Contact Us for a Free Consultation 1 (860) 523-8783


Does Surgery Increase the Value of My Workers Comp Claim?

Posted by James Aspell | Apr 10, 2024 | 0 Comments

Experiencing a severe injury at work places you in the midst of two highly challenging situations: navigating the path to recovery through medical treatment and maneuvering through the process of claiming workers' compensation benefits. A critical juncture in this journey may arise when your healthcare provider suggests surgery as a potential treatment pathway. This decision carries significant weight, not just for your health but also for its potential effects on your workers' comp claim.

Surgery might alter the financial outcome of your workers' comp claim, either positively or negatively, depending on various factors such as the nature of the surgery and its timing in relation to your claim. Let's explore the nuances of how surgical intervention could influence your workers' compensation benefits and the calculation of these benefits.

Impact of Surgery on Workers' Comp Benefits: A Closer Look

Opting for surgery introduces both physical and emotional challenges. Prioritizing your well-being is paramount, rather than focusing solely on the financial implications for your workers' comp benefits. Although surgery might lead to an increase in benefits in some scenarios, this is not a certainty. Making a significant health decision based on the hope of financial gain is risky.

The effect of surgery on workers' comp settlements is influenced by several critical aspects:

  • When the surgery takes place
  • The outcome of the surgery
  • The specific type of surgical procedure undertaken
  1. Surgery Timing
    Initial settlement proposals in workers' comp cases tend to be conservative before any definitive diagnosis or treatment plan, including surgery, is in place. A recommendation for surgery by a healthcare professional usually prompts an increase in the initial settlement offer. However, a successful surgery that demonstrates an improved condition before settlement negotiations conclude may result in a lower settlement, as it could indicate a reduced need for ongoing medical care or the capability to resume work.

  2. Surgical Outcomes
    Conversely, if surgery does not go as planned and results in further complications or worsened conditions, this could potentially increase the settlement amount, though at the cost of your long-term health and well-being.

  3. Type of Surgical Procedure
    Certain surgeries are viewed as more critical due to their impact on your capacity to work, thus affecting the settlement value. For instance, a procedure addressing a carpal tunnel syndrome might not yield as high a settlement as surgery for a significant lower back injury.

Navigating these considerations requires close consultation with your medical provider to understand the full scope of surgical interventions without relying on them as a strategy for increasing workers' comp benefits. Building a strong partnership with your doctor is crucial for supporting your claim.

Understanding Workers' Comp Settlements

Workers' comp settlements are influenced by two key phases:

  • Active Phase: This encompasses the period you are unable to work due to your injury, during which you might receive wage replacements and coverage for treatment costs if your claim is approved.
  • Maximum Medical Improvement (MMI): This stage is reached when further recovery is not anticipated, possibly entitling you to additional benefits for ongoing medical costs or financial losses due to an inability to return to work. The specifics of these benefits can vary significantly by state.

Calculating Workers' Comp Benefits

The calculation of workers' comp benefits is complex, factoring in the type and severity of your injury, received medical care, and the likelihood of returning to work. Your doctor's diagnosis plays a significant role in determining these benefits, with negotiations around your medical rating and adequacy of care being possible through legal support.

Maximizing your workers' comp benefits requires a deep understanding of the system, which can differ widely across states. Engaging a lawyer who is well-versed in workers' comp law can ensure you receive the best possible support and care moving forward.

At James F. Aspell, P.C., we are dedicated to guiding you through this challenging time. By listening to your story and providing initial legal advice at no cost, we aim to connect you with experienced attorneys within our network. Facing a work-related injury is a daunting experience, but you don't have to do it alone. Reach out for personalized, complimentary legal advice today.


About the Author

James Aspell

Principal since August 1, 2006 James F. Aspell is the principal and managing attorney of the firm which he started in 2006 following 20 years of litigation practice in a mid -size firm in Hartford, Connecticut. Jim focuses his practice in the areas of worker's compensation and personal injury l...


There are no comments for this post. Be the first and Add your Comment below.

Leave a Comment


Law Offices of James F. Aspell, P.C
860-521-3808 (fax)
Mon: 08:00am - 06:00pm
Tue: 08:00am - 06:00pm
Wed: 08:00am - 06:00pm
Thu: 08:00am - 06:00pm
Fri: 08:00am - 06:00pm