Back injuries are among the most common and painful injuries people suffer at work. A severe injury can prevent you from moving or doing your job and take a long time to heal. The Bureau of Labor Statistics reports that over 128,000 U.S. workers sustained a back injury in one recent year, and many required surgery to repair the damage.
If you suffered a back injury at work or while performing a work-related task in Georgia, workers’ compensation should cover the cost of any necessary surgery. However, employers routinely dispute workers’ comp claims about back injuries, jeopardizing their employees’ access to essential care. If you are struggling to receive coverage for back surgery after an on-the-job injury, contact the Law Offices of William F. Underwood, III, P.C. for a free consultation.
Does Workers’ Comp Cover Back Surgery?
Workers’ compensation insurance should cover back surgery if you need it after a work injury. If your employer accepts your claim, their insurer must cover all reasonable and medically necessary procedures you need. Workers’ comp should cover the cost as long as your doctor agrees that you need the surgery.
Types of Back Surgery
The Mayo Clinic lists four common types of back surgeries:
- Discectomy – Employees who suffer from herniated discs may need a discectomy, where a doctor removes the herniated portion of the disc from the patient’s spine.
- Laminectomy – In a laminectomy, surgeons remove part of the bone at the back of the spine to make more room for the patient’s spinal cord and nerves.
- Spinal fusion – In a spinal fusion, a doctor removes a damaged disc or discs from the spine and uses metal implants to connect two or more vertebrae.
- Artificial disc implantation – In this procedure, the surgeon replaces a patient’s injured discs with artificial ones made from plastic and metal. Once implanted in the spine, they help cushion the patient’s vertebrae.
What Happens if the Insurance Company Refuses to Pay?
Sometimes insurance companies refuse to approve a claim or won’t pay for a particular procedure. They might argue that your injury is unrelated to your job or that the surgery isn’t necessary. Back surgery is often expensive, and an insurance company might try to avoid paying for your operation if they think it will save them money.
If an insurance company will not pay for your back surgery, talk to a workers’ compensation lawyer immediately. Georgia has a process for resolving disputed workers’ comp claims, and your lawyer can find and provide the evidence to show the surgery is necessary and should be covered.
How a Workers’ Compensation Lawyer Can Help
Workers’ compensation claims and appeals are complex legal matters, and attempting to handle them yourself could leave you without the medical benefits you deserve. A Georgia workers’ comp lawyer can resolve your back injury case by:
- Communicating with the insurance adjuster – Insurance adjusters decide whether to approve or deny a surgery. Your attorney may be able to provide additional evidence to convince them to change their mind.
- Gathering your medical records and other evidence to support your case – Many workers’ comp denials are due to missing information. Your lawyer can review your claim to ensure the insurance company has what it needs to approve your surgery.
- Filing a Form WC-PMT – Filing this form with the Georgia State Board of Workers’ Compensation requests the insurance company make a timely decision about authorizing your back surgery.
- Requesting your doctor to complete Form WC-205 – A physician can submit this form requesting approval for the operation.
- Representing you in hearings – In a hearing, a judge from the State Board of Workers’ Compensation can approve or deny your request for back surgery. An experienced attorney can help present your case in compliance with the state’s workers’ compensation laws.
Get Help from Our Workers’ Compensation Lawyer in Georgia
You should not have to navigate the workers’ comp process on your own. At the Law Offices of William F. Underwood, III, P.C., we can protect your rights and help you get the medical care you need after a work-related injury. Visit our contact page today for a free case review with a workers’ compensation lawyer in Georgia.
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