Workers compensation benefits are supposed to pay for your medical bills and lost wages if you get hurt on the job. For certain types of severe injuries, you might also be entitled to additional compensation as determined by your state’s rules.

If your injuries require you to undergo an operation, you may be interested in finding out the average workers’ comp settlement for surgery. Knowing this information can help you determine how much money you will receive. Unfortunately, there is no one simple answer.

As this guide will explain, the average workers’ comp settlement for surgery will vary depending on the cost of the procedure and the type of injury that necessitates medical treatment. Here’s what you need to know.

What Is a Workers' Comp Settlement?

Work injury cases are not handled the same way as a standard personal injury claim. If you get hurt in a motor vehicle collision or due to medical negligence or a slip-and-fall, you can choose to file a lawsuit against those responsible. But, in most cases, you can’t sue your employer for work-related injuries.

Instead, when you get hurt at work, your employer will report the incident to their workers’ compensation insurer. The insurer can begin paying money right away for medical bills and lost wages if you miss work. The insurer pays you regardless of whether the employer was negligent or did anything wrong. The insurance is automatically available for covered work injuries.

In some cases, though, you won’t just accept ongoing payments of your costs from an insurer. Instead, you may want to enter into a workers’ comp settlement. You can negotiate the terms of this settlement to make sure you get the money you need and deserve.

If your workers’ comp case is settled, the insurer for your employer will pay you a lump sum or pay out a structured settlement that enables you to receive money over time. In exchange for the funds provided in the settlement, you’ll give up any further claims.


Does Workers' Comp Insurance Cover Surgery?

If you are hurt on the job, workers’ compensation insurance should pay for your medical costs, among other losses.

These medical costs can include expenses incurred for surgical procedures you need as a result of an injury or illness that developed due to your job duties.Some of the most common types of surgeries for work injuries include:

  • Spinal fusion
  • Carpal tunnel surgery
  • Surgery for traumatic brain injury (TBI)
  • Knee surgery
  • Burn injury surgery
  • Surgery to repair bone fractures

No matter what type of procedure you undergo, your costs should be covered by your employer’s workers compensation insurer if the operation was necessary due to the harm you experienced at work.


What Is the Average Workers' Comp Settlement for Surgery?

Determining the average workers’ comp settlement for surgery isn’t really possible because your settlement amount is based on the severity of your injuries and many different kinds of injuries could necessitate an operation.

For example:

  • If you break your wrist at work, you might require surgery to put pins or plates in place while your wrist heels. The national average cost of this procedure is around $11,800, according to New Choice Health.
  • If you injure your back at work and need spinal fusion surgery, this could be a much more complex and costly operation. The national average for this procedure is $110,000.

Because the costs of surgical procedures can vary so wildly, you must make sure you understand all the potential surgeries you may need in the future. Don’t settle unless you’re sure your workers’ comp payout will provide enough compensation to pay for them.


What Should a Workers' Comp Settlement Cover?

State laws specify what types of compensation injured workers are entitled to. Specifically, you should make sure your settlement provides appropriate payment for:

  • Past and future medical bills
  • Past and future loss of wages if you earn less money due to injuries affecting your ability to work or if you cannot work at all
  • Scheduled losses or specific loss benefits. These are provided by law if you suffer certain kinds of serious and permanent injuries

If you have already undergone an operation or if you will need one or more procedures in the future, any workers’ comp settlement for surgery would need to be large enough to pay for this medical care.


What Is the Average Workers' Comp Settlement?

Remember, the cost of a surgery is just one of many expenses you should be compensated for if you are hurt at work. That means you will likely receive more money than just the out-of-pocket costs of any operations you endure.

In total, the average workers’ comp settlement was $21,800 according to a 2016 study. However, some cases could be worth as little as a few thousand dollars and others could be worth millions.


How Much Is Your Workers' Comp Claim Worth?

Since there is no single average workers’ comp settlement for surgery that you can use to help estimate the value of your case, you may be confused about how much money you’ll end up receiving.

The reality is, this depends on the state where you live and the type of injuries sustained.

For example, most states set specific values for “scheduled losses.” This means the state entitles you to compensation equal to a set weekly amount of wages based on the injuries sustained. But, the amount of compensation can vary from place to place. For example, if you lose an arm, you might receive:

  • 312 weeks in New York
  • 253 weeks in Illinois
  • 200 weeks in Virgina

An experienced work injury lawyer can help you determine the likely value of your workers’ comp claim based on where you live and the harm you’ve endured. You should contact an attorney ASAP to make sure you get the full amount of compensation you deserve.


Frequently Asked Questions (FAQs)

Can you sue your employer for work-related injuries?

In most cases, you cannot sue an employer for work-related injuries. You must make your claim through the workers’ compensation system. The employer’s workers compensation insurer will provide payment of medical bills, lost wages and certain scheduled losses or specific losses when injuries are serious. You can sue only in limited situations, such as if an employer hurt you on purpose.

What if you can't settle a workers' comp claim?

If you and your employer’s workers’ compensation insurer cannot agree on a settlement, then your case may need to go before an Administrative Law Judge (ALJ). These judges work exclusively within the workers’ comp system and help resolve disputes over appropriate compensation after a work injury.

Will workers' compensation insurance cover surgery?

Workers’ comp insurance is supposed to pay reasonable medical expenses after a covered work-related injury. If you need surgery because you are hurt or made sick while performing job duties, workers’ compensation insurance should cover any operations necessary to help you recover.