Workers who suffer serious job-related injuries often wonder whether having surgery will lead to a higher workers’ compensation settlement. In many cases, surgery does increase the potential value of a claim, but the outcome depends on the nature of the injury, the medical evidence, and how the insurance company evaluates future costs. Understanding how surgery affects your case can help you make informed decisions about treatment and settlement.
Why Can Surgery Affect the Settlement Value of a Workplace Injury?
When a workplace injury requires surgery, it usually signals a more severe condition and a potentially longer recovery. More serious injuries, which factor into a workers’ comp settlement, typically lead to:
- Higher Medical Expenses: Surgery, hospitalization, and follow-up care dramatically increase total medical costs.
- Longer Recovery Periods: Time away from work means more temporary total disability benefits and wage replacement.
- Permanent Impairment: Surgery may not fully restore function, leading to permanent impairment ratings and higher long-term benefits.
Together, these factors often result in larger settlements. Still, each case is unique, and the insurance company will closely examine medical records before making an offer. Before making any decision about surgery or settlement, it’s important to know how Florida’s workers’ compensation system calculates benefits.
How Does Florida Calculate Workers’ Comp Settlements?
In Florida, settlements are based on a combination of things. If surgery is recommended, the insurance carrier must authorize and pay for it as long as it is deemed medically necessary.
The impairment ratings are determined by looking at:
- Temporary Disability Benefits: Covers a portion of lost wages while you recover.
- Permanent Impairment Benefits: Determined by your doctor’s impairment rating once you reach Maximum Medical Improvement (MMI).
- Future Medical Needs: If surgery is required or expected, future medical care is factored into the settlement amount.
Because surgery often changes the impairment rating and the projected cost of future care, it can significantly influence the insurer’s calculation of a fair settlement. In addition, the timing of surgery also plays a critical role in how your claim proceeds.
Why Does Timing Matter When Surgery Is Involved in a Workers’ Comp Settlement?
The timing of your settlement can have a major impact on how much compensation you receive. Settling before surgery may leave you without enough money to pay for the procedure or any complications that arise, while waiting until after surgery gives you a more accurate picture of medical costs and long-term needs.
- Before Surgery: Agreeing to a settlement too early often leads to a lower payout because the full extent of future treatment and recovery is still unknown.
- After Surgery: By waiting, you and your attorney can review the final results, permanent restrictions, and any ongoing therapy needs to negotiate a settlement that reflects your true expenses and losses.
Other factors can also influence the final amount. Deciding when to settle is a strategic choice best made with the guidance of an experienced Florida workers’ compensation lawyer who understands how surgery affects your claim.
What are Some of The Other Factors That Influence a Workers’ Compensation Settlement in Florida?
Several details outside the surgery itself can increase or decrease your final settlement:
- Age and Overall Health: Younger workers may have longer work-life expectancy, affecting wage-loss calculations.
- Type of Work: Physically demanding jobs may require a higher settlement if permanent restrictions limit future employment.
- Complications or Multiple Surgeries: Additional medical needs raise both medical costs and the likelihood of permanent impairment.
- Insurance Company Tactics: Carriers often try to minimize payouts, even when surgery clearly increases costs.
These variables are why it’s critical to work with a lawyer who can present strong medical evidence and negotiate aggressively. Having trusted and professional legal representation can make the difference between a low settlement and one that truly covers your needs.
Why Hiring a Workers’ Comp Attorney Is Essential for Securing the Maximum Compensation Possible
Workers’ compensation insurers have teams of adjusters and lawyers focused on reducing payouts. Surgery often increases the potential value of a workers’ compensation settlement in Florida because it signals a more serious injury, which leads to higher medical costs and possible long-term impairment. Because of this, the stakes are higher, and disputes about necessity, timing, or impairment ratings are common.
