What Effect Could Surgery Have on the Value of My Claim?

Posted on behalf of Jeff Pitman on March 29, 2022 in Personal Injury
Updated on April 24, 2024

surgery effects claim value How does surgery effect the outcome of a personal injury claim? Does it always add value for the victim? The answer may surprise you.

Logically, an injured victim should never have to pay for damages caused by another person’s negligence. The full value of a victim’s claim should include all related medical costs and other damages. That said, there are times when surgery may not improve the value of a victim’s claim. In fact, sometimes, surgery could have the opposite effect.

Learn about surgery in injury claims, including when victims may benefit and when it could do more harm than good.

At PKSD, we are prepared to help you recover maximum compensation for your injuries and other losses. Our Milwaukee-based personal injury lawyers are deeply committed to helping victims hold at-fault parties accountable for their negligent actions. Learn more about our Wisconsin law firm and how you could benefit from our legal services in a free consultation.

FREE Case Review. Call 24/7 to schedule yours. 414-333-3333

Does Surgery Increase the Value of a Claim?

That depends. Surgery is never cheap. The final bill for the surgeon, anesthesiologist, use of hospital facilities and more, could add up to thousands or tens of thousands of dollars. However, despite the expense, if it helps you to recover from your injuries, the outcome is well worth the cost.

The expense of your surgery, along with other medical bills and related damages, could increase your claim’s total value. Your attorney may use this value as a starting point for negotiating a fair settlement.

Other costs that often increase the value of an injury victim’s claim include:

  • X-rays, MRIs and other tests to accurately diagnose your injuries
  • Surgery to address your injury and aid in your recovery
  • Prescription medication to help with pain management and infection risks
  • Lost wages if you were unable to work while recovering from your injuries
  • Added output of money, such as for childcare or help managing household tasks
  • Other pain and suffering costs, such as emotional distress or depression

A qualified attorney adds all of your related and necessary medical costs to the total value of your claim. However, is surgery always needed? Do victims or even doctors push for surgery that is unnecessary when less invasive steps may be effective?

Why You Should Not Push for Surgery You Do Not Need

Surgery, no matter how small, always comes with certain risks. Patients could have an allergic reaction to the anesthesia, for instance. In other cases, the surgery may cause permanent scarring. Some patients could even have an unexpected or fatal outcome.

Victims should never push for surgery if their treating physician does not recommend it. The risks outweigh the benefits if surgery will not help you to recover further or faster.

What About Getting a Second Opinion?

If you do not have confidence in your treating physician, it may benefit you to get a second opinion. Even when a doctor recommends surgery, a patient may gain reassurance from hearing what another doctor recommends.

Could Having Surgery Reduce the Value of Your Claim?

As surprising as it may be, having surgery could reduce the value of a claim- for good and bad reasons.

The insurance company is always looking for ways to reduce what they pay on a claim. They are a for-profit company, so overpaying on a claim makes no business sense. To determine if your surgery was necessary, insurers will:

  • Review your medical records, including diagnostic tests and results
  • Examine your physician’s notes and recommended treatment plan
  • Research whether other less invasive treatments are available

If the insurance company finds the surgery was unnecessary, they may refuse to pay for it. The result is that you could get stuck with the bill and it may also reduce the value of your claim.

Even if your doctor recommends surgery, the final value of your claim could be less than you expected. For example, if surgery helped you to recover faster and also reduced your pain and suffering.

Surgery is Not the Only Treatment That May Affect the Value of a Claim

There are other factors that may have a greater impact on the value of claim than if a victim has surgery, such as:

  • A victim’s physical condition and ability to heal: Some people heal faster than others.
  • The severity of an injury: Some injuries, with or without surgery, may take longer to heal.
  • Whether a condition is permanent: Victims with permanent damages may need ongoing care.

Longer recovery periods incur greater costs – potentially more than if you had surgery. For instance, victims who suffer from a traumatic brain injury or spinal cord damage may never fully recover. Sometimes these victims may also require treatment for secondary conditions that develop months or even years after the original injury.

Having surgery to increase the value of a claim should never be the goal. The best approach is to get the treatment you need to return, as much as possible, to your pre-accident state.

What Injuries Are More Likely to Need or Benefit From Surgery?

Certain severe or life-altering injuries are more likely to need surgery to help a victim reach his or her point of maximum medical improvement (MMI).

For instance:

  • Knee replacement or repair surgeries: Various accidents can cause severe knee damage, but this injury is especially common after a head-on collision. Knees and legs can suffer severe crush injuries in this and other types of car crashes.
  • Fractures: While broken bones are not always severe, those that are may need surgery to insert plates, pins or rods for added support. Infection may also be a risk if the fracture causes an open wound.
  • Damage to Internal organs: Ruptured spleens and punctured lungs are extremely common in accidents, including car crashes. Surgery to repair these and other internal organs is often needed, without delay.
  • Spinal cord injuries: Injuries to the spinal column could require surgery to repair herniated discs, remove bone fragments, repair compression fractures and address other, more serious damage.
  • Traumatic brain injuries: Not all brain injuries need surgery. However, sometimes it is necessary to relieve intracranial pressure or repair other damages.
  • Soft tissue damages: Surgery may be necessary if a victim suffers severe injuries or tears to tendons and ligaments.

Need Help With a Claim? Our Trusted Law Firm is Here to Help

Dealing with an unexpected injury is stressful. When you also have to deal with a complicated legal process, it can interfere with your recovery.

At PKSD, we manage injury claims every day, and we know how to protect your interests. Our firm has a successful track record, and we also have the staff and resources to give your claim the attention it deserves.

If you have been injured because of someone else’s negligence, we encourage you to contact our law firm today. We offer a free consultation with one of our licensed attorneys. If you cannot come to us, we can come to you. Learn more about how an attorney may benefit your claim and get the answers you need.

Proven Results. Millions Recovered. 414-333-3333

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