If you are hurt at work to the point where you need surgery, your mind can race with questions. You might be wondering if the surgery will increase your Maryland workers’ comp settlement or if it will result in more bills that come out of your own pocket. Well, here’s the good news: surgeries tend to result in higher workers’ comp settlements.
However, the type of procedure, your job, your average weekly wage, and the effect on your work life all play a part in the final settlement amount.
At The Law Offices of Alex Poberesky, P.A., we’ve seen hundreds of Maryland workers recover from surgery and secure strong settlements. Indeed, what matters is having strong legal aid by your side to ensure that you receive proper compensation.
How Workers’ Comp Settlements Are Calculated in Maryland
A workers’ compensation settlement should cover the full cost of your work injury. Maryland’s workers’ compensation system is meant to help you pay for medical care, recover lost wages, and receive additional compensation if you’re left with long-term effects.
The key factors in determining this amount include:
- Medical expenses:
ER visits, physical therapy, surgery costs, medications, and any future care.
- Lost wages:
Most pay about two-thirds of your average weekly wage while you’re out of work, up to a state maximum.
- Permanent impairment:
If you can’t return to your regular job or have lasting limits, you may get extra compensation based on your impairment rating.
- Future costs:
Surgery can bring follow-up care, rehab, or even more procedures, all of which must be reflected in a settlement after IME to ensure full compensation.
Why Surgery Increase a Workers’ Comp Settlement in Maryland
- Medical bills soar:
Surgery means higher expenses, including hospital stays, specialist visits, follow-up appointments, and therapy.
- More missed work:
A longer recovery period means you’re away from your job longer, raising compensation for wages that were lost.
- Permanent impairment is likely:
If surgery doesn’t fully restore function, your impairment rating goes up, which can increase your overall workers’ comp settlement.
- Ongoing care:
Cases with surgery often mean more checkups or even additional procedures down the line.
Insurance companies know surgery cases are a bigger risk for them. That’s why they often try to control costs or limit what they pay out. With the right attorney and good documentation, you can push for fair compensation that includes everything you need.
What Factors Can Influence a Workers’ Comp Settlement for Surgery?
When you require surgery, it indicates to the insurers that the injury is more severe, resulting in higher medical bills, longer time off, and possibly permanent changes to your ability to work. Still, not every surgery brings a bigger settlement.
Factors that often lead to a higher settlement after surgery include:
- Higher medical costs
- Extended recovery and additional wages that are lost
- Permanent limitations
- Complexity of the procedure
Other factors that are considered:
- How successful the surgery is:
Full recovery and a quicker return to work might lead to a smaller settlement compared to ongoing issues or complications.
- Negotiation process:
An experienced attorney can make sure all current and future costs are included in your final settlement.
- Maryland workers’ compensation law:
State regulations and the Workers’ Compensation Commission’s guidelines help determine the final outcome.
Types of Surgery That May Lead to the Settlement Amount Increasing
Not all surgeries are viewed the same by insurance adjusters. Some injuries are more likely to lead to a higher workers’ comp settlement in Maryland, like:
- Knee surgeries (ACL, meniscus repair, total knee replacement)
- Back surgeries (discectomy, laminectomy, spinal fusion)
- Shoulder surgeries (rotator cuff, labrum repair)
- Hip surgeries (replacement or repair)
- Hand and wrist surgeries
Surgeries that result in permanent work restrictions or lasting pain typically push the compensation settlement even higher.
How Insurance Companies Approach Surgery Cases in Workers’ Compensation Claims
They know that cases involving surgery can lead to larger settlements. They often:
- Request second opinions to challenge the need for surgery
- Delay approvals to push you to accept a lower settlement
- Offer quick settlements before you reach maximum medical improvement (MMI)
It’s not uncommon for insurance adjusters to question whether your treating physician’s recommendation for surgery is truly necessary. But good medical evidence and clear communication help respond to these tactics and support your claim.
Knowing also what not to say to your workers’ compensation doctor is just as important. It is because one wrong comment about your symptoms or recovery could affect how your case is evaluated.
What Injured Workers Should Know About the Settlement Process
Timing and the Settlement Process
One of the most common mistakes is settling a claim before you know the full impact of your surgery. It’s always best to wait until you reach MMI. That way, your settlement can include any future surgeries or permanent limitations.
Steps to a Fair Workers’ Comp Settlement After Surgery
- Report your injury and file a compensation claim right away.
- Follow all medical advice, especially if surgery is recommended.
- Collect all documents: surgical notes, MRI reports, rehab bills.
- Wait until the MMI to start serious settlement negotiations.
- Review all offers with a compensation attorney before you sign.
How an Attorney Helps Increase Workers’ Comp Settlement for Surgery in Maryland
Workers who undergo surgery often face a long recovery, big medical bills, and uncertainty about the future. Specifically, a workers’ compensation attorney can help you:
- Value your case accurately so that you know what’s fair in your situation
- Negotiate for additional compensation if surgery leads to lasting problems
- Handles pushback from insurers and settlement negotiations
- Take your case to the Maryland Workers’ Compensation Commission if needed
Reaching Maximum Medical Improvement Before Settling Your Workers’ Comp Claim
Reaching maximum medical improvement means your doctor believes you’ve recovered as much as possible. Waiting until MMI gives you a full picture of your needs. This is key for a fair settlement and can help you claim additional compensation if permanent restrictions remain.
Frequently Asked Questions About Maryland Workers’ Compensation Settlements
The following FAQ about workers’ compensation settlements in Maryland will give you a better idea of what to expect.
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Does surgery increase a workers’ comp settlement in Maryland?
Yes, surgery tends to lead to a larger settlement. Surgery can make injuries more costly, increase recovery time, and often create lasting limits that raise the amount of your workers’ comp settlement.
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How is a workers’ comp settlement calculated in Maryland?
Maryland looks at your average weekly wage, medical bills, type of surgery, wages lost, and your impairment rating. All these factors are combined to find a proper settlement amount.
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How does maximum medical improvement affect my settlement?
Waiting for MMI allows you to determine if you’ll require additional treatment or if surgery results in permanent changes. This means your settlement matches your real needs.
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What should I avoid saying to a claims adjuster?
Don’t say your injury is minor or guess about your condition. Stick to facts and let your attorney answer questions you’re unsure about.
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How can a workers’ compensation attorney help with my settlement?
An attorney can negotiate for proper compensation. They also handle insurance disputes and make sure you get all the benefits you deserve, including future care costs.
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How long does it take to settle a workers’ comp claim with surgery?
Cases with surgery tend to take longer because of a longer recovery period and more paperwork.
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Do all surgeries result in a higher settlement?
Most do, but it depends on the type of surgery, its impact on your life, and your job duties. More serious or multiple surgeries typically increase the settlement amount.
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What if the insurer denies my surgery?
A workers’ compensation attorney can fight the denial by gathering medical evidence, working with your treating physician, and appealing to the Workers’ Compensation Commission if needed.
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Can an MRI or diagnostic test increase my settlement?
Yes. Imaging, like MRIs, supports your claim by proving the seriousness of your injury, making it harder for the insurance adjuster to argue against your case.
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What is a reasonable settlement offer after surgery?
A reasonable offer covers your medical care, lost income, any permanent impairment, and all future treatment you may need as a result of the surgery.
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How do I get the most out of my workers’ comp settlement?
Follow your treatment plan, keep records, don’t rush to settle, and have a knowledgeable compensation attorney in your corner.
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How does surgery affect permanent impairment benefits?
Surgery may improve your function, but if it leaves you with restrictions or pain, your impairment rating can be higher.
The Value of Having a Workers’ Compensation Attorney on Your Side
Surgery cases are complex. But insurance companies fight harder to limit settlements when surgery is involved. Hence, you don’t have to face them alone. The Law Offices of Alex Poberesky, P.A., brings decades of experience with Maryland workers’ comp cases involving surgery. Our focus is on maximizing your workers’ comp settlement. Specifically, we help injured workers:
- Avoid quick settlements that shortchange their recovery
- Navigate the workers’ compensation system and commission hearings
- Push for additional compensation when the surgery results in lasting limitations
Secure a Fair Settlement for Those Cases that Require Surgery by Calling Us!
Undergoing surgery for a work-related injury is never easy, but it can make a big difference in your workers’ comp settlement. Surgery often means higher costs, more lost wages, and a greater impact on your life. Your settlement should reflect all of that.
At The Law Offices of Alex Poberesky, P.A., we fight for Maryland workers who need surgery after an injury. We help you claim the full value of your workers’ compensation benefits, negotiate with insurance companies, and move forward with confidence.
If you or a loved one needs surgery after a work accident, contact us today for a free consultation. Let us help you increase your workers’ comp settlement and get the support you deserve.
