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Does Surgery Increase Your Workers’ Compensation Settlement in North Carolina?

On Behalf of Christian Ayers
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Workers’ compensation insurance protects employers from civil liability for their injured employees’ damages, and it provides financial relief to injured employees that can help them recover and return to work. Some workplace injuries are more damaging than others, and it is possible for an injured employee to require extensive medical care. Your North Carolina workers’ compensation settlement can include coverage of all medical expenses related to your injury.

Does surgery increase your workers compensation settlement in North Carolina?

Calculating Your Workers’ Compensation Settlement

When you have suffered an injury while performing your job duties, you are likely covered by your employer’s workers’ compensation insurance policy. A successful claim generally yields two types of benefits: medical expense coverage and income replacement benefits. The exact value of your claim will typically depend on the severity of your injury.

Many injured workers will wonder whether the required surgery will increase their workers’ compensation settlement. Generally, an injured worker can expect full coverage for all medical expenses related to their workplace injury, but the manner in which the insurance company pays for these damages may differ from case to case.

There are two main methods an insurance company will use to pay for a claimant’s medical expenses in their workers’ compensation settlement. The first is stipulation and reward, in which the insurance company agrees to pay for the claimant’s immediate and future medical treatments arising from their injury. The second is compromise and release, which is a lump sum that includes the anticipated total cost of all the medical treatment the claimant will need.

Because compromise and release is essentially an estimation, it is possible that you will need to coordinate with the insurance company going forward should your medical expenses exceed their estimation. Whether your compromise and release settlement is paid as a lump sum or structured settlement, adjustments to your workers’ compensation settlement may be necessary due to unforeseen circumstances.

Filing Your Workers’ Compensation Claim

There are several procedural steps you will need to complete to successfully file your workers’ compensation claim, and your workers’ compensation settlement will largely depend on the scope and severity of the harm you suffered. Part of your preliminary claim filing process will include a disability rating from a physician approved by your employer’s insurance carrier.

This disability rating is a numerical value from 1 to 100, and the higher your rating, the more you can expect in disability benefits. If you disagree with the first doctor’s assessment of your condition, an attorney can help arrange for a second opinion.

Once you complete your claim forms and the disability review, you are ready to submit your claim to your employer’s insurance company. An experienced workers’ compensation attorney is an invaluable asset for this process as they can ensure all parties involved with your claim handle the claim in good faith and that you receive a fair settlement offer for your injury.

If you require surgery, you can reasonably expect the insurance carrier to pay for the cost of the surgery and reflect your recovery time in your benefits determination. This includes multiple surgeries that may be required for severe injuries. If you have any concerns about what your workers’ compensation settlement can and should include, your attorney can clarify these issues and ensure you receive an appropriate settlement.


Q: How Is a Workers’ Compensation Settlement Calculated?

A: Your workers’ compensation settlement is likely to include both medical expense coverage and disability benefits for the time you are unable to work following your injury. You can generally expect full coverage of all your medical expenses related to your work injury, and the disability benefits you receive will reflect whether you are able to work during recovery and how long it will take for you to regain your full earning capacity.

Q: How Much Compensation Can You Receive for a Surgery?

A: When you file your workers’ compensation claim, instead of thinking about your settlement as compensation for damages, as you could expect in a standard personal injury claim, it is more appropriate to consider your settlement as repayment of your expenses related to your injury. The insurance carrier can provide a stipulation and reward settlement, agreeing to pay all medical expenses related to your injury, or they may offer compromise and release.

Q: Does Workers’ Compensation Pay for Pain and Suffering?

A: No, you cannot expect pain and suffering compensation from your employer’s insurance carrier when you file your workers’ compensation claim. This insurance is meant to cover your medical treatment costs and provide relief from your lost income and/or lost earning power when your injury prevents you from working. You could, however, claim pain and suffering compensation in a separate third-party claim if anyone outside your work caused your injury.

Q: Is a Workers’ Compensation Settlement Taxable?

A: No, your workers’ compensation settlement is intended to repay a loss and compensate for your inability to work after an injury. It does not qualify as income; therefore, it is not taxable as income at the state or federal level.

Q: What Does It Cost to Hire a Workers’ Compensation Attorney?

A: Hiring trustworthy legal counsel can make filing your claim much easier, and you will be more likely to maximize your benefits with their assistance. The attorneys at Ayers, Whitlow & Dressler accept workers’ compensation cases on a contingency fee basis, meaning our client does not pay a fee unless we win their case, and their fee will be a percentage of their final case award. There is no fee at all if our firm is unable to obtain compensation for your claim.

Workers’ compensation insurance is meant to function as a safety net for injured workers, but many claimants encounter unexpected complications with their claims that they do not know how to address on their own. When you choose Ayers, Whitlow & Dressler to represent your case, we can provide guidance through every stage of your proceedings. Contact us today and schedule a free consultation to learn more about the legal services we offer.