When you need workers’ comp, it’s natural to have many questions about the benefits you can receive. One question that often arises is whether having surgery for your injury can increase your workers’ compensation settlement.
There can be a relationship between having surgery and the amount of a workers’ compensation settlement. However, since every case has unique circumstances, it isn’t always the only factor.
Let’s take a look at whether undergoing a surgical procedure can impact compensation and, if so, under what circumstances. You can navigate the workers’ compensation process with greater confidence and clarity with help from a workers’ comp lawyer in Atlanta.
What Workers’ Compensation Is Meant to Cover
Workers’ compensation is designed to provide financial support and medical benefits to employees who have been injured on the job. This includes coverage for medical treatment, rehabilitation, lost wages, and disability payments.
The purpose of a settlement in a workers’ compensation case is to provide a lump sum payment that represents a fair and reasonable amount to compensate the injured worker.
Factors that can impact the settlement include the nature and severity of the injury, the necessity of surgery, the cost of the procedure, and the associated medical expenses. You can learn more about the value of your potential settlement by working with an Atlanta personal injury attorney.
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Did the Surgery Happen Yet?
Whether a recommended surgery increases a workers’ compensation settlement depends on whether it has actually occurred. If only recommended, the insurance company will review the proposed treatment plan and determine if the surgery is necessary or if alternative options exist.
In this case, a recommended operation may have little effect on the settlement. However, if the surgery has already taken place, it is more likely to influence the amount. Undergoing surgery often leads to higher medical costs in the short and long term for bills, rehabilitation, and health impacts.
This provides a factual basis for greater lost wages and disability claims. However, it’s important to note that a surgery that has already been performed and paid for is a past expense that has already been covered by workers comp, so the surgery costs will not be included in the settlement.
Does the Type of Surgery Matter?
The type of surgery matters when it comes to workers’ compensation cases because workers comp insurance companies take into account the future long-term rehabilitation costs or permanent disability benefits.
The type of surgery can determine the likelihood of a full recovery or permanent work restrictions. Certain surgeries have a high success rate and offer patients a full recovery with no lingering physical limitations.
Other surgeries, even if initially successful, may result in permanent work-related restrictions due to the nature of the procedure or underlying conditions. These restrictions may restrict the ability to perform certain tasks or limit their work capacity permanently.
Am I Sure To Be Approved To Get Needed Surgery?
Simply because your treating physician recommends surgery does not guarantee immediate authorization. This is because insurance companies are required to cover medical care but have the responsibility of evaluating the necessity and cost-effectiveness of certain procedures.
In cases where the surgery is deemed urgent, the insurance company will review and approve or deny the treatment within a few days. However, if the surgery is non-urgent, it can take several weeks to receive a verdict. During this time, the insurance company might also request an independent medical examination.
This can further prolong the approval process and add even more time before you can move forward with your surgical treatment. It’s important to work with an experienced workers’ comp lawyer to advocate for your rights and help expedite your access to medical treatments.
Main Factors That Help Determine a Workers’ Compensation Settlement Amount
Here are some of the main factors that can impact the amount of a workers comp settlement:
- Nature and severity of the injury/illness: More serious injuries like lost limbs or chronic illnesses will result in higher settlements.
- The extent of disability: Partial or full permanent disability is assessed and compensated accordingly.
- Lost wages: Past and likely future lost earnings are calculated based on the disability level.
- Medical costs: Expenses for doctor visits, surgeries, therapy, prescriptions, equipment, etc. are considered.
- Age: Younger workers have longer left disability periods impacting settlement size.
- Vocational limitations: Ability to find suitable alternate work given disability restrictions.
- Pre-existing conditions: Prior health issues may lengthen recovery or affect disability rating.
Considering all relevant specific factors to an individual workers’ comp claim helps determine a fair settlement value. Your Atlanta workplace injury lawyer can help by negotiating aggressively to ensure you are treated fairly.
Contact a Workers’ Compensation Law Firm for a Free Consultation
While surgery may increase the value of your workers’ compensation settlement, there are many factors that must be considered on a case-by-case basis. At John Foy & Associates, our experienced Atlanta workers’ compensation lawyers understand how complex these cases can be.
We are dedicated to thoroughly evaluating each unique circumstance and advocating strongly on your behalf. Our team works to build the strongest workers’ compensation claim possible. We know what it takes to achieve the maximum settlement.
Contact us for a free consultation. We are here to answer your questions and assess the merits of your case. With our experienced lawyers on your side, you can focus entirely on your recovery, knowing your rights and potential compensation benefits are in good hands.