Richard Chodkiewicz, 53, was working on a lift installation for the new Radisson Blu hotel in Bristol, when the half-metre length of scaffold pole struck him in July 2008.
Chodkiewicz and a colleague had been working at the bottom of the lift shaft.
Another man 18 stories up was lifting the 3.7kg section of pole on a piano wire as an improvised plumb line to help align the lifts.
But the tube slipped the tie, struck Chodkiewicz, and left the father of two needing round-the-clock care.
Main contractor Miller Construction (UK) and specialist Hoistway received fines totalling £110,000 for health and safety breaches in a hearing at Bristol Crown Court last June.
And yesterday an undisclosed seven-figure sum was approved by a High Court judge in the city to cover the 54-year-old’s loss of earnings and the 24-hour care he now requires.
Deborah Bigwood, a serious injury specialist at law firm Irwin Mitchell’s, said: “Although no amount of money will ever turn back the clock, today’s settlement will provide Richard with a vital care package as well as much-needed financial security for his family.”