Do I Have to Have Surgery After a Work Injury if I Don’t Want It?

Do I Have to Have Surgery After a Work Injury if I Don’t Want It?

One of the most difficult decisions an injured worker may face is whether to undergo surgery after a workplace injury.  Perhaps your authorized treating physician has recommended:

• Back surgery;
• Neck surgery;
• Knee surgery;
• Shoulder surgery; or
• Carpal tunnel surgery.

You may be wondering: “If workers’ compensation is paying for my treatment, can I be forced to have surgery?” Fortunately, the answer NO.  In Alabama, workers’ compensation does not give an employer, insurance company, or physician the right to force an injured worker to undergo surgery against their wishes; however, refusing recommended treatment can sometimes affect your workers’ compensation benefits.

Do I Have the Right to Refuse Surgery?

Yes.  Suffering an injury at work does not mean that you give up your right to decide whether or not to have an invasive surgery.  Surgery is a serious medical procedure, and the decision whether to proceed ultimately belongs to the patient as every surgery involves some degree of risk, including:

• Infection;
• Nerve damage;
• Failed results;
• Additional pain;
• Extended recovery periods; and
• The possibility that symptoms may not improve.

Because of these risks, Alabama workers’ compensation law recognizes that an injured worker may have legitimate reasons for declining surgery.

Workers’ compensation is responsible for providing reasonably necessary medical treatment designed to help an injured worker recover from a workplace injury, and when an authorized treating physician recommends surgery, the insurance company may argue that the procedure could improve the worker’s condition and ability to return to work.  As a result, disputes sometimes arise when an injured worker declines the recommended procedure.

Can My Benefits Be Stopped If I Refuse Surgery?

Possibly.

Under Alabama workers’ compensation law, an injured worker’s benefits may be affected if the refusal of medical treatment is determined to be unreasonable.  The key question is often:

Was the refusal reasonable under the circumstances?

This is a fact-specific inquiry that depends upon the nature of the surgery, the risks involved, and the likelihood of success.

When Might Refusing Surgery Be Considered Reasonable?

There are many situations in which an injured worker may have legitimate reasons for declining surgery.

Examples might include:

• Significant surgical risks;
• Multiple prior failed surgeries;
• A low likelihood of success;
• Serious underlying health conditions;
• Conflicting medical opinions.

For example, a worker who is advised to undergo a complicated spinal surgery with uncertain results may have legitimate concerns about proceeding, and in those circumstances, refusing surgery may be considered reasonable.

When Might Refusing Surgery Be Considered Unreasonable?

Some procedures are generally viewed as relatively routine and carry a high likelihood of success.  Examples may include:

• Certain arthroscopic knee procedures;
• Carpal tunnel release surgery; or
• Other low-risk procedures designed to correct a specific problem.

If the surgery is considered relatively safe and likely to improve the worker’s condition, refusing treatment may create issues regarding continued workers’ compensation benefits.

Every case is different, however, and there is no automatic rule.

The Decision Is Still Yours

One of the most important things injured workers should understand is that workers’ compensation generally cannot force a person to undergo surgery.  The decision ultimately belongs to the patient; however, because refusing treatment may affect entitlement to benefits in certain circumstances, it is important to understand the potential consequences before making a final decision.

If you have questions about authorized medical treatment, surgery recommendations, second opinions, or your rights under Alabama’s Workers’ Compensation Act, don’t hesitate to contact the experienced attorneys at Powell and Denny today for a free consultation; and remember, virtual appointments are available through Zoom so you can meet with one of the attorneys of Powell and Denny from wherever you live, and that there is no fee unless you win.

Powell and Denny: We Work When You Can’t.

Offices in Birmingham and Huntsville, Alabama.