What if the Doctors Are Recommending Surgery, But I Don't Want It?

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Can the Insurance Company Force You to Have Surgery?

One of our clients recently asked me "can the insurance company force me to have surgery?" He has a serious injury, and both his treating physician and the insurance company doctors are recommending surgery. But he is a smart guy, and he knows that surgery doesn't always "take." There are well documented risks with any significant surgery and he and his doctor have discussed those.  In fact, we currently have another client who is considering a second spinal fusion because his first one didn't "take," and his pain has progressively gotten back to pre-surgery levels.

These are great guys- fantastic workers who got seriously hurt at work - and who didn't deserve any of this. Nobody wants to trade chronic pain for painful surgery recovery, only to be followed by more chronic pain. And although most qualified surgeons put the odds of a successful spinal fusion to improve pain in your favor, it's still a big decision for any patient. And there is concern, according to US News and World Reports, that spinal fusions are over-utilized.

Can the Insurance Company Force You to Have Surgery?

The answer is no, so don't listen to the insurance company and the adjuster on this. They cannot force you to undergo an invasive surgical procedure in a D.C. workers comp case.  But if surgery is being recommended by your treating physician and the independent (defense medical) exam, doctor, or any second opinion doctor you went to on your own (and we advise our clients to get a second opinion) it is something you should consider and determine what will be best for you and your family, both now and long term.  Surgery can give relief and increase mobility, which is critical as you get older. 

If the insurance adjuster is smart, he or she may recognize that ultimately surgery is a gamble for the insurance company as well (they are responsible for anything that goes wrong in the surgery, or if it makes your condition worse) plus it's more expensive for the workers comp insurance company than conservative treatment. So, it really depends on what you decide - what you think is best for your serious injury and how it will affect you.

The good news is, we have a strategy, for you.

For our clients, we know the details and risks of their medical treatment and we can give them all of the information they need, and options for their DC workers comp case so they can decide the best course of action. Let's face it - for some serious medical conditions and injuries, surgery is the treatment of choice.  But we would never allow a workers comp insurance company to force a client into having surgery  if he or she wasn't comfortable having surgery, so we would work hard to negotiate a different outcome for them, such as a settlement or long-term pain management and other types of conservative medical treatment. On the other hand if our client wants surgery and is aware of the risks, we will fight for that as well. 

Contact the Experienced Workers Compensation Lawyers Who Will Go to Bat For You

It's critical for you and your family to get all of the information you need about the workers comp system before making an important decision on surgery - call us today at (202) 393 - 3320 to get the information you need.

Frank R. Kearney, Attorney-at-Law
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Experienced DC Workers' Comp, Long Term Disability & Accident Lawyer