Does Surgery Increase A Workers’ Comp Settlement?

The impairment rating usually goes up. At maximum medical improvement your authorised physician assigns a permanent partial disability rating, and that rating drives a significant part of what the claim is worth. Surgical cases generally rate higher than conservatively treated ones.

Medical costs rise sharply. The procedure, facility, anaesthesia, follow-up, and post-operative therapy all add to what the insurer has paid and may still owe.

Time out of work extends. Longer recovery means more weeks of wage-replacement benefits.

Future care becomes likely. Hardware removal, revision procedures, ongoing therapy, or later joint replacement. If the settlement closes future medical benefits, that expected care has to be priced in.

Before surgery, an insurer settling your claim is buying certainty about an unknown. After surgery, the outcome is clearer and the remaining risk is smaller — but the costs already incurred are larger and undeniable.

This is why insurers sometimes push to settle before a recommended surgery. Settling first caps their exposure and avoids paying for the procedure at all.

That is a genuinely important thing to recognise. An offer that appears promptly after a surgical recommendation is often not a coincidence.

The reverse also needs saying plainly. Declining or delaying recommended treatment because you are worried about how it looks is a bad idea both medically and legally.

Gaps in treatment and refused care are among the most common arguments used to reduce a claim. An insurer will argue that if you did not pursue recommended treatment, the condition was not as limiting as claimed.

Take the medical decision on medical grounds, with your doctor. The claim adapts to your treatment, not the other way around.

Your average weekly wage, which sets the benefit rate.

The impairment rating and the body part involved, since Georgia uses a statutory schedule.

Whether the injury is designated catastrophic, which removes the 400-week cap on wage benefits and dramatically changes exposure.

Whether you can return to work, and at what wage.

Whether liability is disputed — a contested claim settles differently from an accepted one.

Projected future medical care, particularly where the settlement closes those benefits.

The single most important question is what happens to future medical benefits. Most Georgia comp settlements close them permanently, which for a surgical injury can mean paying for revision surgery or long-term care yourself.

Get a realistic projection of future treatment before agreeing to a number. For hardware, ask specifically whether removal is anticipated. For joint injuries, ask whether replacement is likely down the line.

If you are a Medicare beneficiary or expect to be, Medicare’s interest in future medical costs may also need to be addressed as part of the settlement.