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Does workers’ compensation cover spinal fusion surgery?

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Does workers’ compensation cover spinal fusion surgery?
by Atkinson Gerber Law Office
Jan 05, 2023

Despite the persistent back pain, you soldier on in your job as a construction worker. You have seen doctors and medical specialists, who have prescribed medication and assigned you to physical therapy sessions. However, this only works to a point.

Surgery is an option, and you finally pursue it. Specifically, spinal fusion surgery. But in making this important decision, you wonder whether workers’ compensation insurance will cover spinal fusion surgery. In some circumstances, it does.

State rules allow such surgery

State rules pertaining to workers’ compensation treatment allow for spinal fusion surgery.

However, this primarily applies to workers with debilitating lower back pain that has continued for more than three months and to workers who have degenerative disk disease – which is usually caused by arthritis.

In these situations, though, non-medical complications may arise when dealing with the insurance company. For example, your employer’s carrier may deny the surgery, seek additional information from your doctor, ask you to get a second opinion or select their own doctor to examine you.

Despite such potential developments, you must persist in seeking the treatment that may help you. Typically, the most serious back injuries may require spinal fusion surgery, which will take months from which to recover.

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Employers must properly train workers

If the injury occurred at work, you may qualify for workers’ compensation benefits. Workers most susceptible to back injuries include those in the construction, health care, and transportation and warehouse industries.

This is why it is so important that employers provide the proper training and equipment to allow workers to successfully perform their jobs.

Work-related back problems often surface due to improperly lifting heavy of objects. This may happen when a person relies on back muscles rather than leg muscles for lifting. Twisting and turning while lifting also may lead to back injuries.

Seeking the treatment that may help you

If you choose surgery, please remember that spinal fusion does come with risks. Medical studies unveiled that roughly half of the injured workers who have the surgery improve. Meanwhile, as many as one-third experience poor results. This should not prevent you from seeking a treatment that may help you.

When it comes to workers’ compensation benefits and eligibility, seek the advice of a skilled attorney.

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