Does Surgery Increase Workers' Comp Settlements? (2026)

Does Surgery Increase Workers' Comp Settlements?

In many cases, surgery can increase the total value of your workers’ comp settlement:

• The high cost of surgery may increase the total value of your claim.
• If you can’t work during recovery, you may be owed more wage replacement benefits.
• If you’re permanently impaired afterward, you may be owed a higher settlement.
• If you need physical therapy or rehabilitation after the surgery, your claim’s value could increase.

Many different factors shape the total value of your claim. The best way to understand how much you may recover is to consult an experienced lawyer.

Key Factors That Determine How Surgery Affects Your Settlement

The effects of surgery on your settlement can be complex. These are some of the main factors influencing total compensation:

Success of the Surgery

If your surgery is a success and you have fewer limitations, you may receive less compensation. However, if there are complications, your claim’s value could increase.

Total Cost

The more involved your surgery is, the more it’s likely to cost. This adds to your total claim value.

Rehabilitation

If you don’t need additional physical therapy or rehabilitation after the surgery, the value of your claim may decrease. However, some surgeries require extensive rehabilitation, which could increase your claim’s value.

Recovery Time

If you can’t work while recovering from surgery, you will likely receive temporary total disability (TTD) benefits, which are usually two-thirds of your weekly wage. Longer recovery times mean greater compensation.

Pre-Existing Conditions

If you have a pre-existing condition, the total value of your claim may decrease.

Whether the Surgery Is Approved

If the workers’ compensation insurance company deems the surgery non-essential, having the surgery will probably not increase your total claim value.

Should You Settle Before or After Surgery?

Whether you should settle before or after your surgery depends on your individual case. If you settle before, you could negotiate a larger settlement based on the estimated cost of surgery. You also won’t have to worry about the insurer denying your surgery request.

However, settling beforehand means that you risk not having enough money to cover medical expenses if your surgery leads to unexpected complications.

Average Workers' Comp Settlement Amounts for Surgery Cases

The average workers’ comp settlement (including surgery and non-surgery cases) is about $44,200. Although having surgery doesn’t guarantee a higher settlement, it increases the likelihood that you’ll receive one.

Generally speaking, the average settlement for surgery cases is around $10,000 to $100,000, though the amount depends on the kind of surgery:

Minor Surgery: $10,000 to $30,000

Carpal tunnel surgery and arthroscopic knee surgery are two common surgeries in this category.

Moderate Surgery: $30,000 to $70,000

Common moderate surgeries include rotator cuff repair and many types of back surgery.

Major Surgery: $70,000 to $100,000

Major surgeries include joint replacement and spinal fusion surgery. In some cases, they may cost more than $100,000.

Getting Workers' Comp Approval for Your Surgery

To get your surgery approved by your employer’s insurance company, you generally need to prove the following:

• Your injury qualifies for workers’ compensation benefits.
• Surgery is a reasonable treatment.

Your medical professional will tell the insurer if they think surgery is warranted. In many cases, the insurer will have its own independent medical examiner (IME) review the request.

Sometimes, the IME will require you to exhaust more conservative treatments before they approve the surgery.

What to Do if Your Surgery Request Is Denied

If the insurance company denies your request for surgery, you should first determine the reason for the denial. You can typically file an appeal if you believe the denial was wrongful.

You should consult a workers’ compensation lawyer before filing your appeal. Attorneys understand what it takes to get an appeal approved, and they can increase your chances of success.

How to Maximize Your Settlement When Surgery Is Involved

Does surgery increase workers' comp settlements? Part of the answer depends on the specifics of your case. These steps may help you increase your workers’ comp settlement if your case involves surgery:

• Document all medical costs and lost wages.
• Seek second opinions if you disagree with your medical professional.
• Attend all follow-up appointments and comply with treatment recommendations.
• Think about possible future medical costs.
• Work with a workers’ compensation attorney.

Working with a lawyer is crucial in workers’ comp cases involving surgery. Lawyers handle cases like yours on a daily basis, and they can offer guidance on maximizing your settlement.

Get Legal Help for Your Workers' Comp Surgery Case

If your case involves minor injuries, you may not need legal assistance. However, in any situation involving serious injuries and the possibility of surgery, working with a workers’ compensation lawyer is highly recommended.

If you’re not sure how to find the right lawyer for you, ConsumerShield can help. Fill out our contact form for a free case review!