Will My Personal Injury Settlement Be Higher If I Need Surgery?

When pursuing a personal injury claim, one of the most significant factors influencing settlement amounts is the necessity of surgery. Insurance companies and defendants generally recognize that injuries requiring surgery result in greater medical expenses, more pain and suffering, and longer recovery times. As a result, settlements in cases where the plaintiff undergoes surgery tend to be significantly higher than in cases without surgical intervention. In this blog, we will explore how the need for surgery affects personal injury settlements, examine relevant statistics, and discuss key considerations that impact compensation.

How Surgery Impacts Personal Injury Settlements

1. Increased Medical Expenses

Medical costs are one of the primary factors in determining the value of a personal injury claim. According to the National Safety Council (NSC), the average cost of a nonfatal disabling injury that requires hospitalization is approximately $47,000, while more severe cases involving surgery can reach six figures or more. The more extensive the medical treatment, the higher the settlement to cover these expenses.

Common surgeries in personal injury cases include:

• Spinal fusion ($50,000 – $150,000)
• Knee replacement ($35,000 – $60,000)
• Rotator cuff repair ($15,000 – $50,000)
• Herniated disc surgery ($20,000 – $90,000)

Settlements will often include compensation for hospital stays, surgeon fees, anesthesia, rehabilitation, and post-surgical care, all of which can drive up total damages.

2. Pain and Suffering Damages

Pain and suffering damages are often calculated based on the severity and duration of the plaintiff’s physical and emotional distress. The need for surgery suggests a more serious injury, leading to a higher valuation for pain and suffering. Additionally, surgery often impacts a person’s ability to perform their activities of daily living, which can lead to a higher pain and suffering damages amount.

3. Lost Wages and Loss of Earning Capacity

Individuals who undergo surgery often require extended time off work for recovery. According to the Bureau of Labor Statistics, the median number of lost workdays due to occupational injuries requiring surgery is 30 days. This loss of income must be factored into the settlement.

For more severe injuries, permanent disability or reduced earning capacity can significantly increase settlement values. For example, a construction worker who undergoes spinal fusion may no longer be able to perform physically demanding tasks, entitling them to substantial compensation for lost future earnings.

Statistical Evidence on Settlement Amounts

Several studies and industry reports highlight the impact of surgery on settlement amounts:

• A study by the Insurance Research Council (IRC) found that personal injury settlements involving surgery were, on average, 3.5 times higher than claims without surgery.
• In Illinois, the average settlement for a car accident case without surgery is between $10,000 and $25,000, while cases requiring surgery often exceed $100,000.
• Data from a recent survey of personal injury plaintiffs indicates that those who had surgery received settlements $75,000 higher, on average, than those who did not.

Factors That Influence Settlement Amounts Even with Surgery

While the need for surgery typically  increases settlement values, several factors can influence the final compensation:

1. Liability and Comparative Fault

If the injured party is partially at fault for the accident, their settlement may be reduced under Illinois’ modified comparative negligence law (735 ILCS 5/2-1116). For example, if a plaintiff is found 20% at fault, their compensation is reduced by 20%.

2. Insurance Policy Limits

Even if an injury warrants a high settlement, the at-fault party’s insurance policy limits may cap the amount recoverable. For example, if the defendant carries a $50,000 policy limit, but the damages exceed $100,000, the victim may have to seek additional compensation through underinsured motorist coverage.

3. Pre-Existing Conditions

Insurance companies often scrutinize whether a surgery was solely necessitated by the accident or if a pre-existing condition contributed to the need for surgical intervention. Plaintiffs must provide strong medical evidence linking their injury directly to the accident.

4. Legal Representation

Studies indicate that plaintiffs represented by an attorney recover significantly higher settlements than those who represent themselves. The Insurance Research Council found that, on average, claimants with legal representation receive 3.5 times more compensation than unrepresented individuals. It’s important to speak with a top-rated personal injury lawyer right away to preserve your rights and help you secure the maximum compensation for your injuries.

Contact the Award-Winning Illinois Personal Injury Lawyers at John J. Malm & Associates

While the need for surgery significantly increases the value of a personal injury settlement, it is not a guarantee of a high payout. Several factors—such as liability, insurance limits, and legal strategy—can impact the final amount. However, plaintiffs who undergo surgery generally receive substantially higher settlements due to increased medical costs, pain and suffering, and long-term impacts on their lives.

If you or a loved one have been injured in an accident and require surgery, talk to the experienced Illinois accident attorneys at John J. Malm & Associates to maximize your compensation. With over 90 years of combined experience, we understand how to present medical evidence, negotiate with insurers, and fight for the full value of your claim.

For a free consultation, contact John J. Malm & Associates today to discuss your case and explore your options for financial recovery.