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Workers Comp settlement or Another Surgery?

Athens, GA |

I am currently on Workers Comp for a back injury and I have had 2 surgeries already and I am still in pain. Workers Comp has made an offer to settle but I am afraid to settle while I still hurt and some of the doctors are suggesting a second opinion and possibly another surgery. If I settle now I know I will have to put up with the pain and pay for whatever I need myself, If I don't settle with Workers Comp now, will the same offer amount still be the same when I do decide to settle, even if I wait and do have another surgery? Or will the amount go lower or higher because of another surgery?

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Attorney answers 4


If you settle now, you will be required to sign documents that state all future medical treatment is your responsibility, so that is certainly a big consideration. If you do not settle now, the settlement offer could either increase or decrease in the future depending on many factors. When we evaluate claims for settlement, we essentially make a prediction as to what medical treatment will be reasonable and necessary in the future, place a value on that treatment and include it in our settlement demand. In your scenario, if workers' comp pays for an additional surgery and it reduces your symptoms, then the settlement value would likely decrease; however, if it is unsuccessful like the first two then you are looking at long-term pain management, which can be expensive. Another surgery alone will not increase the settlement value of your claim.


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Unfortunately surgery is not often the answer. Statistically people who have back surgery improve only 50% of the time. Having had 2 already and still having pain, I would think long and hard before undergoing another one. My experience is that a pending recommendation for surgery increases the settlement amount for the claim. Once the insurer pays for the surgery, that amount is removed from the future medical part of the settlement evaluation. Any settlement should include consideration for the likely expenses of future treatment although keep in mind that the money for future medical is not paid to you but to the doctors, hospitals, etc.


There is no guarantee that the settlement offer will remain the same. The value of your case depends upon how much the insurance company thinks they will have to spend on your future medical treatment and lost wages, pursuant to the GA work comp laws. Since there is no money for pain and suffering in the work comp system, the fact that you are in pain adds no value to the case. The only two elements of your case for settlement value are medical care and lost wages. If you have the surgery and it is a success and relieves all your pain, the settlement value may go down. If you have the surgery and it does not work and you require more medical care, the settlement value may increase. Since a settlement is voluntary, there is no right or entitlement to a settlement. Both sides must agree on the amount. Keep in mind that at any point during your case, the estimated settlement value is based upon the insurance company's expected exposure, in terms of future medical costs and lost wages for your case. I handle workers' compensation cases in Florida and Georgia. If you do not already have an attorney, you can call me to discuss your situation further.

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