an overview of how surgery can impact your workers’ comp settlement, what you need to know to get fair compensation for your claim, and how you can get help from a qualified attorney like those at O’Connor Law.

How Does Needing Surgery Affect Your Workers’ Comp Settlement Amount?

Requiring surgery for a workplace injury or illness will likely increase the settlement value of your workers’ compensation claim. Surgeries, especially major operations, can significantly add to an injured worker’s medical expenses and recovery time. 

This means the insurance company will likely have to pay out more in disability benefits, lost wages, and medical care.

Some factors that determine how much surgery will increase your settlement include:

• The severity of the surgery – More complex, risky, and invasive surgeries that require extended hospitalization and recovery periods will result in higher settlements than minor outpatient procedures. Spinal fusion surgery, for example, would likely lead to a larger payout than carpal tunnel surgery.
• Multiple surgeries – Needing more than one surgery can also increase the value of your claim. Additional operations mean added medical costs and time off work.
• Your average weekly wage – Higher earners get larger settlements to account for their lost income. If surgery causes you to miss substantial work time, your average weekly wage will be used to calculate the lost earnings portion of your payout.
• Permanent disability – If surgery results in decreased functionality or permanent impairment, you can claim additional compensation on top of medical expenses and lost wages. The more disability caused, the higher the settlement.

While every claim is different, requiring major surgery could potentially double or triple your settlement amount compared to similar injuries that don’t need surgery. An experienced workers’ compensation attorney can help determine how your specific surgery may impact your payout.

What Should Your Workers’ Comp Settlement Cover After Surgery?

There are a few main categories of compensation your workers’ comp settlement should provide for after undergoing surgery:

• Medical expenses include surgical costs, hospital fees, physical therapy, medications, assistive devices like crutches, and any other medical care required for treatment and recovery. Both past and estimated future expenses should be covered.
• Lost wages – Any income you lost from missing work due to the injury, surgery, and recovery period should be replaced through the settlement. Calculations are based on your average weekly wage.
• Disability benefits – If surgery results in permanent partial or total disability that affects your earning capacity, you can claim benefits in addition to medical and wage reimbursement. The exact amount depends on the severity of a disability.
• Vocational rehabilitation – In some cases, surgery may mean you cannot return to your old job. Vocational retraining can help you transition to a new career and should be included in a fair settlement.
• Pain and suffering – Although less common, some states do allow injured workers to claim additional damages for pain, mental distress, loss of enjoyment of life, and other hardships caused by a severe work injury requiring surgery. This is something your attorney can help you pursue.

Thoroughly documenting all costs and losses associated with your surgery will help when negotiating your settlement. Be sure to account for both past and potential future expenses and losses to protect yourself.

What is the Average Workers Comp Settlement?

While settlements are tailored to each specific claim, looking at average payout data can provide a general idea of what to expect. According to a recent report, the overall average workers’ compensation settlement amount is $21,800. However, settlements can range from a few thousand dollars to millions for catastrophic injuries resulting in permanent total disability.

Some additional statistics on average settlements include:

• Minor soft tissue back injuries – $3,500
• Major back injuries involving surgery – $77,000
• Shoulder injuries – $16,600
• Severe burns – $878,900
• Leg amputations – $97,200
• Permanent total disability – $718,400

Remember, your particular settlement amount will depend on your injuries, treatment, prognosis, lost wages, and state laws. Don’t rely on averages alone when deciding whether to accept an offer. Evaluate your own claim circumstances with the help of an attorney.

$12 million workers comp settlement for employee injured by a state trooper (New York) 

In 2021, George Cole, along with four coworkers, was riding a minivan on the New York State Thruway when the rear of their vehicle was struck by a New York State Trooper’s car. Cole suffered severe injuries, which left him paralyzed from the waist down. 

During the investigation, it was found that the state trooper was sending and receiving text messages while driving and even opened a Facebook page moments before the impact. The trooper was also not responding to an emergency at the time of the crash. The case was due to go to trial, but a few days before it began, Cole received a settlement agreement worth $12 million. 

Factors That Determine Your Workers’ Comp Settlement Amount

As discussed, surgery is just one factor impacting your potential workers’ comp settlement. Some other key considerations include:

• Type and location of injury – Back and shoulder injuries often result in higher settlements than arm and hand injuries since they cause more lost time. Injuries requiring surgery typically lead to larger payouts as well. Your attorney can use your state’s injury benefit chart to estimate settlement ranges.
• Severity and permanence – More severe, disabling, and permanent injuries warrant higher settlements for long-term effects on your earning capacity and quality of life. Scarring and disfigurement may also increase payouts.
• At-fault party – Some states allow you to claim additional damages from third parties responsible for your injury. However, you usually can’t sue your direct employer.
• Experience and skill of your attorney – A workers’ compensation lawyer well-versed in workers’ compensation can maximize your settlement by thoroughly documenting losses and negotiating aggressively.

While you can look to average settlement data for a general gauge, every case has unique factors that impact value. An attorney experienced in workers’ comp cases can consider all your specifics when pursuing the maximum settlement.

Can You Get a Settlement Before Surgery?

In some cases, you may be able to get a workers’ comp settlement before undergoing a recommended surgery. There are a few potential reasons to seek early settlement:

• You need money upfront to cover initial medical costs and lost wages.
• You want to use the funds to pay for surgery and recovery expenses.
• You need closure on the incident and want to move on.
• You have concerns about risks or complications from surgery.

However, settling before surgery can be risky if your condition deteriorates or new issues arise. You lose the ability to claim additional compensation related to the injury after settling your claim.

It’s recommended to undergo all required medical treatment and recovery before settling whenever possible. This allows your attorney to fully document all expenses and losses to maximize your payout. However, a personal injury attorney may be able to get you an interim settlement in special circumstances.

Should You Settle Your Claim or Go to Trial?

Most workers’ comp cases settle out of court, avoiding a trial. Settlements are usually faster, simpler, less stressful, and still provide fair compensation. But in some situations, taking your claim to trial makes sense:

• The insurance company is offering an unreasonably low settlement.
• Significant disputes exist over liability or compensation amounts.
• Serious injuries warrant extremely high compensation.
• The court may award additional damages unavailable in settlement.

Talk to your workers’ comp attorney to decide whether settlement or trial is best. They can provide guidance based on your specific claim circumstances.

Hiring an Experienced Workers’ Compensation Attorney

Because surgery significantly impacts your claim and settlement value, having an experienced work injury lawyer on your side is crucial. An attorney can help you:

• Determine how surgery affects the value of your claim.
• Gather evidence to demand higher compensation.
• Negotiate aggressively with the insurance company.
• Handle legal paperwork and proceedings.
• Decide if settlement or trial is best.

Don’t leave money on the table – contact a dedicated workers’ compensation lawyer at O’Connor Law in New York as soon as possible after your injury to get the maximum settlement you deserve.