What Is the Average Workers' Comp Settlement for Shoulder Surgery?

To begin with, there is no straightforward answer to this question. This is because each case is unique and depends on factors such as:

• the severity of the injury;
• the cost of medical treatment;
• the impact on the employee's ability to work; and
• and the state-specific laws and regulations.

That said, workers' compensation settlements for shoulder surgery can range from a few thousand dollars to hundreds of thousands. Another thing you need to know is that the more severe the injury and recovery period, the higher the settlement. But that is not always the case in states that limit the amount of compensation that can be awarded for a workers' compensation claim.

Since the settlement amount is usually negotiated between the injured employee and the workers' compensation insurance provider, hiring an attorney is always a good idea. An experienced workers' compensation attorney can provide valuable guidance and representation to ensure you receive fair compensation for your injury and associated expenses, including medical bills, lost wages, and rehabilitation costs after surgery.

Shoulder injuries in the workplace occur due to a variety of factors. Here are some common causes of such injuries:

Repetitive motion: Jobs that require repetitive motion, such as assembly line work, can cause shoulder injuries over time. In addition, jobs needing repeated lifting, reaching, or overhead work can cause strains, sprains, or tendinitis in the shoulder.

Overexertion: Overexertion occurs when you push yourself too hard physically. This work-related injury can occur when lifting or carrying heavy objects, pushing or pulling heavy loads, or performing tasks requiring significant force.

Falls: Falls are a common cause of shoulder injuries in the workplace. To put things into perspective, one study found that in 2020 alone, 805 workers in the US died from falls only. In addition, more than 211,000 suffered serious injuries, requiring time off work that year.  

Motor vehicle accidents: Workers who drive various vehicles or machines as part of their job may be at risk of shoulder injuries in related accidents. The impact of a car accident can cause shoulder dislocations, fractures, or soft tissue injuries.

Contact injuries: Workers who come into contact with equipment or machinery can also suffer shoulder injuries. Examples of such scenarios are when a falling object strikes a worker or their shoulder is caught in machinery.

Awkward postures: Awkward postures, such as reaching overhead, can exert excessive strain on the shoulder muscles and tendons, leading to shoulder injuries over time.

Generally, when you require surgery due to a work-related injury, chances are you may be entitled to a higher workers' compensation settlement than if you did not. The logic behind this is that surgery is often expensive. In addition, depending on the nature of your injuries, the recovery time can be lengthy, resulting in lost wages and other expenses.

It's also important to note that workers' compensation settlements are typically determined by state law. For this reason, the rules and regulations can vary from state to state. Therefore, consulting a workers' compensation attorney is a great idea. The attorney can help determine the potential value of your claim and the factors that could potentially impact your settlement amount.

One more thing you need to know is that while surgery could increase the settlement amount, factors such as the circumstances that led to the injury could also have a huge influence. Take, for instance, a situation where an employee does something they are not supposed to do while at work, and then gets injured in the process. A good example is driving a forklift while drunk. In that case, the insurance company will likely deny such a claim.

Let's further discuss other reasons for denying a worker's compensation claim.

The injury did not occur at work: Since workers' compensation insurance only covers work-related injuries, the insurance carrier may deny the claim if they believe the injury did not occur on the job or during work-related activities.

Lack of evidence: The insurance company may deny the claim due to lack of evidence. A good example of such a scenario is if you work with a team, but none of them witnessed the injury.

Pre-existing condition: The insurance provider may also deny the claim or reduce the settlement amount if you had a pre-existing condition. This is actually one of the many reasons it is always advisable to hire an attorney to defend your rights if you get injured at work.

Failure to report the injury on time: Workers' compensation claims are time-sensitive. In other words, you must report them to the employer within a specific timeframe. The insurance company may deny the claim if you fail to report the injury on time. For example, in Oregon, you have five days to report the injury to your employer.

Failure to seek medical attention: Seeking immediate medical attention is one of the first things you need to do after suffering a work-related injury. The insurance company may deny the claim if you fail to seek medical attention within a reasonable timeframe or follow the doctor's instructions.

The general rule is that you should seek medical attention as soon as possible. Most medical professionals recommend seeking medical attention within the first 48 hours of the injury. The sooner you seek medical attention, the better it is for your own health. As mentioned earlier, taking too long to get checked by a doctor is one of the many reasons an insurance company may deny your workers' compensation claim. 

We mentioned that a workers' compensation lawyer could provide valuable assistance if you or your loved one has been injured. Let's look deeper at the different ways this attorney can help.

Filing a workers' compensation claim: The workers' compensation claims process usually involves mountains of paperwork, most of which are time-sensitive and with minimal room for errors. An experienced lawyer can help you file a workers' compensation claim and ensure all necessary documentation is completed correctly and submitted on time.

Advocating for your rights: A good attorney can advocate for your rights and work to ensure that you receive the medical care and compensation you deserve after such an injury. And since most workers' comp lawyers get paid only if they win, that alone motivates them to put up their best fight against the insurance company.

Negotiating a settlement:  If your injury results in a workers' compensation settlement, a seasoned attorney can help negotiate on your behalf. This is done to ensure that you receive a fair and just settlement that covers your medical expenses after surgery, lost wages for the time you were unable to work, and other qualifying damages.

Assist with appeals: Suppose the insurance carrier denies your workers' compensation claim. In that case, a lawyer can help you file an appeal and represent you in any subsequent hearings or legal proceedings.

Provide legal guidance and strategies: A skilled workers' comp lawyer can provide legal guidance throughout the workers' compensation process. They can also answer any questions about your rights and entitlements under your state's workers' compensation laws.

Generally, having a workers' compensation lawyer by your side is one great way to ensure that your rights are protected and that you receive the medical care – including surgery if necessary — and compensation you deserve.

The truth is that although workers' compensation insurance is designed to cover employees when they get injured while on duty, insurance companies are all the same. Regardless of how valid your claim may seem, insurance carriers will always try to find a way to avoid liability. But that is not the only reason such claims are difficult to settle.

Let's explore more below.

One common reason is that such injuries typically involve more complex medical issues, higher medical expenses, and longer recovery times. Insurance companies will likely challenge your claim if you need surgery because they know that, in most cases, surgeries are expensive. Also, the longer you take to recover, the higher your claim for lost wages, medical bills, and other qualifying damages.

In some cases, you may not know the full extent of the injury until after the surgery has been completed. This can make it even more challenging to determine the appropriate settlement amount.

In addition, employers and insurance companies may dispute the cause of the injury or even the need for surgery. As mentioned earlier, because insurance companies know that surgeries are usually expensive, they will want to avoid them at any cost. This can lead to delays in the settlement process.

There is also the possibility of disagreements between the injured worker, their doctor, and the insurance company over the appropriate medical treatment. This also applies to the need for surgery, making such a case much more difficult to settle.

At Morgan & Morgan, we have an army of attorneys specializing in different areas of injury law, including workers' compensation. Our attorneys deeply understand workers' compensation law, including the specific rules and regulations that apply in your state.

Keep in mind that as the nation's largest injury firm, we serve clients from coast to coast. This means that we have the right attorney for every situation and location.
 
Because we have been fighting for the rights of the injured since 1988, our attorneys have experience handling a wide range of complex workers' compensation claims. This includes claims involving serious injuries, pre-existing conditions, and disputes over benefits. No matter how complex your case is, we can fight for you.

Morgan & Morgan has the resources necessary to investigate your claim thoroughly and gather the evidence needed to support your case. This includes access to medical experts, accident reconstruction specialists, and other professionals who can provide expert testimony.

Remember that our attorneys typically work on a contingency fee basis. This means that they only get paid if you win the case. This payment system can provide peace of mind knowing that you won't have to pay upfront legal fees in the unlikely event that you lose the case.

In addition, Morgan & Morgan attorneys are skilled negotiators and litigators who can represent you in settlement negotiations or in court if your case goes to trial. We are not one of those law firms that settle for anything just to avoid going to trial.  

But don't take our word for it—we have the track record to prove everything we say. With over $25 billion already recovered for the injured and a record of filing the most employment-related cases in the country, you can trust us to fight for you or your beloved.

If you or your loved one has suffered severe injuries requiring surgery, we know how complicated such a case could be. But with a Morgan & Morgan attorney by your side, you can rest easy knowing that you have America's largest injury firm fighting for your deserved compensation.

Contact us to discuss your case for free and without obligations.