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Surgery & Workers Compensation
08-27-2010, 10:35 PM
Post: #1
Surgery & Workers Compensation
I am in Illinois (29 years old) with 2 herniated discs from being hit by a car while walking in the parking lot at work. I have exhausted all conservatory methods without a lot of improvement, and my orthopedic doctor has recommended that I see a surgeon. I have an appointment on Monday. If the surgeon recommends surgery and I decline, can worker's compensation drop my case? Does seeing a surgeon lock me into having to get surgery? My bills are already above $30,000.00, and I want to make sure that my bills get paid. Thanks for your help.
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08-27-2010, 10:52 PM (This post was last modified: 08-27-2010 10:53 PM by AQA.)
Post: #2
RE: Surgery & Workers Compensation
If WC has accepted your claim. Then the medical bills will be paid. If the surgeon recommends surgery and you decline. WC can put you at MMI and stop the medical benifits. With that being said, you may be able to request a second oppinion.

BBBB knows more about your state than I do. He will be along shortly.

8-05, Micro laminectomy/disectomy. 10-05 lumbar fusion L5-S1. 2-07 exploritory surgery. 12-07 medical implant, Spinal Cord Stimulator. now receiving SSDI. Jesus died for our sins. Soilders died for our freedom.
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08-27-2010, 10:52 PM
Post: #3
RE: Surgery & Workers Compensation
no one can force you to have surgery,but if that is the only option and you refuse it what do you expect from the IC?

........I love cats, I just cant eat a whole one by myself......
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08-28-2010, 09:08 AM (This post was last modified: 08-28-2010 09:14 AM by Bad Boy Bad Boy.)
Post: #4
RE: Surgery & Workers Compensation
In Illinois, the minute it is said you need surgery, and if you tell the surgeon you will think about it, or you say you will not have the surgery, it gets documented. The IC will automaticly stop your TTD checks as of that date. No MMI has to even take place in this case if that is said in Illinois. How do I know this, I had an IME for a carpal tunnel injury back in 1991. The IME reported to the IC that I didn't want surgery. Which I never said, I had asked the IME surgeon if he do the surgery because he was known around the USA of being the very best Hand Surgeon. I wanted him to do the surgery, I wanted it fixed. When I had the hearing 18 months later with 18 months of no TTD checks, the IC was stumped on how the information was crossed up. here to find out, the IME never said I didn't want surgery, it was the Adjustor the said it. I was awarded all TTD money back for the 18 months, had the surgery and 6 weeks later returned to work.

That's how it works in Illinois.

Now as AQA said, if the surgeon said you need surgery, say okay, let me think on this for 2 weeks. That buys you 2 weeks time, and another appointment with the surgeon. Nothing will happen and TTD checks continue. You then in that 2 weeks time, right away find a surgeon you want a second Medical opinion from, tell the IC adjuster or your attorney, the IC will pay for second opinion for you. Then from there your on you own with what you decide. If you say no, go back to the top on my post here, and it starts that process.

Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor.
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08-28-2010, 11:59 AM
Post: #5
RE: Surgery & Workers Compensation
Thanks for that information.

After the accident happened on 5/11, I was out of work and receiving pay from worker's compensation/FMLA for 17 days (2/3rds of my pay), and my employer (a school) payed the remainder as a courtesy (they do this up to 20 days). I ended up using 17 FMLA days and went back the last two days of school to avoid loosing 1/3 of my pay during the summer, when I was off work anyway. I was still in pain and seeking regular treatment from a PT, MT, and an orthopedic doctor. School has started again, and I am going to work and still in pain, which means I am getting paid from the school district and not worker's compensation. Recently, my orthopedic doctor recommended I speak to a surgeon on Monday.

Does this change anything? If I am not being paid by workers compensation and I decide to wait my injuries out longer, could it impact my settlement or their pay for future medical expenses?

Thanks for your help.
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08-28-2010, 12:13 PM (This post was last modified: 08-28-2010 04:21 PM by AQA.)
Post: #6
RE: Surgery & Workers Compensation
You could be playing a very dangerous game.

If the herniated disc/s are pressing on the nerves. You do not want to wait to long. You can be left with permanent nerve damage.

As far as your question about " waiting out your inury longer " How would you do that??? Decline the surgery??????

8-05, Micro laminectomy/disectomy. 10-05 lumbar fusion L5-S1. 2-07 exploritory surgery. 12-07 medical implant, Spinal Cord Stimulator. now receiving SSDI. Jesus died for our sins. Soilders died for our freedom.
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08-28-2010, 05:38 PM
Post: #7
RE: Surgery & Workers Compensation
If you wait to long a period the Work Comp Insurance takes that as you not wanting surgery, and as refusal.

Then you go right back and read my Post Reply here #5....

Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor.
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