Filing a workers’ compensation claim can be a confusing process. You must follow your employer’s procedures, collect countless medical records, and meet strict deadlines. And in some cases, you might struggle to reach a fair compensation settlement with the insurance carrier.
At Mehta & McConnell, clients often ask, “Does surgery increase workers’ comp settlement?” We always say the same thing – surgery may enhance your settlement, but it might also have no effect at all.
Call our office if you have questions about workers’ compensation, surgery, or other concerns. Our attorneys are here to help you get the most for your claim.
Overview of North Carolina Workers’ Compensation
Workers’ compensation provides support to employees who suffer work-related injuries or illnesses.
Most employers need to carry workers’ comp insurance, and employees are generally covered from their first day on the job.
The program offers benefits to help workers recover from injuries and manage their affairs while they recover.
Workers Compensation Covers Surgeries and Other Treatments
Workers’ compensation covers all necessary medical treatments, including surgeries. Your employer’s insurance should pay for:
- All costs associated with the surgical procedure,
- Hospital stays,
- Post-operative care, and
- Related medications.
In some cases, employees may need rehabilitation after surgery. Workers’ compensation will cover the cost of these services as well.
What Is a Workers’ Compensation Settlement?
Workers’ compensation covers all costs associated with a workplace injury. But in some cases, employees and insurers disagree on these costs.
Employees may seek care that they think is essential for their recovery. This can include surgeries, specialized therapies, or extended rehabilitation.
On the other hand, insurance companies want to minimize costs. They might dispute the need for some treatments or recommend less expensive options.
Workers’ compensation settlements resolve these disputes. Employees negotiate with the insurer to reach an agreement and get fair compensation for their injuries.
Does Surgery Increase Workers’ Comp Settlement?
The value of your workers’ compensation is contingent on many factors. A settlement offer often involves factors such as the cost of treatment and the extent of disabilities.
Surgery may lead to increased medical expenses, which can have long-term implications on your ability to work.
However, workers’ compensation only covers necessary care. The insurer may challenge the need for certain surgeries during settlement negotiations.
Likewise, you need to follow the workers’ compensation claim process to receive a settlement. Insurers often have the right to choose if and how employees receive care. You may not receive a high settlement offer if you don’t work with the insurer during this process.
Speaking with an attorney during this time can provide personalized insights based on the case’s circumstances.
How Does Surgery Increase Workers’ Comp Settlement Amounts?
A workers’ compensation settlement should cover the current and future medical expenses associated with a workplace injury.
Depending on the type and severity of your workplace injury, you may need extensive medical treatment and rehabilitation to recover fully.
Examples of medical expenses covered by workers’ compensation include:
- Costs of prescription medication,
- Hospital bills,
- Physical therapy,
- Surgical procedures,
- X-rays, and
- Reimbursement for travel expenses.
Medical expenditures pile up quickly, so any additional treatment or surgical requirements will increase the value of your claim.
The amount a surgical procedure can improve your workers’ compensation settlement depends on the cost of the surgery itself.
A knee replacement surgery in North Carolina costs an average of approximately $27,000. This is assuming there are no complications during the procedure or recovery.
As you can see, the average workers’ comp settlement for surgery varies based on the specific procedure performed.
An experienced attorney can collect evidence about the cost of surgery and the subsequent rehabilitation process to include in the value of your losses.
What Goes into the Cost of Surgery?
Surgery is expensive because hospitals use lots of resources and manpower during most procedures. Some of the costs incurred during a surgical procedure include:
- Surgeon’s fee,
- Operating room booking fee,
- Pre-surgery preparation,
- Meetings with the surgeon, and
The cost of a particular operation depends on several different factors unique to each patient. The final cost will also vary based on the medical provider performing the operation.
An attorney can collect evidence from financial experts to help determine the value of future medical treatment.
How an Attorney Can Help with Your Workers’ Comp Settlement
Negotiating a settlement with the worker’s compensation carrier can be difficult. Hiring an attorney who understands the law and claims process can simplify this process and give you peace of mind.
Your attorney’s services include:
- Legal knowledge. Your attorney’s understanding of North Carolina law will ensure you know your rights and meet all obligations.
- Case evaluation. Get a thorough assessment of your situation to determine the best strategy to recover the most compensation for your damages.
- Negotiation skills. Attorneys know effective ways to negotiate with insurers, increasing the chances of a fair settlement.
- Evidence collection. Get help collecting and organizing evidence to build a convincing case that meets all legal requirements.
- Appeals support. If your claim is denied, your attorney can handle the appeals process with the North Carolina Industrial Commission.
- Mediation and litigation. If disputes arise, your attorney will represent you in court, presenting a compelling case and fighting for your rights.
On top of all this, your attorney will take on many of your burdens. They will handle all the paperwork and legal process so you can spend time recovering.
Schedule a Case Evaluation
Mehta & McConnell is here to help you get fair compensation for your workers’ compensation claim.
FAQs About Surgery and Workers’ Compensation
Here are some common questions our law firm has answered for clients. If you have any other questions, the attorneys at Mehta & McConnell are here to help.
Does Surgery Guarantee a Higher Workers’ Compensation Settlement?
Not necessarily. While surgery can significantly impact the settlement amount, it depends on various factors.
These include the nature of the injury, the extent of medical expenses, and the long-term impact on your ability to work.
Can I Negotiate a Fair Workers’ Compensation Settlement Without a Lawyer?
When you talk to a workers’ compensation insurance provider, their first settlement offer will often fall significantly below what you may be entitled to recover.
It is no secret that insurance companies care more about themselves than about injured workers. In most cases, their ultimate objective is to settle a workers’ compensation claim for as little money as possible.
A qualified attorney can compile invoices and receipts to demonstrate the value of your current medical expenses and consult with experts to estimate the value of your future losses.
Additionally, they can negotiate with the insurance company on your behalf to secure a fair settlement offer.
Can I Choose My Surgeon for a Work-Related Injury?
In North Carolina, the employer or the insurance company typically has the right to choose the initial treating physician.
However, there are circumstances where you may seek a second opinion or request a change of physician. An attorney can help you with this if you believe choosing a different surgeon is necessary for your recovery.
How Does the Workers’ Compensation Process in North Carolina Address Recovery After Surgery?
Workers’ compensation benefits cover the duration of your recovery. Some surgeries result in a temporary disability that affects your ability to work.
You may be eligible for temporary disability benefits during this recovery period.
Will I Receive Compensation for Pain and Suffering Related to the Surgery?
The average workers’ comp settlement for surgery only covers medical care, lost wages, and disability.
The North Carolina Workers’ Compensation Act does not allow for non-economic damages like pain and suffering. However, speaking with a lawyer can help you explore all potential avenues for compensation.
Can I Be Fired for Pursuing Workers’ Compensation After Surgery?
North Carolina law prohibits employers from retaliating against employees for workers’ compensation claims. Speak with our firm if you’re facing wrongful termination due to a workers’ comp claim.
How Long Does It Take to Receive a Workers’ Compensation Settlement After Surgery?
The timeline for receiving a settlement can vary. It depends on factors such as the complexity of the case, negotiations between parties, and the extent of your recovery.
Working with our workers’ compensation attorneys can help speed up the process and ensure a fair settlement.
Can I Negotiate the Terms of the Workers’ Compensation Settlement If I’m Not Satisfied with the Initial Offer?
Yes, negotiation is possible. Working with an experienced attorney can enhance your ability to negotiate a fair settlement. They can use damage models to show the value of your case and advocate for your best interests during negotiations.
What Steps Should I Take If I’m Considering Surgery for a Work-Related Injury In North Carolina?
Before getting surgery, it’s crucial to notify your employer and consult with a workers’ compensation attorney. You need to follow a set process to ensure insurance covers your surgery.
An attorney can guide you through this process so that you don’t jeopardize your claim.