Can I be forced to get surgery for my work injury?

by Karl Voigt

We are often asked by our clients if they can be forced to get surgery for their work injury. The decision whether or not to undergo surgery can be life-altering. Surgery gone wrong can worsen your condition or even disable you. On the other hand, surgery done right can reduce pain and increase physical capabilities. However, can surgery be forced upon you?

The first thing you have to consider is whether or not surgery is in your best interests. Many patients would likely have fared much better had they never undergone surgery, particularly low back surgery. However, many have done better having undergone surgery.

If your doctor has proposed surgery, NOW would be the time to discuss the chances of success. Discuss this with your surgeon, making sure he or she spends enough time with you to explain everything well and answer all of your questions. You also may wish to seek a second opinion, as this is a critical issue. Naturally, you have the right to a second opinion. Only a small percentage of patients actually exercise this right, but we encourage it.

You have to seriously consider if your condition warrants intervention. Generally, if you can’t bear your symptoms, and if surgery will likely alleviate your symptoms, you’ll probably want to get surgery. Decisions get more difficult if your symptoms are tolerable, but your condition might improve with surgery.

So, can the insurance company force you to undergo surgery? The short answer is “no”. No one can put you under general anesthesia without your consent. However, there are possible consequences if you exercise your right to decline surgery.

If a doctor says that you are 75% — or even 80% — likely to improve following surgery, you might face the possible forfeiture of your rights to future workers’ compensation benefits if you decline surgery. We’re talking both wage loss and medical benefits. And we’re talking permanent. No order to attempt to stop these benefits, the workers compensation carrier has to file a petition against you and meet its burden of proof. This is certainly not an easy burden of proof for the insurance company to meet. However, the consequences are severe. If the judge finds that the proposed surgery is likely to improve your condition and capacity, and you have exercise your right to decline that surgery, the judge may stop your wage loss and medical benefits. These instances, however, are rare.

Facing surgery can be one of the most difficult decisions you ever make. It is wise to take these decisions seriously, become informed, and way the possible consequences before undergoing such a drastic treatment.

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