Do I Need Back Surgery?

Many people dread a doctor mentioning the possibility of back surgery.  Unfortunately, serious back injuries happen too often at work.

I have represented many clients who suffer from herniated discs, injured facet joints, and fractured vertebra as a result of injuries at work.  Many of these clients have had back surgery.  Sometimes, that surgery has helped them.  Other times it has not.

Before going any further, it is important to understand that I am not a doctor.  I am an attorney that specializes in Georgia workers’ compensation cases.  Nothing in this article is meant as medical advice.  That leads me right into my first point.

Talk to your doctor about whether you need back surgery

If you have back pain and are wondering whether you should have back surgery, talk to your doctor.  Your doctor is the expert when it comes to making decisions about medical treatment.

Be sure to find a good doctor who you trust.  Unfortunately, your choice of doctors may be limited in a Georgia workers’ compensation case. You will probably have to choose from your employer’s list of doctors, but there are exceptions to that. Even if you have to choose from the list, you often have the right to change doctors or to get a second opinion.

Ask Questions To Get Good Advice From Your Doctor

To make a good decision about treatment, you often need to ask questions of your doctor. Your doctor may tell you that you definitely need back surgery and could end up paralyzed if you do not have it. Your doctor may tell you that back surgery is an option to consider but recommend that you consider other options as well.

You need to get whatever questions you have addressed before you make your decision about having back surgery. Here are a few of the questions I would ask if I had an injury where back surgery was a potential treatment:

• What are the chances that surgery will make me better?
• What are the chance that surgery will make me worse?
• Is the surgery likely to relieve pain? If so, will it likely relieve all my pain or just some of my pain?
• What are the risks of surgery?
• How long will it take to recover?
• What other treatment options are there?
• What will happen if I do not have surgery?

You probably have your own questions that you want to ask.  I would just recommend that you get answers.  You may even want to write the questions down so that you can remember them at your appointment with your doctor.

Can the workers’ compensation insurance company force me to have back surgery?

No. Neither your employer nor the workers’ compensation insurance company can force you to have surgery.

You may have valid concerns about the risks of back surgery.  You may just want to pursue other treatment options.  Know that you you have the option to refuse medical treatment even if it is recommended by your doctor. If you want more information about refusing medical treatment, take a look at this article.

Even if you are considering back surgery, you also do not have to be rushed into that decision.  You may want to consider a second opinion with another doctor before having surgery.  Once again though, consider the information that your doctor gives you about any risks associated with waiting on having the surgery.

Will having back surgery make my workers’ compensation case better?

I cannot give you the answer to that. The only thing I can tell you is that the decision about whether to have surgery or not should be a medical decision and not a legal decision.

There are some workers’ compensation issues you should understand if you have a serious back injury.

Limits on medical and indemnity benefits in Georgia workers’ compensation cases

You need to know that you now have a limited period of time to receive medical treatment and wage loss benefits in most Georgia workers’ compensation claims.  Unless your case is designated catastrophic, you probably only have 400 weeks (about 7.5 years) to make the insurance company pay for the medical treatment for your injury.

Back surgery will probably take you out of work for some time.  The insurance company is also only responsible for paying for wage loss benefits for a limited time after your injury.

The time limits on medical treatment and wage loss benefits make it important to get the treatment you need quickly.  Even if you do decide to have surgery, the workers’ compensation insurance company will often deny the surgery or request a second opinion before approving it.  Delaying the surgery could cause you to miss out on medical treatment you need later because it is after the 400 week deadline.

Permanent partial disability benefits after back surgery

Permanent partial disability (PPD) benefits are benefits paid to you when your workers’ compensation injury causes some permanent impairment.  If you have back surgery, you should end up with a permanent partial disability rating.  The amount of the rating usually depends on the type of back surgery you have.

Georgia law requires doctors to use the 5th Edition of the American Medical Association Guides to the Evaluation of Permanent Impairment to assign PPD ratings.  Doctors often use using the diagnosis-related estimate (DRE) method to rate back injuries.  Under this method, injuries fall into five categories.  Each category has a range of percentage ratings.

The type of back surgery often determines the category number for the DRE method.  A discectomy or laminectomy will often result in a Category 3 DRE rating.  A surgical fusion will usually result in a Category 4 or 5 DRE rating.  The higher number categories result in a higher PPD rating.

Catastrophic designation for back injuries

Unfortunately, back surgery does not always make people better.  Some people continue to have significant pain after surgery.  This pain can make it very difficult to return to work.

You may decide not to have back surgery.  If you make this decision, you may have to live with very serious pain, even if you get pain management treatment.  This pain can also make it hard to get back to work.

You may qualify for a catastrophic designation if your injury prevents you from going back to most types of jobs.  One of the benefits of qualifying for a catastrophic designation is that you avoid the 400 weeks cutoff for both your wage loss and medical benefits.

Settlement with or without back surgery

Many people have questions about settlement.  Should they settle their case? If so, when should they settle?

Settlement is complicated.  The answers to these questions and many others really depend on your particular situation. Since settlement is a choice, you should make the best choice for you.

If you have had back surgery or it has been recommended, you need to put a lot of thought into your decision about settlement.  There is one thing that is certain about settlement – it is almost always final.  You cannot go back and change your mind later.  So, make an informed decision if you are considering settlement.

Other issues associated with back surgery

This article covers a few of the issues you may face when considering back surgery.  You may face other issues in your case as well.

Talking to an attorney is usually the best way to answer specific questions that you have about workers’ compensation. I provide free consultations in workers compensation cases so you can get answers to your questions.