Q: The doctors say I probably need surgery for my workplace back injury. I know this type of surgery can be very expensive. Will workers’ compensation in Pennsylvania cover the cost?
Surgery can be required for some of the most serious back injuries.
One of the most common procedures is called spinal fusion surgery, which has the technical name spondylosyndesis. During this operation, the surgeon will permanently bond together two or more vertebrae (bones of the spine). The operation is performed under general anesthesia, so you will be asleep during the procedure. Natural bone or artificial bone-like material is used in the grafting process, and metal pins may also be put in place to fuse the vertebrae.
Patients typically face a long recovery time after back surgery, and pain is quite common. You will be gratified to know that the pain diminishes during the healing process, and the post-surgical pain is said to be much less than the ongoing, chronic pain from your job-related back injury.
Is This Surgery In Your Best Interest?
You note that your doctors have told you that back surgery will “probably” be required. Because this sort of surgery can be so painful and slow to heal, you may wish to consider alternatives to spinal fusion or any other procedure that your treating doctor recommends.
During the first 90 days of medical care for an injury covered under Pennsylvania workers’ compensation law, you are obliged to be treated by one of the doctors that your company has selected for employee claims. As long as your employer has followed critical rules—for instance, identifying at least six company-approved doctors and posting their names and contact information in an accessible place—you must seek treatment from a company doctor.
However, if that doctor recommends invasive surgery (such as most forms of back surgery), you have the right to seek a second opinion from any other physician you choose. Your employer’s insurance will pay for the consultation. You should realize, though, that even if the second opinion recommends a different course of treatment, you still must obtain that treatment from the company-approved health care provider.
Who is Going to Pay the Surgeon’s Bill?
You are certainly right that back surgery is expensive. However, under workers’ compensation law in Pennsylvania, you are entitled to receive any form of conventional treatment that can reasonably be expected to make you feel better and lessen your degree of disability. Your employer’s workers’ compensation insurance should pay all your medical expenses.
Unfortunately, insurance companies and employers often try to evade their responsibility to cover expensive injury cases. It would be a good idea to contact a workers’ compensation attorney in Harrisburg as soon as possible to make sure your rights to a full recovery are protected.
At Schmidt Kramer, we have steered workers’ compensation cases to a successful conclusion for hundreds of clients. You can reach us today by calling 717.888.8888 or (888) 476-0807 toll-free to schedule a free, confidential case review. Give us a chance to work for a full recovery from your workplace back injury.