So your company's WC carrier has denied your request for shoulder surgery, the refusal based on either necessity (they don't think you really need it) or predicted outcome (they don't think that the surgery would help with the condition enough to make it worthwhile.)
Otherwise, yes, if they deny your physician's appeal, they will determine that if no further treatment is possible, you have reached Maximum Medical Improvement (MMI)
and they will give you a permanent disabiity rating, a PPD. You will then be offered a Worker's Comp settlement. This will be done according to a very clearly established schedule, in other words, they pay exactly so much for this much of an impairment to the body, which is what a shoulder issue will be. There is no trial or negotiating that will get you more money for this particular injury and rating. It's not subject to bargaining.
You could have someone (an attorney) review this case if your appeal to have surgery is denied. If it appears that the rating they are assigning you is too low, the thing you do is could ask for is an Independent Medical Evaluation (IME) from another doctor, one which you have selected. There is some possibility that you could get a higher permanent disability rating this way, if this other doctor feels you have been rated too low.
But eventually, they are going to pay you whatever the schedule shows for your level of permanent disability rating, and then you will be sharing part of this fixed amount with an attorney.
