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Will Having Surgery Increase the Amount of My Workers’ Compensation Claim?

Will Having Surgery Increase the Amount of My Workers' Compensation Claim
Will Having Surgery Increase the Amount of My Workers' Compensation Claim

The Florida workers’ compensation system was designed to provide injured workers or those with occupational diseases the financial support needed to recover quickly. Part of this includes covering the cost of your medical treatments.

You may wonder, “If I have to have surgery, will my workers’ compensation settlement increase?”

The answer to this is usually “yes.” Generally, if you have to have surgery because of a work injury, your workers’ compensation settlement will increase to cover the cost. While true, several factors will impact the payout you receive.

At Sternberg | Forsythe, P.A., we understand how the workers’ compensation system works and can help ensure you get the full benefits you are entitled to after a workplace injury. You can call our office or use the information here to learn more about the impact of surgery on your workers’ compensation settlement.

Understanding Workers’ Comp Settlements

Workers’ comp is a form of insurance that provides wage replacement and medical benefits to employees injured during employment. This system facilitates a quick and fair resolution to workplace injuries without prolonged litigation.

The Role of Medical Treatment in Workers’ Comp Claims

Medical treatment is at the heart of any workers’ comp claim. The type and extent of medical care you require—such as surgery—can significantly influence the settlement amount. This is because settlements are often based on medical costs, lost wages, and the injured worker’s ability to return to work.

Does Surgery Increase Settlement Amounts?

Generally speaking, the more severe the injury and the more intensive the required medical treatment, the higher the workers’ comp settlement can be. Surgery is a significant medical procedure that typically reflects a more severe injury, which may naturally lead to a higher settlement. However, this isn’t a universal rule, and each case must be evaluated on its merits.

How Settlements Are Calculated

Workers’ comp settlements are calculated based on several factors, including:

  • The cost of medical care, including surgery.
  • Lost wages during recovery.
  • Future medical expenses if ongoing treatment is needed.
  • The potential for permanent disability or impairment.

Surgery can affect all these factors, potentially leading to an increased settlement.

Specifics in Florida Workers’ Compensation Law

In Florida, where Sternberg | Forsythe, P.A. practices, workers’ compensation laws specify what constitutes a compensable claim. The Florida Workers’ Compensation Law (Chapter 440, Florida Statutes) dictates that for an injured worker to receive benefits, their injury must be work-related, and they must adhere to the process set forth by the state, which includes reporting the injury to their employer promptly.

Permanent Total Disability (PTD)

In some cases, if surgery leads to a determination of Permanent Total Disability (PTD), an injured worker may be entitled to benefits until the age of 75. Under Florida law, this is a consideration if the surgery does not fully restore function or if it results in significant permanent limitations.

The Role of a Boca Raton Workers’ Comp Lawyer

Having an experienced Boca Raton workers’ comp lawyer by your side is crucial, particularly when surgery is involved. An attorney can guide you through the complex claims process, ensuring that all necessary documentation is provided and that you receive the maximum compensation to which you are entitled.

Legal Representation Can Make a Difference

Legal representation is often instrumental in achieving a settlement that truly reflects the severity of your injury and the impact it has on your life. A lawyer can negotiate with the workers’ comp insurance carrier on your behalf, advocate for your needs if a dispute arises, and represent you in hearings if necessary.

Considerations Before Agreeing to Surgery

Before agreeing to surgery, it’s essential to consider the following:

  • Second Opinions: It may be beneficial to seek a second opinion to confirm that surgery is the best course of action.
  • Authorization: Ensure that the surgery is authorized under workers’ comp to avoid personal liability for medical costs.
  • Recovery Time: Consider the potential length of recovery and how it may affect your claim.

Navigating the Road Ahead

The decision to undergo surgery is not only a medical one but also has legal implications for your workers’ comp claim. It is essential to navigate this decision carefully, considering the potential benefits and risks.

FAQs in the Context of Workers’ Comp and Surgery

Q: Can I choose my doctor for surgery under Florida’s workers’ comp system?

A: Florida law typically requires you to see a doctor authorized by your employer’s workers’ comp insurance. However, you may have a right to a one-time change of physician and, in some cases, to seek a second opinion.

Q: Will I get paid if I’m out of work recovering from surgery?

A: Yes, if you’re unable to work while you’re recovering from surgery, you should be eligible for temporary disability benefits.

Q: What if I need additional surgeries or treatments after the initial one?

A: Additional necessary medical treatment can be covered under your workers’ comp claim. It’s crucial to have this documented and approved within the claim.

The Bottom Line

While surgery can indicate a more serious injury and potentially lead to a higher workers’ comp settlement, it is not a guarantee. The impact of surgery on your claim depends on multiple factors, including the specifics of your case and Florida law. At Sternberg | Forsythe, P.A., our Boca Raton workers’ comp lawyers are committed to providing personalized and professional service to guide you through each step of your claim.

To get a more detailed understanding of how surgery may affect your workers’ comp settlement, please consult with a knowledgeable attorney who can provide legal advice tailored to your specific situation.

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