Thursday, April 11, 2024

Average Workers Comp Settlement For Surgery

What Happens If You Leave A Torn Meniscus Untreated

Will Surgery Increase a Workers’ Compensation Settlement?

If you leave it untreated, a torn meniscus may result in more damage to the knee.

For example, an untreated meniscus injury can increase in size, cause an earlier onset of osteoarthritis, and slip into the joint, causing damage to other structures.

Further, these complications may result in disability from work . And the delay in treatment provides additional defenses to the insurance carrier.

We recommend considering potential complications when determining how much your work-related meniscus tear is worth.

These complications may include:

  • Development of osteoarthritis or posttraumatic arthritis: Indeed, meniscus injuries are more likely to result in degenerative joint disease.
  • There is an increased risk of re-injury or a recurrent tear if you return to a similar job, mainly if that involves kneeling or squatting. The risk for additional injury is greatest in the first 4 to 8 weeks after surgery.

Is It Worth Getting A Lawyer For A Workers Comp Settlement

While workers compensation is meant to make it easier for you to recover from a workplace injury, it can get complicated. If your injuries have caused you to have a permanent disability, if the insurance company is trying to dispute your claim, or if your injuries arent clearly work-related, a personal injury lawyer can help make sure youre getting what you deserve.

Any time you have a question or are not sure what to do about your case, its worth reaching out to a law firm that offers free consultations.

Complete a Free Case Evaluation form now

Contact Our Workers Compensation Attorneys For Free Today

John Foy & Associates has been helping injured workers win the settlement they deserve for over 20 years. We will support you through the entire process and make sure your rights are upheld. To schedule a FREE consultation with one of our experienced and compassionate workers compensation lawyers, call us at or contact us online to get started.

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Average Workers Comp Settlement Amount

There are a variety of factors that go into how much an employee gets in a workers comp settlement.

Overall, the average employee gets around $20,000 for their payout. The typical range is anywhere from $2,000 to $40,000.

This may seem like a huge range in possible payout amounts. But the injuries that qualify for a workers comp settlement also have a huge range and dont all require the same amount to cover fees and lost wages.

The majority of employees who fill out claims will get some kind of reimbursement. And there are specific ways that help employees get a bigger settlement across the board.

When an employee is offered a settlement amount they have the option to negotiate the terms and the workers comp payout amount. Typically, if the employee accepts the first offer they receive much less than if they counter for a higher amount.

Even the act of starting a negotiation can push the insurance company to increase the payout amount significantly.

Types Of Workers Comp Settlement

Workers Comp Settlement Amounts For Shoulder Injury

When a workers comp claim is filed there are a few different things that can happen.

The first is that the workers comp insurance will pay for treatments after a claim is filed. This could be physical therapy, doctors visits, medications, lost wages, or even disability coverage.

Insurance companies can offer a payment sum that they think is fair. If the injured employee believes the payout should be more they can negotiate for higher.

If a settlement is reached the employee most likely will be able to choose how it is paid out. They can choose a lump-sum, where they get the full amount up-front. Or they can choose a structured settlement that spreads the total out over monthly payments.

Unfortunately, after a claim is made occasionally the employer or insurer will try to avoid payment. They will try to argue that the injury wasnt fully because of the job or that it was pre-existing.

If this is the case, then the employee will have to argue their case . This is done through an appeals process. Every insurance company has a different process.

The appeal process doesnt always work in the employees favor. They may feel that going to court and having a legal battle is their next option. Though this is rare because of the fees involved in taking it all the way to court.

A workers comp case can be quick and painless or a long-drawn-out process. It all depends on the insurance company.

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Michigan Lawyer Discusses The Average Workers Comp Settlement For Ankle Surgery

Our experience shows that ankle surgery is one of the worst things that can happen after a workplace accident. Standing and walking can become extremely difficult. It can take weeks for a person to even start weight bearing. Work injury benefits are supposed to cover all medical treatment and a percentage of lost wages. A lump sump cash payout allows a person to finish medical and vocational rehabilitation on their own terms. Here is some information about the average workers comp settlement for ankle surgery.

We have seen all kinds of on-the-job injuries over several decades of practice. Some people get better quickly and return to their jobs after a couple weeks. Others are disabled for much longer and need help finding a new career. Employees who undergo surgery can go either way. Some people end up having multiple surgeries that include pins and screws. Walking or standing for long periods of time becomes very painful and interferes with essential job duties. The average payout amount awarded is going to depend upon several factors.

Step : Applying Discount Rates Over Time

In order to properly determine the correct settlement value of an employees workers compensation claim, the employee must apply certain discount rates to the lost wage figures determined thus far.

Generally speaking, there are two types of discounts that should be applied to lost wage benefits: actual discounts and time discounts.


Actual discounts are discounts to lost wage benefits on the basis that an employee may not expect to actually receive those benefits.

For example, if an injured worker received $500 a week in workers compensation indemnity benefits, and has 5 years of Supplemental Earnings Benefits remaining, then the value of those full remaining SEBs is $130,000.00.

However, if this same employee and this employees attorney determine after a thorough analysis that due to the employees medical status and work skills and abilities the employee in all likelihood will only be able to receive 2 more years of Supplemental Earnings Benefits , even those 5 years are technically possible, then this employee and his or her attorney should apply an actual discount from 5 years of SEBs to 2 years of SEBs, and calculate the employees correct settlement value of the employees lost wage benefits to be $52,000.


Just like lottery winnings, if the lottery winner wants all his or her money upfront , the lottery winner will need to take less money.

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How Does Negotiating A Workers Compensation Settlement Work

When you bring a workers compensation case after a work injury, the insurance company might offer payment for medical bills and disability. You can choose to accept the offer, or you can seek a settlement to cover more of your damages.

To reach a fair settlement, you will need to negotiate with the insurance company. Its best to have a workers compensation lawyer to help with this, as its very difficult to go up against workers comp insurance companies alone. You will need to work with an attorney who specializes in workers comp claims and understands what goes into them.

How Workers Compensation Settlements Are Calculated

What Makes A Workers Comp Case Worth A Big Settlement?

A large contributor to the total settlement amount when calculating workers compensation settlements is the severity of injuries.

Workplace accidents may be broadly categorized as follows:

  • Soft tissue injuries Includes sprains, strains, and contusions
  • Complex injuries Broken bones and lacerations
  • Severe injuries Permanent disfigurement, brain injury, spinal cord injury, or death

Workers who have suffered more severe injuries will generally experience higher settlement amounts than those who suffered an injury like a sprain or contusion. This is often because of higher medical expenses and lost wages due to an inability to work.

Factors used to calculate workers compensation settlements include:

  • Injury severity
  • Medical expenses
  • Fault & negligence

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The Consequences Of Your Workers Compensation Settlement Decision

Never negotiate your own workers compensation settlement. Once you formalize your back injury settlement, you cant go back and change your mind if you discover your back injuries are far worse or more expensive than you thoughtand they usually are.

Before signing away your rights to future benefits, you should learn everything you can about your back injurys value. Consider any impairments, work restrictions, and future medical issues that may affect your ability to work.

You must also recognize whether you are being treated fairly throughout negotiations. Always call a workers compensation attorney to review your case before settling. Here are some additional points to keep in mind:

  • When you reach a workers compensation back injury settlement, you give up your rights to collect future medical and wage loss benefits.
  • You cant reopen your claim if your injury causes additional problems.
  • To help you gain a better understanding of future medical issues, you should discuss your prognosis with your doctor.
  • Once you settle, youll be responsible for current unpaid bills and future medical costs.
  • Many states have a Department of Revenue that has the right to take some of your settlement funds and apply them toward any unpaid child support obligations.

Past Medical Treatments And Expenses

In order to calculate the medical settlement value of a workers compensation claim , it is also critical to evaluate past medical treatment history and past medical payment history.

Especially without the potential clarity of a Medicare Set-Aside , an employees past medical treatment history and past medical payment history can help dictate what the employees future medical treatment and expenses will be.

Also, important questions about how the workers compensation insurance company is handling the claim must be evaluated, such as:

  • Is the claim compensable , and are current medical benefits being paid?
  • Is the claim as a whole, or any part of the claim, being denied as non-compensable?
  • If any current medical benefits are being denied, it should be understood that most denials are being made for medical necessity, and disputes must go through the medical treatment guideline procedures.

    But not all treatments, for example, medical devices and prescription medications, are covered by the medical treatment guidelines, and therefore there are often conflicting opinions as to whether it is proper to use the medical guidelines for such treatments.

    And even in claims that the workers compensation insurance company admits are compensable, there can also be disputes over the choice of physician and/or change of physician.

    An employees past medical treatment history and past medical payment history can help identify common issues with past medical benefits, such as:

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    How Do I Seek A Workers Comp Settlement After Surgery

    In order to seek a workers comp settlement after surgery, you should contact an attorney promptly. You need to notify your employer of your injury or illness by your states deadline and, if you have already received treatment, this deadline could be expiring very soon. Your attorney can make sure you still have time to file, do everything that is necessary to protect your right to benefits, and help make sure seeking a settlement is your best option.

    Other Determinations For Settlement Value In Louisiana Workers Compensation

    Making a Personal Injury Claim

    The value of a workers compensation claim in most instances requires an assessment of the value of the remaining entitlement to indemnity benefits or the potential thereof and the value of the future medical expenses or potential thereof.

    Again, the settlement value of an employees workers compensation is based on the expected future lost wages and future medical expenses, minus offsets and discounts .

    Therefore, after properly evaluating lost wage benefits and future medical expenses, in order to accurately determine the correct settlement value of an employees workers compensation claim, the employee must properly evaluate other considerations important to settlement value.

    These other considerations important to settlement value are commonly referred to by the acronym TREE, which stands for:

    Common issues to be evaluated by the employee and the employees attorney for these other determinations for settlement value include the following legal issues:

  • The future value of Supplemental Earnings Benefits
  • The appealable value and
  • Penalties and attorneys fees.
  • The issues related to the acronym TREE include the following:

  • In a disputed claim that is set for trial, the time and process of navigating the legal system is always a consideration in terms of settlement value.
  • For employees who are being paid benefits, the value of the claim over time, generally goes down, not up!
  • How well will the employee be able to testify at trial?
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    Does Workers Comp Cover All Of The Costs Of Surgery

    In general, if you are eligible for workers compensation, your medical benefits should cover all of the costs of your surgery. This includes everything from your initial diagnosis through the procedure itself, as well as your hospital stay, therapy appointments, and prescriptions.

    There is one major exception: If you are not able to fully recover from your surgery, then workers compensation will only cover your treatment until you reach maximum medical improvement, or MMI. If your doctor tells you that you have reached MMI, or if your employers insurance company tries to stop paying by asserting that you have reached MMI, you should consult with a lawyer. An MMI determination has significant consequences for your workers compensation claim, and you need to make sure that this determination is not made prematurely.

    Eight Tips To Increase Your Torn Meniscus Settlement

    There are several things you can do to increase your torn meniscus settlement offer.

    First, get medical treatment immediately, using your private health insurance if needed. Many workers comp claims turn on the medical evidence, and waiting to treat may result in a worse outcome. Further, you can address potential insurance subrogation issues when settling the claim.

    Second, tell your employer about the work accident as soon as possible. Failure to give timely notice may result in forfeiture of benefits.

    Third, take photographs of visible injuries to the knee and the accident scene.

    Fourth, never accept the insurers first offer to settle your claim. It has more to offer and expects you to negotiate.

    Fifth, if the insurer does not agree to offer an Award Letter, serve discovery requests . This pressures the insurer to act and lets the claim adjuster know you are serious about pursuing the case.

    Sixth, ask your doctor to complete a report addressing causation and disability under the workers comp laws in your state. This is why selecting a claimant-friendly doctor from the panel of physicians is so important.

    Seventh, look for work within your restrictions if your doctor releases you to light-duty but your employer will not offer appropriate work. And keep track of what jobs you reviewed and copies of applications. The Workers Compensation Commission expects you to conduct a good faith job search to get wage loss payments.

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    Workers Comp Settlement Before Or After Surgery

    by Jaleh K. Slominski

    A surgical operation can sometimes be necessary after you get injured at work. What many employees want to know is whether workers compensation will pay for the surgery, and whether they should settle before or after the operation. Here are answers to some common questions about workers comp and surgery in Virginia.

    What If I Am Not Eligible For Workers Compensation

    Workers’ Compensation Settlements for a Knee Injury

    If you are not eligible for workers compensation, you may have other options available. You will want to contact a legal practitioner to go over these options as well. Depending on your personal circumstances, your other options for seeking compensation after suffering a job-related injury or illness may include:

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    Insurance Companies May Delay Their Response In An Attempt To Derail Your Claim

    The response time of the insurance company and your employer can also affect the full amount of time it takes to negotiate and settle a workers compensation claim. Insurance companies will sometimes delay sending you an offer or answering your inquiries. They may hope this encourages you to accept a smaller claim and settle the case sooner.

    It can also take longer to negotiate if you are still receiving treatment for your injuries. Your lawyer will want to ensure any future medical costs are accounted for, so they might wait until a doctor can determine your maximum medical improvement before deciding on a fair settlement.

    Benefits To Injured Workers During Workers Compensation Claim Process

    When a worker suffers a back injury on the job, they often struggle financially, emotionally, and physically. Workers compensation benefits can help reduce this strain, but often, you receive minimal benefits over time. The workers compensation payment rate only affords you a portion of your pre-injury wages. Depending on a workers back injuries and injury-related impairments, this process can continue indefinitely.

    A lump-sum back injury workers compensation settlement may give injured workers the power to change their financial circumstances. A lump sum may allow you to better plan your finances and live more comfortably. This can give injured workers the freedom to begin to pay off accumulating debts while relieving financial stressors.

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