If you’ve had surgery after a workplace injury, you’re probably wondering what kind of settlement you can expect. The average workers’ compensation settlement for surgery depends on factors such as the type of procedure and the severity of your injury. How the injury affects your ability to work also affects compensation. Understanding these factors helps you understand what to expect from your workers’ compensation claim.
Quick Links​
- Average Workers’ Comp Settlement for Surgery
- Costs and Coverage of Surgical Procedures
- What Work Injury Pays the Most?
- What Body Part Has the Highest Value in a Workers’ Compensation Claim?
- Navigating the Workers’ Compensation Claim Process
- How Workers’ Compensation Attorneys Meirowitz & Wasserberg Can Help
- What Our Workers’ Comp Clients Are Saying
- Settlement Negotiation Strategies
- Evaluating Your Claim’s Worth
- Communicating Clearly With Insurance Adjusters
- Using Medical Evidence and Expert Testimony
- Anticipating Common Insurance Company Tactics
- Using Precedents To Support Your Argument
- Handling Disputes
- Understanding State-Specific Regulations
- Will Workers’ Compensation Pay for Therapy?
- Get the Help You Need After a Work Injury
In your experience, what’s the most common mistake people make early in the process that hurts their case?
"There are a lot of mistakes people can make early on, whether it's not notifying the employer within 30 days (which is required), or not seeking treatment for a while. This can set off red flags with the insurance carrier, making it seem like the injury might not be serious or that it happened elsewhere and is being fabricated. Those are two of the biggest mistakes."
Average Workers’ Comp Settlement for Surgery
The average workers’ compensation settlement varies based on factors specific to each situation. In many cases, surgery significantly increases the workers’ compensation settlement amount. It can range from as little as $1,000 to $100,000 or more, depending on the type of surgery you need. A knowledgeable lawyer can help you determine a fair settlement based on the costs related to your injury.
Costs and Coverage of Surgical Procedures
Workers’ compensation covers surgical procedures necessary due to injuries or illnesses sustained on the job. The cost of surgical procedures for work-related accidents and injuries can vary drastically based on the type, location, and severity of the injury. Again, some may cost as little as a few thousand dollars, while others tip the scales well over $100,000.
For example, suppose someone suffers a herniated disc injury at work, preventing them from doing their job. The worker files a workers’ compensation claim after discovering they need surgery. Herniated disc surgery can cost upwards of $35,000. Workers’ compensation often covers the cost of surgery because it was directly caused by a workplace accident.
Keep in mind that workplace accidents can result in lost wages and disability. In workers’ compensation claims, there are two primary types of disability: temporary and permanent.
Temporary disability applies to cases where employees can’t perform their job duties or functions for a limited time. Injured employees can often apply for temporary disability benefits by getting proof of their disability from their doctor. With disability benefits, employees may temporarily receive a percentage of their original income.
Permanent disability applies to those who cannot return to work due to injury or illness. Approval for these benefits grants the employee a percentage of weekly wages up to a specific limit.Â
The amount you can recover depends on factors specific to your case, including lost wages, the severity of your impairment, and medical expenses. The value of your settlement may also vary based on state law.
What Work Injury Pays the Most?
Generally, the more severe the injury, the higher the payout. For example, amputation injuries are among the highest workers’ compensation claim payouts. However, it’s important to understand that every case is different, so the average workers’ compensation settlement may vary.Â
What Body Part Has the Highest Value in a Workers’ Compensation Claim?
Injuries to the brain and head often have the highest value in workers’ compensation claims, as they can have life-altering consequences. Severe injuries to the spinal cord may also be eligible for higher values in a workers’ compensation claim. Ultimately, how much a workers’ compensation settlement is worth varies widely based on the circumstances specific to your injuries and accident.
Navigating the Workers’ Compensation Claim Process
The process of filing a workers’ compensation claim can vary from state to state. However, most states outline the process on their official workers’ compensation government website.
For example, in New York, you must complete a C-3 Employee Claim form by filling out the paper form or calling (866) 396-8314 to speak with a board representative who will do it for you. If approved, you’ll receive payments every two weeks throughout your disability period.
The general process remains the same across the states. Typically, you must:
- Seek medical attention as soon as possible, even if you don’t think your injuries are severe. Keep records like medical reports and receipts.
- Notify your employer in writing as soon as possible.
- File your workers’ compensation claim through the avenues your employer and state provide.
- Follow up on your claim and keep receipts of any out-of-pocket expenses you make to treat your injury before your claim is approved.
The process can be overwhelming, especially when dealing with a severe injury. This is where our skilled lawyers at Meirowitz & Wasserberg come in. Our skillful lawyers can handle your claims process, ensuring you know your full legal rights and avoiding missing deadlines.
“If you’re injured, you should file the claim as soon as possible, especially if you’re out of work. You are entitled to lost wage benefits, and to free medical treatment for your injuries.”
How Workers’ Compensation Attorneys Meirowitz & Wasserberg Can Help
Workers’ compensation claims aren’t always straightforward, especially if your claim gets denied. Between the complexity of state laws and the variation in claims processes from one state to the next, having help from a skilled lawyer is essential.
Your lawyer can help you navigate your claim, ensuring you know all applicable deadlines. If your claim is denied, your lawyer can help you fight to secure the benefits you’re entitled to.
The experienced team at Meirowitz & Wasserberg has helped many employees navigate their workers’ compensation claims and can help you do the same. We’re proud of our case results, which include securing millions of dollars in verdicts and settlements, including those involving mesothelioma in the workplace.
If you’re feeling overwhelmed by the process, you’re not alone. Our lawyers will walk you through the entire process, ensuring your rights are upheld to help you seek the compensation you deserve.
What Our Workers’ Comp Clients Are Saying
Settlement Negotiation Strategies
Negotiating a workers’ compensation settlement isn’t just about responding to the insurance company’s offer. It’s about understanding your claim’s full value, anticipating pushback, and using evidence to your advantage. The stronger your preparation, the more likely you are to secure a settlement that truly reflects your losses.Â
From evaluating the value of your case to communicating with the insurance company, handling a claim alone can be daunting when dealing with an injury. Our skilled lawyers at Meirowitz & Wasserberg are well-versed in workers’ compensation cases and understand common insurance tactics. We can help you negotiate your case to fight for a maximum settlement amount.Â
Evaluating Your Claim’s Worth
Before any negotiation begins, it’s important to know how much your workers’ comp case is worth. This isn’t always straightforward. Several factors can influence the value, including:
- Current and future medical expenses: including surgery, hospital stays, doctor visits, medications, physical therapy, and other necessary treatments related to your injury.
- Lost income: covering wages missed during recovery and any long-term reduction in earning capacity if you can’t return to your prior job or hours.
- Permanent impairment ratings: medical assessments that determine the extent of lasting injury and influence the amount of disability benefits.
- Ongoing care needs: such as medical equipment, home or vehicle modifications, or in-home assistance required for daily living.
- Pain and suffering: not typically covered under workers’ comp but may be available through a separate personal injury claim involving a third party.
In cases involving surgery, injured workers often ask about the average workers’ compensation settlement for surgery as a reference point. While each case is unique, comparing similar injuries and procedures helps set realistic expectations, exposing lowball offers.
Communicating With Insurance Adjusters
Effective communication helps prevent misunderstandings and strengthens your credibility during negotiations. Clear, organized documentation can shift the outcome of your workers’ comp claim.Â
First, provide complete and accurate details about your injury from the very beginning. Submit all relevant medical records, including physician notes and diagnostic imaging, such as X-rays or MRIs, to support your case. When the insurance adjuster requests information, respond quickly and professionally.
Keep written records of every conversation and formal request related to your claim. Avoid speculation or exaggeration, as insurers may use this information to challenge your credibility. Most importantly, maintain uniformity in all statements, whether during recorded interviews or written correspondence.
Remember, adjusters are interested in discrepancies. Staying consistent and organized protects your workers’ compensation claim.
Using Medical Evidence and Expert Testimony
Medical documentation and expert analysis are integral to any workers’ comp claim. The goal here is to clearly connect your injury to your job and show how it affects your ability to work. Evidence may include:
- Initial injury reports and first responder notes: documenting the circumstances of the accident and immediate observations at the scene.
- Specialist evaluations: especially those from surgeons or other medical experts who assess complex or long-term injuries.
- Follow-up care summaries: including updates from physical therapy, rehabilitation, or ongoing medical treatment.
- Independent medical examinations (IMEs): third-party assessments often required by insurers to evaluate the nature and extent of the injury.
- Functional capacity evaluations (FCEs): tests that measure your physical limitations and ability to perform work-related tasks.
- Expert testimony: providing insight into long-term consequences, permanent disability, or the expected trajectory of recovery.
Detailed, ongoing medical documentation proves the injury is job-related. It’s also necessary to support long-term benefits and disability claims.
Anticipating Common Insurance Company Tactics
Insurers often rely on pressure and delay to push injured workers into accepting less than they deserve. Being aware of these tactics makes it easier to respond effectively. Common strategies include:
- Disputing whether the injury happened at work: or questioning whether work was the direct cause of your condition.
- Challenging the necessity or scope of treatment: particularly when it involves surgery, long-term rehab, or specialized care.
- Requesting repeated medical exams: often to obtain a more favorable opinion that minimizes the severity of your injury.
- Implying fault: or suggesting that a preexisting condition, not the workplace, is responsible for your symptoms.
- Delaying responses: in hopes of pressuring you into accepting a lower settlement or giving up your claim.
- Offering quick settlements: that may seem appealing but fail to cover future medical costs or lost wages.
Recognizing these tactics allows you to respond appropriately and focus on securing fair compensation.
What’s the most common tactic employers or insurers use to minimize payouts? Or, this something that you see often?
"Once the insurance company gets involved, they tend to use more legitimate tactics within the framework of the law. Employers, especially small ones, might act differently before the case even starts. They don’t want the claim to show up and raise their premiums, so they might say, ""Oh, I'll just pay for your medical treatment, but don’t file a claim,"" or they might threaten employees. Both of these things can happen in the beginning. As for retaliation, I've definitely had clients who were terminated after asking for the necessary forms or saying they were going to file for workers' compensation. That’s illegal, and we can file a discrimination case for that. We've done it, and we've been successful in every single case so far."
Using Precedents To Support Your Argument
When negotiating a settlement, past outcomes in similar cases can strengthen your position. These precedents help demonstrate that your expectations are realistic and grounded in law. Some useful comparisons include prior settlements involving similar surgeries or injuries.
Your workers’ compensation attorney can also reference cases with comparable permanent disability ratings. Outcomes tied to the same employer or insurer can also boost your negotiating position.
Using precedent shifts the discussion from emotion to evidence. It also holds insurers accountable to industry norms.
Handling Disputes
Disputes between workers and their employers’ workers’ comp insurance providers are common in workers’ compensation cases. Common areas of disagreement include the extent of the injury and the appropriate compensation amount.
When disputes arise, alternative resolution methods such as mediation or arbitration can be effective and avoid costly court proceedings. These approaches often lead to faster resolutions while giving you and your lawyer greater control over the outcome.
Remember, you don’t have to face insurance companies alone. Professional legal representation protects your rights throughout the negotiation process.
Understanding State-Specific Regulations
Workers’ compensation laws differ across states. While most states require employers to carry this insurance, the requirements vary depending on factors such as the type of business, the number of employees, and the industry.
In New York, employers must provide workers’ compensation coverage to all employees, including construction workers and part-time staff. But not everyone qualifies. Some public servants in New York, including police officers and firefighters, are ineligible for workers’ compensation.
New Jersey’s no-fault workers’ compensation program takes a different approach. The law excludes certain workers, such as casual laborers, independent contractors, and volunteers.
In the state of Pennsylvania, employers must provide workers’ comp insurance to employees. This applies to most businesses, regardless of size. The state allows employers to obtain coverage through private carriers or the State Workers’ Insurance Fund. The state also allows employers to self-insure their liability. They can do this by applying to the Bureau of Workers’ Compensation for approval.
Because each state sets its own rules, you need a workers’ compensation lawyer who knows the laws in your jurisdiction. For instance, if you work and live in New York, look for a workers’ compensation attorney with experience in the state’s laws and regulations. For personal injuries caused by another party’s negligence, seek the help of a personal injury lawyer.Â
Will Workers’ Compensation Pay for Therapy?
Recovering from a serious workplace injury doesn’t end with surgery. Many injured workers face months of physical therapy and retraining before they can safely return to work. That’s where medical and vocational rehabilitation come in.
- Medical rehabilitation restores physical function: Focuses on restoring your physical abilities after surgery or injury. Treatment may include physical therapy, pain management, or occupational therapy. Recovery often takes time and can interrupt your ability to work full-time or perform your previous job duties.
- Vocational rehabilitation prepares you for employment: Helps you reenter the workforce after an injury has limited your ability to do your previous job. If you can’t return to your old position, this type of support helps you train for a new one. Services may include job counseling and placement assistance.
Workers’ compensation typically covers the costs of medical rehabilitation and treatment. However, vocational rehabilitation coverage depends on your state’s workers’ compensation laws. An experienced workers’ compensation attorney can evaluate your situation and explain your legal rights.
Get the Help You Need After a Work Injury
Whether you were injured on a construction site or sustained a work-related illness, you may be facing a long recovery time and costly medical bills. If you sustain injuries while working in New York, New Jersey, or Pennsylvania, you have the right to seek compensation.
At Meirowitz & Wasserberg, we have the resources, ability, and know-how to stand up to large corporations that place profit over public safety. While every case is different, we can review how your injuries compare to the average workers’ compensation settlement for surgery. Our knowledgeable lawyers can help you secure fair compensation for your work-related injury.
With over $500 million won in settlements and verdicts, our legal team is ready to protect your rights and give your case the personal attention and dedication it deserves. We understand the tactics insurance companies use to devalue or deny workers’ comp claims. You can count on our attorneys to handle settlement talks on your behalf while you rest and recover.
Contact us today for a free, no-obligation consultation. Let us protect your rights and get you the support you need.
