What Is the Average Workers’ Compensation for Surgery?


If you sustained a severe injury while working in Indiana, the last thing you want to worry about is paying for any surgeries you need as a result. Surgeries can cost patients thousands of dollars, and the extensive recovery time after a procedure can take a big bite out of your income.

The good news for injured workers in Indiana is workers’ compensation benefits generally cover the cost of surgery. If you have suffered a work-related injury that requires surgery, you might also qualify for additional benefits, such as wage replacement.

The Indianapolis workers’ compensation lawyers from Klezmer Maudlin PC put together this guide to help you understand the average workers’ comp benefits for surgery. Below you’ll find more information on how workers’ comp claims work in Indiana, what workers’ compensation covers, and what benefits you might qualify for.

Workers’ Comp Benefits in Indiana

First and foremost: Does workers’ compensation cover surgery for Indiana employees? The short answer is yes. If you qualify for workers’ compensation benefits and your employer accepts your claim, they will cover all reasonable and medically necessary treatments for your injury. So, as long as your doctor says your surgery is medically necessary, you don’t have to pay for it.

State law says most Indiana employers must provide workers’ compensation insurance covering their full- and part-time employees.

The law lists a handful of exempt workers, such as:

  • Railroad workers
  • Farm laborers
  • Some police officers and firefighters
  • Independent contractors

Workers’ compensation provides more than just medical benefits for injured employees. According to the state Workers’ Compensation Board, workers who cannot work for at least seven days qualify for income-replacement benefits. These benefits cover two-thirds of your average weekly income during the year leading up to your injury. You can find the statutory cap on such benefits here.

Can Injured Workers Choose Their Own Doctor in Indiana?

State law requires injured workers in Indiana to be a doctor chosen by their employer or the employer’s insurer. That said, you should speak with an attorney right away if you believe your employer’s choice of doctor is not providing the care you need.

The Steps in an Indiana Workers’ Comp Claim

The basic steps in an Indiana workers’ compensation claim are:

Report your injury to your employer

Make sure you report your injury to your employer as soon as possible. Make your report in writing, or ask someone you trust to do so for you. Having a written record of your accident report can help if your employer disputes your claim.

Seek Medical Attention

You should address any serious injuries immediately before reporting the incident to your employer. Otherwise, your employer or their insurer can choose the doctor who treats you. Promptly seeking medical treatment shows your employer and their insurance carrier that you took your injuries seriously. Additionally, waiting to seek medical attention could worsen your injuries, potentially complicating your claim.

Follow Your Doctor’s Prescribed Treatment

It is crucial to follow your doctor’s instructions in the letter. If you don’t, you might run into trouble with your claim or worsen your injuries. If you disagree with your doctor on your course of treatment, talk to an attorney before you see another doctor.

Wait to Hear From Your Employer’s Insurance Carrier

After you submit your injury report to your employer, they have seven days to file a report with their insurance carrier and send you a copy. If you don’t receive this form within the allotted time period, contact an attorney. Once the insurance carrier has the report from your employer, they have 30 days to decide on your claim.

If the insurance company approves your claim, you should receive your benefits shortly. If the insurer denies your claim, you can appeal to the state Workers’ Compensation Board. Hire an experienced attorney to help with any workers’ comp claim appeal, as those without legal representation frequently lose.

Can Injured Workers in Indiana Sue Their Employers?

Injured workers in Indiana generally do not have the right to sue their employer. Workers’ compensation is the sole remedy for injured workers to get the money they need to treat their injuries and return to work.

However, you can file a third-party claim if someone other than your employer caused your injury. Third-party claims happen outside the workers’ compensation system, allowing you to pursue additional compensation for your injuries.

A third-party claim could provide you with money for:

  • Your medical expenses
  • The full value of your lost income
  • Any reduction in your future earning potential due to an injury or disability
  • Your physical pain and suffering
  • Your emotional anguish
  • Your diminished quality of life due to an injury or disability
  • Your damaged personal property

How an Indiana Workers’ Compensation Lawyer Can Help

If you suffer a work-related injury, you should consider hiring an attorney to handle your claim.

An Indiana workers’ compensation lawyer can help you by:

  • Filling out the initial paperwork for a workers’ compensation claim
  • Gathering your medical records and other evidence to support your claim
  • Examining your benefits to ensure you recover maximum compensation
  • Assisting with any appeals if your employer denies your claim
  • Filing a third-party claim against other parties who contributed to your injuries

If you are a covered employee, the workers’ compensation system entitles you to benefits, including for any necessary surgeries. Working with an experienced attorney in Indianapolis will help you get the care you need at no cost to you.

Schedule a Free Initial Consultation Today!