Everyday, thousands of accidents happen at the workplace. While most of them are minor, others can have detrimental consequences, rendering various levels of disability. Costs of medical care and recovery can cost a fortune, and impact both the employees and employers. This is why it is crucial to maximize workplace safety, but also to be familiarized with workers’ compensation legislation in your state. Knowing what type of procedures will be covered and what injuries are considered eligible for compensation can make a big difference. Not only will you be able to plan your budget accordingly, you will also feel much more protected and be able to focus on your recovery.
However, what if your recovery would include extensive surgical interventions? For example, you have sustained heavy burns, or broken your jaw and nose in several places. Is a complex reconstructive surgery covered by workers’ compensation insurance? You will learn the answer to these questions and more in this article. Keep reading!
Can plastic or reconstructive surgery be considered eligible for workers’ comp?
First off, it should be clear from the start that certain criteria need to be met in order for an injury to be eligible for compensation. This means that the injury:
- happened during your usual working hours
- happened at work or while you were performing your duties
- was not a result of your personal negligence or carelessness
- was not connected to (or directly caused by) a preexisting health condition
Secondly, you should clear up the terminology. Plastic and reconstructive surgery should not be confused by cosmetic surgery. The purpose of reconstructive surgery isn’t only to restore the appearance of a certain body part, but also to ensure that it functions properly.
Therefore, if you have sustained your injuries at work, performing your everyday work duties, in line with the code of conduct, and as a result of the accident, you require reconstructive surgery, you may qualify for workers’ compensation benefits.
However, in order to be completely sure, it is best to collect evidence and file your claim in a timely manner. You would require sworn and signed testimony from any witnesses, ideally your coworkers, your previous medical records, and the report about the injury from your selected doctor. With the assistance of an experienced work comp attorney, you will already have an advantage in case of any dispute with the insurance carrier or your employer.
What type of plastic surgery would be covered by workers’ comp insurance?
The range of potential scenarios in which you would require help from a plastic or reconstructive surgeon is endless. However, you can expect the following injuries and interventions to qualify for workers’ compensation:
- Burns – whether caused by chemical, thermal, or electrical source, especially if extensive, usually require a significant amount of time to recover from and surgery would include transplantations and various other interventions
- Cuts and lacerations – cuts usually require a lot of stitching. In more severe cases, reconstructive surgery would require use of prosthetics and casts.
- Facial bone fractures, such as broken nose, cheekbone, upper or lower jaw, forehead, and the bones around the eyes.
If you’re in any doubt whether you are to be covered for the injury and subsequent surgical procedure, it’s best to get in touch with a savvy legal professional that will give you the necessary guidance, help you file your compensation claim, and assist you in any potential legal proceeding. A specialized lawyer will even be able to get you the necessary medical attention and keep good track of your record and ensure you receive maximum reimbursement for the medical bills and lost wages.
