There is no way to calculate an average workers’ comp settlement for surgery. Each case is unique, and settlements depend on many factors. Even in two claims for injured workers who require the same type of surgery, their medical care and lost income could be dramatically different.
If your employer’s workers’ compensation insurance carrier offers you a lump sum settlement, an Orlando workers’ compensation lawyer can help you determine whether that offer is fair. You do not want to settle for significantly less than you need and deserve.
There is No Reliable Way to Determine an Average Workers’ Comp Settlement
When injured workers inquire about an average settlement or payout, they are generally looking for guidance to help them understand what they can expect out of their case. Unfortunately, there is no good way to get this guidance without working with an experienced workers’ compensation attorney because settlements in these cases are highly individualized.
Workers’ compensation settlement negotiations use statutory guidelines, medical documentation, and wage loss calculations to arrive at a fair settlement range. This total should reflect each individual worker’s ongoing or future medical needs, wage replacement costs, and permanent disability, when applicable. All these factors vary widely.
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Factors That Could Influence a Workers’ Comp Settlement for Surgery
Several variables could affect a workers’ comp claim settlement after surgery, such as:
The Type and Complexity of Surgery
The type of injury, the type of surgery required to treat it, and the complexity of the patient’s medical treatment and recovery matter when determining a workers’ comp settlement. For example, a routine arthroscopic procedure generally requires a shorter recovery period and fewer limitations than a spinal fusion. The nature of the injury and surgical repair can affect:
- Medical expenses incurred
- Future medical care and support needs
- Expected recovery time
- Long-term work restrictions or lasting disability
The Worker’s Extent of Permanent Impairment
After surgery and recovery from a work-related injury, you may have lasting limitations. If so, your treating physician will assign you a permanent impairment rating (PIR). This is a medical estimate of how much physical function you lost because of your injury. A higher impairment rating will likely support a higher settlement amount.
In many states, including Florida, this rating can play a significant role in determining the number of weeks of income benefits you receive, which will also affect any potential lump-sum settlement.
Future Medical Expenses
If your injury requires ongoing care—physical therapy, pain management, or future surgeries, for example—those costs will factor into your settlement. The estimated costs of your future treatment may come from your current medical records, physician recommendations, and expected need for medical care over time. Medical expert testimony could also play a role.
Lost Wages and Work Restrictions
Your lost income will play a significant role in your workers’ comp settlement if:
- Your surgery and recovery period caused you to miss work.
- You cannot return to your prior position due to permanent restrictions.
- You cannot work at all due to your new impairments.
Whether you can return to the workforce will affect whether the workers’ compensation insurance company pays you temporary total disability (TTD), temporary partial disability (TPD), permanent partial disability (PPD), or permanent total disability (PTD) benefits. The more severe your restrictions, the larger your settlement will likely be.
Your Pre-Injury Wages
Workers’ compensation benefits are calculated using your average weekly wage for the 13 weeks before your injury, according to the Florida Department of Financial Services. This amount influences how much you receive in disability benefits, which is important when determining a fair settlement range. Higher pre-injury earnings generally lead to larger settlements.
The Willingness of the Insurance Carrier to Settle
Some insurance companies push for lump sum payments, but this is not true in all cases. An insurance company may choose to continue paying benefits on an ongoing basis rather than agree to a payout. This could depend on:
- Whether there is a dispute over the treatment or lasting disability
- The strength of the medical documentation
- Whether you have reached maximum medical improvement (MMI)
- The insurer’s desire to close the case quickly
In some cases, the insurer might offer a lowball settlement early in the process. They do this hoping you will accept the payout without understanding the long-term impact of your injury and surgery.
How a Lawyer Can Help With Your Workers’ Compensation Settlement After Surgery
Having an attorney on your side ensures you include all possible variables in your calculations before agreeing to a settlement amount. Your workers’ comp lawyer will help you by:
- Ensuring your medical records reflect the severity of your injuries
- Securing an accurate impairment rating
- Calculating future medical care costs and wage losses
- Negotiating for a fair settlement with the insurance carrier
Unfortunately, injured workers often undervalue their claims or overlook long-term expenses and losses, settling for less than they deserve. Working with an attorney familiar with workers’ compensation settlements can help you get the money you need to cover all your injury-related expenses.
What to Do If Your Workplace Injury Requires Surgery
If your workplace injury requires surgery and you are considering a workers’ comp settlement, contact our team at Bogin, Munns & Munns. Our personal injury law firm provides free case reviews, and our experienced attorneys will ensure you understand the potential value of your case.
It is imperative to ensure your settlement covers your full range of future care needs and financial losses. If you accept a settlement, you cannot go back and ask for more money later. You also cannot sue your employer for compensation under Florida law.
The type of surgery you require, your degree of lasting impairment, your medical care costs, your lost wages, and your future required treatment all contribute to your possible settlement amount. Your attorney can determine how much each factor affects your possible payout and negotiate an appropriate settlement for you.
Talk to Our Central Florida Workers’ Comp Team Today for Free
At Bogin, Munns & Munns, our attorneys practice virtually the full spectrum of Florida law, including handling workers’ compensation claims, challenging denials, and negotiating settlements. We have offices across Central Florida and have served the area since 1979.
Contact us today for a free case consultation with our team. We represent injured workers based on contingency.
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