Does Surgery Increase My Workers’ Compensation Settlement in Texas?

Workers’ compensation will cover you for workplace injuries in Texas provided your employer subscribes to the state system

Unlike the rest of the states in the country, this is not a mandatory requirement for employers in Texas.

The extent of your workplace injuries will generally determine the amount and duration of compensation but many people who have surgery after their accidents want to know if it will increase the amount of workers’ compensation they are entitled to.

Generally, the workers’ compensation scheme will meet all medical costs associated with your injuries, including surgery.

However, if your employer is not part of the scheme, you can sue for damages in a lawsuit. In this case, surgery is likely to increase the amount of compensation you can expect for both the medical bills component of your injury claim and the pain and suffering caused.

Workers’ compensation benefits in Texas

If your employer subscribes to the Texas workers’ compensation scheme and you’re injured in a  workplace accident, you can apply to receive the following benefits:

• Partial wage replacement
• Payment for medical treatment
• A lump sum (if you suffer a permanent impairment or disability)

If surgery is required to aid the recovery process, workers’ compensation will meet the costs and during the recuperation period, some of your wages will be paid to help you meet the financial costs of your injury.

If, after surgery, the medical professionals agree that a victim has reached maximum medical improvement and he/she is expected to be permanently physically impaired, a lump sum benefit can be paid to the accident victim (in proportion to the extent of the disability suffered).

Because workers’ compensation involves no “settlement” as such, it is largely unaffected by whether you have surgery or not. As long as the surgery is medically necessary, it’s usually covered by the state’s workers’ compensation scheme.

If there is permanent disability after surgery, however, it may be possible to negotiate the lump sum you will receive — usually with the aid of a seasoned personal injury lawyer.

When can you file a lawsuit against your employer for injuries?

If your employer subscribes to workers’ compensation, no lawsuit is necessary to claim workers’ compensation.

Although you don’t receive compensation for pain, suffering, or mental anguish (which is often substantial in severe workplace accidents), the lack of legal action means that benefits are generally received relatively quickly, easily and with a lower burden of proof than in civil personal injury claims.

Because workers comp is not mandatory in Texas, however, some employers opt-out. This lays them open to the risk of a personal injury lawsuit if there is a workplace accident.

With lawsuits, proving liability may be more challenging (you generally need a personal injury lawyer to help you do so) and it will usually take longer to settle but you may be rewarded with higher compensation.

Employers who do not subscribe to workers’ compensation are excluded from using certain defenses. For instance, they cannot simply claim that your case should be dismissed or your judgment reduced because you were at least partly at fault (unless you were intoxicated at work) or another employee caused the injury.

The courts in Texas can help ensure that employers do not get off lightly and workers receive the compensation they deserve — but it can be a complex process.

How are personal injury settlements calculated in Texas?

Personal injury damages in Texas fall into two categories:

General Damages

General damages are the easily calculable, out-of-pocket expenses incurred from an accident/injury: medical fees, rehabilitation costs plus the estimated costs of expected future treatments, as well as property damage and loss of income.

Special Damages

Special damages are more difficult to calculate and include the non-economic costs of an injury, including pain and suffering, psychological treatment and the loss of quality of life.

Personal injury settlements in Texas are usually based on adding up the damages you have suffered and then applying a multiplier. This can be anything from 1.5 to five depending on the level of pain and suffering endured as a result of the injuries (or, sometimes, depending on the actions of the employer after a workplace accident injury).

How can surgery affect the value of a settlement in a personal injury case?

The costs of surgery in Texas are almost universally high, though they vary greatly from procedure to procedure.

You don’t need to concern yourself with these costs with a workers’ compensation claim but with a lawsuit, surgery is likely to substantially affect the overall payout.

All but the most basic surgical procedures cost tens of thousands of dollars in Texas when we factor in the expertise required, the preparation, potential complications, the costs of recovery/follow-up and so on.

Most surgical procedures not only add to the general damages component but also the pain and suffering caused during the after-accident period. This means that it can increase the “multiplier” used to calculate the final settlement amount of a lawsuit, adding significantly to the overall value of a compensation case.

A long recovery from surgery, which is normal in the case of procedures for serious injuries, also adds to the value of a case because it will mean more time off work, a higher amount of lost wages, and more follow-up visits for medical assessment.

Ultimately, surgery is likely to increase the compensation received from a personal injury lawsuit but the decision on whether to proceed with surgery should be a strictly medical one.

Note that most personal injury cases settle out of court for less than the full value. A good personal injury lawyer will push for the best possible outcome and, sometimes, in the interests of avoiding the delays and stress associated with a trial, this means it’s best to accept a slightly lower payout.

It’s important to speak to a qualified personal injury lawyer so that you understand the true value of your case before considering any settlement.

If you’ve suffered a workplace injury in the Houston area and your employer does not subscribe to workers’ compensation, Ryan De Hoyos can help. He is a skilled litigator and negotiator and will not rest until you claim the maximum possible damages.

Contact the DeHoyos Accident Attorneys, PLLC today for a free consultation to evaluate your personal injury case.