Your workers’ compensation settlement depends on the severity and extent of the injuries sustained at the workplace. People usually associate surgery with severe injuries, albeit it isn’t always the case.
Nevertheless, getting surgery usually feels like a reason to claim a higher settlement. So, does surgery increase a workers’ comp settlement? Here is a detailed answer to this and other related questions.
Does Surgery Increase a Workers’ Comp Settlement?
Whether or not having surgery will increase your workers’ compensation settlement depends on several factors, including:
Workers’ compensation settlement for surgery primarily depends on the timing – whether the surgery will be performed before or after the settlement. Notably, the workers’ compensation insurance company covers all surgical procedures performed before settlement under its medical benefits plan, effectively taking those medical expenses off the negotiating table. It is also worth noting that the insurer can reduce the original settlement offer if your health improves after the surgical procedure.
Your workers’ compensation settlement can appreciate if you anticipate undergoing surgery for your injuries after settling. The insurance company can offer cash payment or agree to cover all future medical expenses related to the injury, depending on your preferred settlement plan.
2. Settlement plan
You must choose between one of two workers’ compensation settlement plans:
- Stipulation & Award – The insurance company agrees to cover all medical costs related to your injuries or pay periodic permanent disability benefits.
- Compromise & Release – The insurance company pays you the estimated amount of money treating your injuries will cost in cash, leaving you to cover all future medical expenses yourself. You can opt for a structured (long-term) or lump-sum (one-time) payment.
Most people refer to the compromise and release plan when discussing workers’ compensation settlements. It is under this plan that you can receive a higher cash settlement.
3. The surgical procedure’s complexity
Some surgical procedures are simpler and less expensive than others. For example, carpal tunnel surgery is more affordable and less complex than spinal surgery. Usually, the amount added to your workers’ compensation settlement will reflect the surgical procedure’s cost and complexity.
4. Associated medical expenses
Ideally, your workers’ compensation settlement should be enough to cover all future medical expenses related to your injuries. A cash payment negotiated under the compromise and release plan covers the following medical costs and expenses:
- Future medical care (including surgical procedures)
- Anticipated costs of complications resulting from the surgical procedure
- Indirect medical costs and expenses, such as lost wages and prolonged medical stay
- Future permanent disability benefits
The insurance company also covers indirect medical costs and expenses related to the surgery under its medical benefits plan for surgical procedures conducted before settlement. It is important to get a formal review by your physician detailing all future medical procedures and expenses.
Let A Florida Workers’ Compensation Attorney Help
Are you a victim of an injury sustained at the workplace in Florida and need surgery? Was your workers’ compensation claim denied, or do you have concerns about whether or not your settlement will cover all your expenses?
Surgery Under Workers’ Compensation FAQs
How much more money can I get added to my workers’ compensation settlement if I need surgery?
The amount of money you can get added to your settlement will depend on the surgical procedure’s cost and complexity. For the most part, complex and costly surgeries usually warrant higher settlements.
Should I undergo surgery before or after settling my workers’ compensation claim?
Ideally, you should undergo surgical treatment as soon as your doctor recommends it. It isn’t prudent to risk your health and life by postponing your surgical procedure to negotiate a higher settlement.