My Workers Comp Doctor Has Recommended Surgery. Should I get the Surgery?

Virginia and North Carolina workers compensation attorney Joe Miller gives some practical advice for those who are having trouble deciding whether or not to have a surgery recommended by your authorized treating physician. He discusses both the legal and the practical considerations.

[@blueberry.2020]

Very good info thank you 😊

[@personalinjuryshow]

Great information, thank you.

[@JoeMillerLaw]

Thank you so much for the feedback. Makes my day. 😀

[@benalexender3046]

Thanks ❤

[@JoeMillerLaw]

You are very welcome. I hope the video helped you.

[@BearPapa49]

Great info thanks. This advice helped me out . A lot ! After I went for the surgery option it helped my case .

[@JoeMillerLaw]

Thank you so much.

[@BearPapa49]

Mr Miller does this pretty much apply to California WC ?

[@GMONEY79]

​@@JoeMillerLaw I'm soon to get a platelets in my tendon in my wrist. My dominant hand was crushed by a machine. I been suffering for 6 months. Workman's comp stop paying me. Bills are pileing up

[@JoeMillerLaw]

@@GMONEY79 so sorry about your difficult situation. While it's hard to comment on your specific circumstance without knowing a lot more or whether your claim is pending in VA or NC, generally, if you are not under an Award, the carrier will stop payments when the doctor releases you to any kind of light duty instead of keeping you out of work 100%. In VA or NC, the only remedy to that is to file for a Hearing and get you under an Award or an Accepted Claim. Sometimes, under the right circumstances, for instance if the doctor again takes you out of work 100% in advance of the surgery, the carrier may agree to accept the claim instead of head to a hearing. Unfortunately, a Hearing is a long process. If your claim is pending in VA or NC, I encourage you to please give us a call at 877-622-8656. Thanks!

[@christopherskulina350]

What if you said no to the surgery but later changed your mind after talking with family. Great videos! Very informative.

[@JoeMillerLaw]

Should not be an issue. Just tell ur doctor!

[@JoeMillerLaw]

So sorry you are going through this. So in my opinion, you should try and avoid telling the doc you don’t want the surgery. I’m curious as to what makes you think the insurance company doesn’t want to settle? Tell the doc you need to discuss it with your family first. If you have already told the dr you don’t want the recommended surgery, your case may be in trouble. If you were injured in VA or NC please feel free to call our office as it is difficult to speak to your situation without more details pertaining to your case. If your case is pending in another state, you need to discuss this with a qualified attorney in your state who focuses on workers comp. www.AVVO.com is a good resource.

[@JoeMillerLaw]

Quite impossible to say. Every State Workers Comp law is different. You need to consult with an attorney in CA if that is where your injury occurred.

[@ro-landocalrissian4633]

If you don’t like the workers comp doctor, can you change them & get a second opinion? The hospital orthopedic surgeon said it’s not necessary..now I’m scheduled to see a workers comp doctor for my humerus fracture. I hope they don’t say I need surgery because I want to heal it naturally.

[@JoeMillerLaw]

Well, the Millennium Falcon is the fastest ship in the Galaxy, so you can go anywhere, right? Seriously, it would depend on what State your case is pending in. The laws about 2nd Opinions vary from state to state. For instance, in Virginia, you can see any doctor you want, but there is no way to force the insurance company to pay for it. Only doctors chosen from a panel and authorized and accepted by the workers comp insurance company can be your authorized treating physician. Also in Virginia, any doctor whom you see who is not your authorized treating physician can render an opinion, but the Commission is generally going to give more weight to the authorized doc's opinion. On the other hand, in North Carolina, you are entitled to a 2nd Opinion (but not necessarily treatment) from a doctor you agree on with the defense/insurance company, and the insurance company must pay for the examination. Unlike Virginia, you MAY NOT just pick any doctor in North Carolina, even if you pay for the doctor yourself, because the Industrial Commission will generally not listen to doctors who are not authorized either as an officially authorized treating doctor or official second opinion doctor pursuant to the laws regarding Independent Medical Examinations. What is happening to you now is they have asked for DEFENSE Independent Medical Exam, which in both VA and NC they are entitled to do. But in NC, that would not diminish your right to have your own Independent Exam per the law, if you want it. Hope that helps.

[@OnlinecarshowNet1]

What if I am the only person at company thats been randomly selected for drug test? No accidents or workers comp. I am taking the test but I feel like this is not random at all? My employee handbook says they do 50%. Well out of 102 employee 1 is not 50%. Should I be seeking a lawyer? just got back from passing test but I am not comfortable with how this worked out and I feel scared for my job and singled out. This whole testing came 2 weeks after I declined another job and told current employer.

[@JoeMillerLaw]

So this is not a workers comp issue, more of an employee discrimination issue, which is not.my area of expertise. You need to speak to an attorney who specializes in worker discrimination.

[@jayhawkr86]

Don’t you have the right to a second opinion from another doctor? And what is the first prescribed surgery and the second says no? Then what do you do? Can you go back to the first to het the surgery?

[@Filterfinder]

In my state they send you to a third doctor in that situation and go with the majority.

[@hysterlife7854]

Same case but I’m in California? Can I refuse the surgery

[@victorvalenzuela6949]

Get the surgery authorization first, so if you don’t get the surgery they will have to give you the money for surgery at a later time when you’re ready.

[@dreyb2660]

Workers comp denied my surgery and now they want me to do physical therapy? Is this normal? And how long will they make me do physical therapy before I can get the surgery? I’m so ready to get back to my life and back to work 😩

[@BearPapa49]

Workers comp is sometimes a long process. You need to work closely with your treating doctor and lawyer for insights and understanding. If your rushing your case and you need surgery then it may not happen fast for you . Remember in most cases you have 1 year of fmla after that point depending on your state and rules you maybe laid off . So keep all of this in mind . Workers comp isn’t a fast going process . Each case is different good luck

[@dfaro8453]

If a person get laid off, will that person lose work compensation benefits?

[@victorvalenzuela6949]

Sounds like your doctor didn’t think you injury was bad enough. Meaning no tear, broken bone did they do an MRI on that body part? Worker comp law saids they have give physical therapy before surgeries. Unless you went to the hospital right after your accident that caused your injury and they find broken bones

[@victorvalenzuela6949]

@@dfaro8453 Not if you put in your claim or told a supervisor before getting laid off.

[@kimberlyhager2872]

What if I was told by my primary physician that I cannot have surgeries due to chef or j could die on the table. So I said no to surgery now what?

[@JoeMillerLaw]

I'm sorry either your auto correct took over or i'm not understanding your meaning. "chef?" Is that an abbreviation for something? I'm not doctor, but i can tell you that virtually ALL surgeries, especially those which involve general anesthesia, involve a risk of death. Look at what happened to Joan Rivers. But of course, you may have a specific, pre-existing condition that increases your risk of death much more than other folks. If that is the case, you would certainly want to take that into consideration. But of course, this is not medical advice and I can't really address anything else unless i knew more about specifically what you were told. Without giving medical advice, in my opinion, if your PCP just told you the standard stuff everyone else is told about the risk of death in undergoing surgery, and you have no specific condition that multiplies or substantially increases that risk, that should not stop you from getting surgery if the surgery is medically necessary.

[@ryantaylor2342]

I just watched your video, I’m from California, I tore my acl and meniscus at work, they have been paying for my physical therapy, and they recently paid for my MRI, which confirmed that it’s torn both acl and meniscus, they sent me to a specialist where the surgery will take place and I have an appointment tomorrow with the specialist to go over the game plan and get another MRI, I work on telephone phones climbing ladders so I’ve not been able to do my job. I don’t really want the surgery because I can live with no acl and I just don’t wanna do it, I heard you say never tell the doctor that. I’m going to wait until the doctor schedules my surgery to see if workers comp will settle. If not I’ll have some choices. I’m only 32 years old I’m just scared of doctors offices. Also I was making 2500 a week at my job before all this😢

[@JoeMillerLaw]

Sorry you're having to go through that. Glad my video helped a little bit. I hope you get a good settlement that can get you to a new career more appropriate for your knee condition.

[@the_truth50]

I have a similar case to you in cali ! I just got my meniscus taken out and a lateral release on my knee I guess is what was written. The pain is insane I wish I would have not gotten the surgery but I had no choice.

[@JoeMillerLaw]

@@the_truth50 So sorry you are hurting. Make sure you report all the pain to your doctor. Also know that "surgical pain" usually subsides within a few weeks after surgery. If you continue to have pain and swelling that persists, hopefully your doctor will find another way to address it.

[@rafflegiveaways]

Are you in the union by Any chance?

[@luisjavier3982]

Hi, i just had a second surgery about 10 days ago, first was last March on right shoulder and now my left shoulder this happened during my job activities installing industrial batteries, is bei reported to NCWC as a ocupacional disease, right had a full and a partial tear left one a full tear, still today the insurance have not put out a penny for anything i had cover all my medical and personal spensces we had a hearing last week and 2 hours before the hearing they started calling my lawyer offering 50k i refuse it cause i believe it's ridiculous than they offered 75 I still believe is wrong i have a lot of limitations on my right arm my surgeon said it might require a second surgery to fix it but my lawyer is pushing me with everything he got to get me to take that, what do you think.

[@peketraves2446]

What about if Dr recommend disc replacement, I don’t want to do it and Insurace don’t want to settle. What should I do?

[@BearPapa49]

I can tell you that some insurance will press the issue to see if your willing to go forward with the procedure. If you don’t they may just settle for less . If you do they’ll accept the claim and settle. You have to make a personal choice based on your Physical needs . Also review your QME. In there is a lot of insights. Did the qme doctor recommend surgery based on his review? This is hard to answer for you . You need to talk to your lawyer ASAP . Get an understanding between you both . Hope that helps you

[@Lila77722]

My work comp doc recommended surgery or be released and when i told my employers, they told me I didn’t have to do the surgery. Do you know why they would tell me this? I told them what I know is I have to follow doc instructions because this is workers comp.

[@JoeMillerLaw]

As I always tell people I can only speak for VA or NC, I do not know what State your accident was in. But at least in VA or NC, your treating doctor is the absolute last word on what kind of treatment you need. The only way the comp carrier can sometimes get around it is if they get you to an Independent Medical Exam and that doctor says surgery is not necessary. Sometimes they will even just have some hack doctor from another State review the medical records and say the surgery is not medically necessary, but those reports, where there is no exam, are typically given very little, if any weight. Of course the Commission will follow the treating doctor almost every time. If you are in VA particularly, I strongly urge you to watch my video on How to Keep from Losing your Case and the issue of Reasonable Medical Probability or Certainty. If your doctor believes the surgery is related to the accident and medically necessary, he or she will need to say so in writing, using the "magic words" along with proof on reasonable medical certainty and a few other issues mentioned in that video. This is only if the carrier actually DENIES the surgery and forces you to go to hearing or Motion to get it. In NC, that is often not enough, your doctor's sworn Deposition must be taken within 60 days after the Hearing to get those opinions into evidence. If it's just a medical motion, the written opinion may still suffice. One other consideration: if you really don't want to have the surgery and you would rather settle, don't tell your doctor that, but you might tell the adjuster you would consider doing the surgery later on your own dime....for the right settlement amount. Again, though, if you are not in VA or NC, none of this advice may apply. I would not make any additional moves without consulting with a workers compensation attorney within your state. Good luck!

[@renee1484]

Hello got diagnosed with nerve damage neck, cubital tunnel syndrome, and got hit in forearm area. Can I get for body parts. If dont get surgery could get worse

[@JoeMillerLaw]

Sorry for the very late reply. The point of the video is that Surgery is a personal choice. If you are not at maximum medical improvement on the body parts, you cannot get impairment money until you reach that point as to each specific body part you are claiming is permanently impaired. I think if you ask yourself the question I pose in the video, you'll know the answer.

[@kimberlyhager2872]

I do have congestive heart failure and take prescription meds to try to get it under control. I have an elarged left side of my heart and I understand what you mean about going under anasthesi, bu it's way above that risk.

[@kimberlyhager2872]

@@JoeMillerLaw but I don't have maximum improvement on my injury.

[@JoeMillerLaw]

@@kimberlyhager2872 Sometimes the doctor will say well, if you don't get the surgery, then i'll say you're at MMI now and we can rate your body parts now, since you cannot get the surgery. Good luck with your claim.

[@teresaknutsen8731]

DOCTOR REQUESTED KNEE REPLACEMENT. INSURANCE COMPANY IS NOT PAYING ME WORKMENS COMP. I NEED TO WORK TO PAY MY BILLS. I CAN NOT BE LAYED UP FOR MONTHS. I WAS FIRED BY MY COMPANY DUE TO WORK INJURIES.

[@JoeMillerLaw]

I always tell my clients that the workers compensation system-no matter what State you got hurt in---can be thought of like this: It was started and designed about 100 years ago by a bunch of fat-cats in a room filled with smoke, puffing on cigars and laughing about how they are messing over the little guy. And each and every one of those men's name is Ebenezer Scrooge. In other words, the workers' compensation system is tough. It causes you to make very hard choices, particularly if the insurance company is denying your claim. it's a little easier if your claim is accepted, because then you at least get 2/3rds of your average weekly wage while your doctor is holding you out. But if you live paycheck to paycheck, that can be hard, or if you are a high wage earner, most states have maximum comp rates that are far less than what you would make each week if you were working. I strongly encourage you, though, to discuss your case with a workers comp attorney in your state. He or she may be able to get your claim moving in the right direction, even while you are working, so that you can get comp to pay for your knee replacement surgery, get you paid while you are held out of work by your doctor, and possibly some money for permanent impairment on your knee as well. If you are in VA or NC, please feel free to give us a call. If not, I suggest AVVO.com to find a good workers comp attorney near you. Best of luck and feel better!