Your doctor may recommend surgery if you suffer a serious neck injury at work. The decision about whether you need neck surgery and which type of surgery would be best for you should be made by you and your doctor.
Doctors perform many different types of neck surgery to relieve pain and impairment that comes from work injuries. Some of the most common types of neck surgeries performed in workers’ compensation cases include the following:
- Cervical Discectomies: This surgical procedure removes a damaged or herniated disc in the neck (cervical spine) that is pressing on a nerve or the spinal cord, causing pain, numbness, or weakness in the neck, shoulders, or arms. In workers’ compensation cases, a cervical discectomy often results in a DRE Cervical Category III impairment rating (15–18% to the body as a whole) under the AMA Guides, 5th Edition, or higher if a spinal fusion is performed.
- Cervical Fusions: Also called cervical spinal fusion or anterior cervical discectomy and fusion (ACDF), this is a surgical procedure in which two or more vertebrae in the neck are permanently joined together to stabilize the spine after a damaged disc has been removed or the vertebrae have become unstable due to injury, degeneration, or surgery. In Georgia workers’ compensation cases, a successful cervical fusion usually qualifies as a DRE Cervical Category IV impairment (25–28% to the body as a whole) under the AMA Guides.
- Cervical Laminectomies: A cervical laminectomy is a surgical procedure performed to relieve pressure on the spinal cord or nerves in the neck by removing part of the vertebra called the lamina, a thin layer of bone that forms the back wall of the spinal canal. Under Georgia workers’ compensation law, a cervical laminectomy without fusion typically results in a Category III impairment (15–18% to the body as a whole), while one that includes fusion would generally be rated as a Cervical Category IV (25–28%) or higher under the AMA Guides.
If workers’ compensation pays for your neck surgery, you may end up with some degree of permanent impairment as a result of your neck injury. Under Georgia law, the workers’ compensation insurance company should pay you permanent partial disability benefits when you suffer a permanent impairment as a result of a work-related injury. These permanent partial disability benefits provide some compensation for the permanent loss of function from your injury.
This article focuses specifically on permanent partial disability benefits for neck injuries under Georgia’s workers’ compensation law. If you would like to find out more about permanent partial disability benefits (including when the insurance company pays them and when you should receive your permanent partial disability rating), be sure and read this article that covers PPD benefits more generally and speak to a workers’ compensation attorney.
How Are PPD Benefits Calculated in Georgia?
Permanent partial disability (PPD) benefits are based on a formula set by Georgia law. The amount you receive depends on two things: your impairment rating and your weekly benefit rate. For injuries to the neck or spine, the rating applies to the “body as a whole,” which is worth up to 300 weeks of permanent partial disability benefits.
To calculate the amount for a body as a whole rating, multiply your impairment percentage by 300 weeks to find the number of weeks owed, then multiply that by your weekly benefit rate. For example, if your rating is 25 percent to the body as a whole and your weekly rate is $675, your total PPD payments for that rating would be 75 weeks (25% × 300) × $675 = $50,625.
The weekly rate is usually two-thirds of your average weekly wage, up to the state maximum in effect on the date of your injury. Workers who earned higher wages before their injury can reach the maximum quickly, so the difference between a 15 percent and 25 percent rating can equal tens of thousands of dollars in permanent partial disability benefits.
What Should Your Permanent Partial Disability Rating Be For Your Neck Surgery?
That depends. Georgia law requires doctors to use a certain book to assign your permanent partial disability rating. Currently, Georgia law requires doctors to use the 5th Edition of the American Medical Association’s Guide to the Evaluation of Permanent Impairment.
This book is over 600 pages. The spine is covered in Chapter 15 of the American Medical Association’s Guide to the Evaluation of Permanent Impairment. Most workers’ compensation neck injuries are rated using Chapter 15.
There are a few different ways that doctors might rate a neck surgery, but the most common method is the Diagnosis-Related Estimates Method. This method is known as DRE for short.
Using this method, permanent partial disability rating for neck injuries fall into one of five different categories. Almost all neck surgeries result in a rating that falls into Category III, IV, or V. Some other types of neck injuries, which do not require surgery, can fall into Category I or II.
DRE Cervical Category III Ratings Of 15 To 18 Percent To The Body As A Whole
This is usually the lowest category rating that you see following neck surgery in a Georgia workers’ compensation case. The part of Category III that talks about surgery says, “individual had clinically significant radiculopathy, verified by an imaging study that demonstrates a herniated disk at the level and on the side expected from objective clinical findings with radiculopathy or with improvement of radiculopathy following surgery.”
So, what does that mean? The definition has three important parts.
The first is radiculopathy. This likely means you had pain, weakness, or numbness radiating from your spine into another area of your body as a result of nerve compression. With cervical injuries, this is often pain that radiates into some part of the arms.
The rest of the definition of this rating is a little more confusing. It discusses an imaging study which verifies a herniated disk that is the likely cause of the radiculopathy. This would typically be an MRI, which shows a herniated disk where the doctor would expect it.
In the case of surgery, it also says this rating covers “improvement of radiculopathy following surgery”. If surgery improves or cures the radiculopathy, it is not clear whether you have to have the MRI showing the herniated disk in order to get a Category III rating of 15 to 18 percent to the body as a whole.
DRE Cervical Category IV Ratings Of 25 To 28 Percent To The Body As A Whole
Cervical fusions are the most common workers’ compensation neck surgeries that result in Category IV ratings. The language that covers cervical fusions under Category IV is, “… the individual may have loss of motion or a motion segment due to a developmental fusion or successful or unsuccessful attempt at surgical arthrodesis; radiculopathy as defined in cervical category III need not be present if there is alteration of motion segment integrity.”
Surgical arthrodesis refers to cervical fusion. So, a workers’ compensation injury that requires a cervical fusion surgery should result in at least a Category IV rating of 25 to 28 percent to the body as a whole.
This is the case even if the cervical fusion is completely successful and completely relieves all radiculopathy. The AMA Guides make this clear by giving an example of an individual who has a successful, one-level cervical fusion that completely resolves the radiculopathy in the individual’s arms. The example indicates that this person would qualify for a Category IV rating of 25 percent to the body as a whole.
It is important to understand this because there are many cases where a doctor gives less than a Category IV rating following a cervical fusion. If your workers’ compensation doctor rated you at Category III following a cervical fusion, your PPD rating would be about 10 percent less than it should have been.
A rating of 10 percent less to the body as a whole is a difference of 30 weeks of permanent partial disability benefits. Depending on the amount of your weekly workers’ compensation benefits, this could result in you receiving up to $24,000 or so less than you should have in PPD benefits.
Fortunately, an incorrect PPD rating can be corrected. But you or your attorney will have to understand the reason that the rating is incorrect and take steps to get the rating corrected. We discuss this later in this article.
DRE Cervical Category V Ratings Of 35 To 38 Percent To The Body As A Whole
Category V ratings are pretty rare. One situation where a Category V rating comes up is when the neck injury requires an individual to use adaptive devices to compensate for the symptoms from the injury.
The AMA Guides do not fully spell out what they mean by adaptive devices, but they do give a general example. The example indicates that an individual who had a cervical fusion and still has radiculopathy but has to use adaptive devices to grip and turn objects would qualify for a Category V rating.
The question is how significant the adaptive devices need to be. Would it be enough if you have to use a jar opener or other gripping device because of weakness in your hands and arms, or does it require something more significant?
The AMA Guides are not completely clear, so they leave room to argue that you may qualify for a Category V rating if you continue to have significant impairment in your arms after treatment.
Arguing for a higher rating in this situation would often be worthwhile because there is roughly a 10 percent difference between a Category IV and a Category V rating. As I discussed above, these additional weeks of PPD benefits could result in a much higher overall PPD payment.
Are There Other Ways To Assign PPD Ratings For Neck Surgeries?
Yes. There are other methods to assign PPD ratings following neck surgeries. Some of the other methods include Corticospinal Tract Impairment and the Range-of-Motion Method. These methods are seen less frequently than the DRE method.
Corticospinal tract impairment comes up when you have neck surgery to repair a spinal cord injury. This impairment rating method focuses on how your neck injury affects your use of the following body parts:
- Arms
- Legs
- Bowel
- Bladder
- Sexual Function
- Breathing
Spinal cord impairments are serious injuries. The corticospinal tract impairment may be used to rate injuries where an individual had an injury or surgery that would often be rated using the DRE method, but the DRE method does not fully account for their loss of function. With spinal cord injuries, the corticospinal tract impairment method can provide a more accurate method of assessing the loss of function.
The Range-of-Motion method focuses more on combining the particular diagnosis and surgery, along with measurements of spinal range of motion. It is used much less frequently than the DRE Method, so we are not going to discuss it in detail here.
When Are PPD Benefits Paid?
PPD benefits are paid only after your doctor determines that you have reached maximum medical improvement (MMI). MMI means your condition is stable and unlikely to improve further with medical treatment.
Once the doctor assigns a PPD rating, the insurance company should start paying your benefits 21 days of their knowledge of the PPD rating. But, if you are still receiving temporary total disability (TTD) or temporary partial disability (TPD) wage loss payments, the insurnace company does not start payment your PPD benefits until the TTD and TPD payments stop.
If the insurance company delays payment after receiving the rating, you or your workers’ compensation attorney can request enforcement through the State Board of Workers’ Compensation. Also, the insurance company can owe late penalties and assessed attorney’s fees when the insurance company does not pay PPD benefits on time. Keeping track of these timelines helps prevent payment gaps and ensures you receive what you are owed.
Common Disputes About PPD Ratings for Neck Surgery
Disagreements about PPD ratings are common in neck injury cases, and they can make a major difference in the benefits you receive. These disputes, which are outlined below, usually arise when the doctor or insurance company disagrees about which rating method or category applies to your surgery.
- Incorrect Rating Method: Some doctors use the Range-of-Motion method instead of the Diagnosis-Related Estimates (DRE) method described in Chapter 15 of the AMA Guides.
- Misclassification of Category: Workers who have undergone a cervical fusion are sometimes given a Category III rating instead of Category IV. Because successful fusions fall within Category IV (25–28% to the body as a whole), this mistake can cause a major loss in the number of compensable weeks and total payment.
- Disputed Medical Findings: Insurance companies may argue that medical evidence, such as MRI results or nerve studies, does not support the assigned rating. They might claim the impairment is temporary or unrelated to the original work injury, which can delay or reduce payments.
- Partial or Incomplete Evaluation: A treating physician may overlook persistent symptoms like arm weakness, numbness, or reduced mobility. These symptoms can result in an increased rating, so failing to consider them can lead to an inaccurate rating.
What If You Believe The Workers’ Compensation Doctor May Have Assigned The Incorrect PPD Rating?
Your workers’ compensation authorized treating physician usually assigns the PPD rating. The insurance company usually pays PPD benefits based on that rating. So, if your authorized treating physician assigns the wrong rating, you will not receive the benefits you should.
Fortunately, actions can be taken to correct an incorrect PPD rating. Some of the options include:
- Pointing out the incorrect rating to the authorized treating physician and having a revised rating issued
- Getting an opinion from another physician with the correct rating. Georgia law provides option for an injured worker to obtain an Independent Medical Examination (IME) by another qualified physician. An IME can provide evidence of a correct rating
- Going to court and proving the correct rating to a workers’ compensation judge
Which one of these actions is best to take will depend on the particular facts of your case. For example, the doctor who issued your rating may not respond very well to being told that you think the rating they issued is wrong. Also, going to court will probably not help if you do not have the evidence to support your argument.
Also, you need to understand that there are deadlines known as statutes of limitations that apply to the payment of PPD benefits. This means that waiting too long to get the rating corrected could result in the insurance company not having to pay the correct amount of benefits.
So, be sure that you do not wait if you think your rating is incorrect. It is important to figure out the right strategy and take action to correct the rating.
What Other Issues Will Likely Come Up In Your Case If You Have Had Neck Surgery?
If you have neck surgery in a workers’ compensation case, these are a few of the issues you could face in the future:
- Will you need ongoing medical treatment and physical therapy for pain and other symptoms after neck surgery? If so, what time limits are there on getting that medical treatment?
- Will your employer continue to provide you with a suitable job?
- Does your injury potentially qualify for a catastrophic designation?
What If You Have Other Questions About Workers’ Compensation?
Georgia’s workers’ compensation system can be very confusing. You have to worry about getting the treatment you need and paying your bills while also worrying about not missing any deadlines that could cause you to lose your right to receive workers’ compensation benefits.
If you have questions, we would recommend that you try to get answers. To find out more about how to schedule a time to talk to us about your workers’ compensation questions, just read this short article. To schedule a free consultation with a workers’ compensation lawyer, call 770-214-8885 or contact us online today.
Related:
Can I Claim Workers’ Comp in Georgia If I Was Injured While Traveling for Work?
Georgia Workers’ Comp Rule Changes for 2025 — 5 Things Injured Workers Must Know
