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Work InjuryWorkers Comp Claims

Do You Need Approval for Your Surgery?

Workers’ Compensation and Surgery Approvals

If you were one of the 173,267 people who got hurt on the job in Pennsylvania last year, you may have been entitled to workers’ compensation under state law. Workers’ compensation benefits can help you stay on top of your finances as you recover from your injuries. However, the situation could get complicated if you need surgery.

Surgery After an Accident

Workers who have suffered severe injuries on the job might need surgery. This medical procedure is necessary to put the employee back on the road to recovery. Surgery may even be required for those who suffer injuries from minor workplace accidents. Depending on the severity of the injury, the nature of the accident and the particular medical doctor, surgery might be the best option for the employee.

In most cases, it’s in the best interest of all parties to allow the worker to get surgery for the injuries. You might think it will be easy to set up a time and date for a procedure. However, there are times when you will have to follow a process to schedule your surgery. Unfortunately, with insurance companies and legal protocols, you must have the operation approved to be covered under workers’ compensation claims.

Contact Your Insurance Company

If you want to have your surgery approved under workers’ compensation, you will have to reach out to the insurance company provider of your employer. When you call the insurance company, there will be an adjuster assigned to your case. Once you speak to the adjuster, you can ask them to approve the surgery. In most cases, the procedure will be approved by the insurance company. However, there is always a chance that the insurance company will deny the surgery even though you require the procedure.

File a Petition for Benefits

Workers’ compensation insurance should grant you the right to have surgery for your injuries. If that claim is denied, you can file an appeal. You can also file a petition for benefits with the Workers’ Compensation Adjudication Board. You need to make sure to fill out the right claim forms and file them by the deadline. If you fail to do this, you might lose out on your entitled benefits from your employer.

Request a Hearing

If there is an issue with getting your surgery approved, you have the right to request a hearing with the Workers’ Compensation Adjudication Board. If you had a surgery denied by your employer’s insurance company, there are ways to dispute that denial. In some cases, the insurance company does not want to pay out for a surgery claim. The agency might want to spend as little as possible when the claim is filed, and it may insist on using its own doctors to deny a medical procedure.

During this hearing, you should present evidence and medical reports to back up your claim. However, if it has reached this level, consider seeking the help of an experienced personal injury attorney. There is too much at stake to handle this issue by yourself.

Consult a Workers’ Compensation Attorney

If you got hurt on the job and now need medical help, you should consult an experienced attorney. During the claims process, a lawyer will help you file the correct petitions, request a hearing and handle all correspondence with the insurance company. If your medical provider has recommended surgery, you should not have to worry about fighting to get it approved. If you’ve been injured on the job, you’re entitled to those workers’ compensation benefits.

Experienced Workers’ Compensation Law Attorney

It can be devastating to get injured on the job. If you have been injured in a workplace accident, speak to an experienced workers’ compensation attorney. After an accident, it’s in your best interest to contact a lawyer as soon as possible. At the Voorhees Law Office in Somerville, we can help with your case. Contact our office at (908) 200-2297 or send us a message to schedule a consultation.

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