Workers’ compensation can reimburse and cover costs that result from a workplace industry, but can it cover surgeries? If so, how much coverage can workers’ compensation provide? Keep reading to find out.
Workers’ Compensation Basics
Workers’ compensation benefits are intended to cover medical bills, lost wages, and other costs for those hurt on the job. In some cases, injuries may need more invasive treatment or long-term care. For example, traumatic brain injuries (TBIs) often necessitate extensive surgeries, therapies, and potential home health services. If a TBI is the result of a workplace accident, the employer could be liable for those costs.
However, whether or not a company’s worker compensation program covers an injury depends on a number of factors. The employer’s policy needs a certain level of coverage, and the insurance company has to approve the claim. The insurer must pay the employee regardless of whether the employer was negligent.
For more extreme cases, the employee could enter into a workers compensation settlement.
Workers’ compensation attorneys should cover all costs including expenses for surgical procedures and treatments for illnesses or injuries on the job. The most common injuries that require surgery include:
- Spinal fusion
- Knee surgery
- Burn surgery
- Carpal tunnel
- Traumatic brain injuries
- Bone fractures
Regardless of the type of injury or level of procedure needed to address the injury, the insurer should provide coverage.
There is not necessarily an average coverage amount for surgery because all injuries are at different levels of severity and necessary treatment. For example, not all TBIs result in comas or extensive surgical intervention. Because of these factors and the unique nature of each person’s physiology, there are not standardized examples of appropriate coverage.
It is better to evaluate the degree of injury by comparison rather than the injury itself. In other words, comparing serious injuries separately from minor injuries is a key point in the process of quantifying workers’ compensation coverage.
In general, the total average workers’ compensation settlement for any injury whether surgery was needed or not was around $21,800. However, this number should be taken with a grain of salt as not every settlement has a similar pay out. Some settlements result in hundreds of thousands of dollars while other barely provide $1,000.
Because workers compensation is complex, you must consult an attorney about your options. Contact the Law Offices of Wax & Wax today.