Spinal Fusion (Cervical and Lumbar) Workers Compensation
Does Workers Compensation Cover Spinal Fusion Surgery?
Yes, as long as you meet the following conditions:
- You received a Workers Compensation Award letter that entitles you medical benefits for a work injury.
- You can prove that your spinal fusion procedure is necessary and related to your work injury.
However, insurance companies can put up fight when it comes to approving a workers' comp settlement for spinal fusion surgery, even if they have approved everything to that point.
Common defenses for denying these types of claims include:
- Saying that the surgery is needed because of degenerative disc issues that would have happened regardless of the work-related injury
- Claiming that different accident, like a fall or car accident, is the reason you need the surgery.
- Insisting you should undergo a discectomy first
- Claiming you aren't the right age for the procedure
- Saying that you need to quit smoking (if you're a smoker) or reduce how much you smoke because smoking can affect the success of surgical outcomes.
Our experienced team of work comp attorneys has been going up against insurance companies for decades. We know what to expect at every step of your claim – and what to do to protect your rights. You can reach us 24/7 at 412-394-1000 if you have work comp legal questions.
What Is the Average Workers Comp Settlement for a Spinal Fusion Surgery?
The average work comp settlement for spinal fusion is not a one-size-fits-all equation. A qualified work comp attorney won't apply a “typical” work comp payout for a lumbar fusion to your case. He or she should take your specific circumstances into account.
We outline some of those circumstances in the section below.
How Are Cervical & Lumbar Fusion Settlements Calculated?
We know that each client's case is unique, and we take a number of factors into consideration when calculating a cervical fusion verdict or settlement.
These factors include:
- How much you made before you were hurt: Many work comp benefits are based on your pre-injury weekly wage.
- The type of fusion you require: The more levels fused, the bigger the risk for complications or permanent injury. There are a variety of different spinal fusion procedures–2 level ACDF surgery, L 5 s1 fusion, the list goes on–and your specific procedure plays a role in your potential settlement.
- Additional medical procedures you may require after your initial fusion surgery
- How likely you are to face complications from surgery
- How altered your lifestyle will be affected as a result of the surgery
- Whether you suffered emotional distress as a result of your work injury
- And more
We will get to know you, your injury, and how your life has been impacted by your accident to help ensure we pursue every possible avenue to get you the settlement you deserve.
Do I Have to Have Surgery to Receive Workers Compensation Benefits for a Spine Injury?
The short answer is not always. Spinal fusions are risky procedures, and after discussing your options with your treating physician, you may decide it's not the best option for you. Though work comp benefits can be denied over unreasonable refusal of medical treatment, insurers may not pursue this option when it comes to spinal surgeries.
However, we advise that you do NOT speak with an insurer or third-party administrator managing your claim about the decision not to have surgery. Instead, contact our work comp team. You need someone who is on your side helping you navigate the workers' compensation claims process.
We can explain all of your options when it comes to your workers comp settlement for spinal fusion.
Contact Our Workers' Compensation Attorneys Today to Discuss Your Options
We know that the workers' compensation system is confusing. There are a million twists and turns, and any one of them can lead you to a dead end.
This is especially true when it comes to cervical fusion workers' compensation claims. You shouldn't try to figure out what to do next on your own. Our team has the experience and resources to answer even your most complicated legal questions.
Your injury isn't only open during business hours, and neither are we. You can contact us 24/7 at 412-394-1000, by chat, or via the form on this page to talk about your workers comp settlement for spinal fusion.