Knee injuries at work can cause many difficulties. These injuries often affect your ability to stand, walk, squat, climb, and lift. The restrictions from a serious knee injury may prevent you from doing your job and keep you out of work.
After evaluating your knee injury, your doctor may recommend surgery. Sometimes, this surgery may be a more minor surgery. Other times, the doctor may determine that you need a partial or total knee replacement.
If your doctor recommends knee replacement surgery, it may frighten you. After all, knee replacement surgery is a serious surgery with an extended recovery time. Almost 800,000 knee replacements are performed each year in the U.S.
What if the insurance company refuses to pay for knee replacement surgery?
Knee replacement surgery is also expensive. Because it is expensive, the workers’ compensation insurance company often will refuse to pay for knee replacement surgery.
The insurance company may try to argue that your employment did not cause you to need the knee replacement. The insurance company may blame the knee replacement on your age or a previous knee injury.
The insurance company will often try to get the doctor to say that your knee replacement was mostly caused by these things instead of your workers compensation injury. They will try to make this argument even when your knee was doing fine before you got hurt at work.
It is important to understand that you do not need to have a perfect knee prior to your injury for knee replacement to be covered under workers compensation. Even if you had prior knee problems, the insurance company should still pay for your knee replacement surgery if your employment made your knee worse and caused the need for surgery.
If the insurance company refuses to pay for your surgery, do not just accept your denial. There are things you can do. Find out more by reading our article about what you can do when an insurance company denies treatment.
What happens after my knee replacement surgery?
After surgery, you will go through a period of recovery. This often involves physical therapy and check up visits with your doctor.
Many people have questions about how long it will take for them to walk on their own and to return to work. I am an attorney, not a doctor. So, I’ll leave it to medical experts to give you a better idea about what sort of time period you can expect for your recovery after your surgery.
This information from the Mayo Clinic may be helpful to you. Also, I would suggest that you discuss your recovery with the doctor performing the surgery. It is often helpful to have your questions written down so you can make sure and cover them with your doctor.
Will I receive a permanent partial disability rating?
After you have recovered from your surgery, your doctor should assign you a permanent partial disability rating. Currently, Georgia law requires the doctor to use the 5th Edition of the American Medical Association Guides to the Evaluation of Permanent Impairment.
Your doctor should rate your knee replacement using Table 17-33 and Table 17-35. These tables allow the doctor to evaluate how successful your knee replacement was. Some of the factors your doctor will consider include:
- The residual pain you have after surgery
- Range of motion in your knee
- The stability of your knee
- Your knee alignment
If you have a good outcome from your knee replacement, you should end up with a permanent partial disabiltiy rating of 37 percent to the lower extremity. If your outcome is only fair or poor, then you will end up with a higher permanent partial disability rating.
What if I cannot go back to work after surgery?
I have represented many clients who have had knee replacement surgery as a result of their injuries at work. Many of them had good results from their surgeries. The surgery usually reduces their pain. But, almost all of them still end up with permanent activity limitations from their doctors.
Many times, these limitations make it difficult to work. If you have a physically demanding job, you should probably talk to an attorney to find out how your workers’ compensation case is affected if you cannot go back to your old job after your surgery.
