At The Law Offices of Mark T. Hurt, we understand the complexities and challenges that come with navigating workers’ compensation claims, especially for those involving serious surgeries such as lumbar and cervical fusion. With over three decades of legal practice, we fight for the rights of injured workers, ensuring they receive the full compensation and benefits they rightfully deserve under the law.

If you are considering or have undergone a lumbar or cervical fusion due to a work-related injury, we invite you to call our office to schedule a free consultation with an experienced workers’ compensation lawyer. We can listen to the facts of your case, explain your legal options, and tenaciously fight for the full benefits to which you are rightfully entitled.

Understanding Lumbar and Cervical Fusion

Spinal fusion surgery, involving either the lumbar or cervical regions, is often recommended after a work-related injury has led to significant back or neck issues. This type of surgery is considered when other treatments have failed, and the goal is to alleviate pain and restore function by fusing two or more vertebrae together.

Numerous techniques exist for performing spinal fusion, each aiming to halt movement and stabilize the spine. This is achieved by decompressing the spinal area and utilizing bone grafts to fuse the vertebrae together as they heal. The primary hope is to alleviate pain and prevent additional neurological deficits. While spinal fusion may halt the progression of functional decline, it’s generally not expected to enhance functionality.

Spinal fusion can be carried out at any part of the spine: cervical, thoracic, or lumbar. However, fusions in the lumbar and cervical regions are more frequent than those in the thoracic spine. This higher incidence is due to the lumbar and cervical areas being more flexible, thus more prone to injuries from sudden impacts or the gradual wear and tear of repetitive motions.

Why Might I Need a Back Fusion Surgery?

Injuries at work can sometimes lead to chronic conditions that make fusion surgery a necessary step. You might need fusion surgery for several reasons, particularly if you’ve suffered a significant injury to your spine or if you have a degenerative spinal condition that hasn’t improved with conservative treatments. Here are some common scenarios where fusion surgery could be considered:

  • Chronic Pain. If you’ve been experiencing persistent back or neck pain that hasn’t responded to non-surgical treatments like physical therapy, medications, or injections, your doctor might suggest fusion surgery to stabilize the spine and alleviate pain.
  • Degenerative Disc Disease. Over time, the discs in your spine can wear down, leading to instability and pain. Fusion surgery can help by eliminating the motion at a problematic vertebral segment, reducing the discomfort.
  • Herniated Disc. If a herniated disc is causing severe nerve pain and other treatments have failed to provide relief, a fusion might be recommended after removing the damaged disc.
  • Spondylolisthesis. This condition occurs when one vertebra slips over another, often leading to pain and instability. Fusion surgery can correct the alignment and stabilize the spine.
  • Spinal Stenosis. Narrowing of the spinal canal can put pressure on the spinal cord and nerves, causing pain and numbness. In some cases, fusion surgery might be part of a broader surgical intervention to relieve this pressure.
  • Fractures or Injuries. Severe spinal fractures or injuries might require fusion surgery to stabilize the spine and facilitate healing.
  • Scoliosis or Other Spinal Deformities. Fusion surgery can help correct significant curvature or deformities of the spine, improving posture and reducing discomfort.
  • Failed Previous Surgery. If you’ve had spinal surgery before and it didn’t provide the expected relief or led to further instability, fusion surgery might be considered as a next step.

Fusion surgery aims to improve your quality of life by stabilizing the spine, reducing pain, and preventing further degeneration or injury. However, it’s a significant procedure with its risks and considerations, so it’s typically recommended only when other less invasive options have been exhausted, and the potential benefits outweigh the risks.

Does Workers’ Compensation Pay for Cervical, Thoracic, or Lumbar Spinal Fusion Surgery?

Yes, workers’ compensation typically covers cervical, thoracic, or lumbar spinal fusion surgery if the surgery is deemed necessary due to a work-related injury. Workers’ compensation is designed to provide medical benefits and cover the cost of treatment for injuries sustained in the course of employment, including surgeries and rehabilitation needed to address those injuries.

However, obtaining approval for such a significant and costly procedure can be challenging. Insurance carriers may scrutinize the necessity and appropriateness of spinal fusion surgery, often requiring extensive medical documentation to prove that the surgery is directly related to a workplace injury and that it is the most appropriate course of treatment. This may include evidence of the injury, history of conservative treatment attempts, and medical opinions supporting the need for surgery.

To ensure the best chance of having spinal fusion surgery covered by workers’ compensation, it’s crucial to:

  • Report the work-related injury promptly to your employer.
  • Seek immediate and continuous medical treatment for your injury.
  • Follow your healthcare provider’s recommendations and document your medical care and any work restrictions.
  • Consult with a workers’ compensation attorney. As experienced workers’ compensation lawyers, we can help you gather the necessary documentation and represent you in appeals, if necessary. 

How Can The Law Offices of Mark T. Hurt Help With My Fusion Surgery Case?

From the moment you consider fusion surgery as part of your treatment for a work-related injury, our team is here to support you. We assist in every step of the process, from ensuring the surgery is approved by workers’ compensation to negotiating settlements that cover your medical expenses, recovery, and any potential long-term impacts.

What Types of Workers’ Compensation Benefits Can I Recover For My Back Fusion Surgery?

If you’re undergoing back fusion surgery because of a work-related injury, workers’ compensation can cover a variety of benefits to support your recovery and compensate for your losses, including:

  • Medical Expenses. Workers’ compensation should cover all necessary medical treatment related to your work injury, including the cost of the back fusion surgery, hospital stays, medications, physical therapy, and any follow-up care. This coverage is designed to ensure you receive the required treatment without out-of-pocket expenses. 
  • Temporary Total Disability (TTD) Benefits. If your back fusion surgery and recovery period prevent you from working at all, you may be eligible for TTD benefits. These benefits are intended to partially replace lost wages during the time you are completely unable to work. Typically, TTD benefits amount to a percentage of your average weekly wage prior to your injury. 
  • Temporary Partial Disability (TPD) Benefits. Should you be able to return to work in a limited or modified capacity (e.g., reduced hours or light-duty work) at a lower wage, you may qualify for TPD benefits. These benefits make up a portion of the difference between your pre-injury earnings and what you earn in your modified work role. 
  • Permanent Partial Disability (PPD) Benefits. In some cases, a back fusion surgery may lead to permanent restrictions or impairments that affect your ability to perform certain work tasks as you did before your injury. If this is the case, you might be eligible for PPD benefits, which compensate for your loss of earning capacity. The calculation of PPD benefits can vary significantly depending on the severity of your permanent impairment and its impact on your ability to work. 
  • Vocational Rehabilitation. If your injury and surgery prevent you from returning to your previous job, you may be entitled to vocational rehabilitation services. These services aim to help you find new employment within your physical capabilities, which might include job placement assistance, retraining, or further education. 
  • Mileage Reimbursement. Workers’ compensation may also cover travel expenses for medical appointments related to your back injury and surgery. This includes mileage, parking, and tolls. 
  • Death Benefits. In the tragic event that a worker dies as a result of their work-related injury or surgery, workers’ compensation provides death benefits to the worker’s dependents. These benefits help cover funeral expenses and provide financial support to the deceased worker’s family.

Worker’ compensation laws and benefits vary by state, so it’s advisable to consult with a workers’ compensation attorney in your jurisdiction to understand the specific benefits you’re eligible for and how to maximize your compensation. As experienced attorneys, we can help navigate the complexities of workers’ compensation claims, especially when dealing with significant medical treatments like back fusion surgery.

What Can I Do If My Lumbar or Cervical Fusion Surgery Claim is Denied?

Denials are not uncommon, but they are not the end of the road. If your claim for a fusion surgery has been denied, we’re prepared to appeal the decision. As workers’ compensation lawyers with over three decades of experience, we understand the evidence needed to counteract denials and are ready to advocate on your behalf to ensure your surgery and related expenses are covered.

How Long Will The Settlement Process Take?

The duration of the settlement process can vary greatly from case to case. Our goal is always to expedite your claim while ensuring we achieve the most favorable outcome. We keep you informed at every stage, providing transparency and guidance throughout.

Can I Still Work After My Surgery? 

Many of our clients are able to return to work in some capacity after recovery. However, it’s not unusual for there to be restrictions or the need for accommodations. Part of our job is to ensure these are factored into your settlement, providing for adjustments to your employment or compensation for any loss of earning capacity.

Schedule A Free Consultation With An Experienced Spinal Fusion Lawyer.

If you’re facing the prospect of spinal fusion surgery due to a work-related injury, don’t navigate this complex process alone. Contact us for a free consultation to discuss your case and learn more about how we can help you secure the settlement you deserve. Your fight for justice is our fight, and we’re here to stand by your side every step of the way.