If you suffered a work-related accident resulting in a knee injury or rotator cuff tear, your doctor may recommend arthroscopic surgery. As you consider your treatment options, you likely have questions about whether workers' compensation benefits cover this procedure.
At Rechtman & Spevak, our experienced Atlanta workers' compensation lawyer is dedicated to helping injured employees get the medical treatment and benefits they deserve.
Attorney Jaret A. Spevak understands the challenges you face when filing a workers’ compensation claim, especially when you need surgical intervention like an arthroscopy, and he’s ready to protect your rights for a proper medical and financial recovery.
What Is Arthroscopic Surgery for Work Injuries?
This is a minimally invasive procedure used to diagnose and treat joint problems. You may need this type of surgery if you suffered a knee, shoulder, wrist, elbow, ankle, or hip injury. During the operation, a tiny camera called an arthroscope is inserted through a small incision. This allows the surgeon to view the joint and guide miniature surgical instruments to diagnose a problem without making a large incision.
For work-related injuries such as meniscus tears, rotator cuff tears, and ligament damage, a physician might also use arthroscopic surgery to repair the damage. For example, they can:
- Trim or repair torn cartilage.
- Remove loose fragments of bone or cartilage.
- Reconstruct torn ligaments.
- Release tight ligaments or tendons.
Compared to traditional open surgery, arthroscopy offers several benefits:
- Smaller incisions and scars
- Less postoperative pain
- Shorter recovery time
- Lower risk of complications
When Does Georgia Workers' Compensation Cover Arthroscopic Surgery?
Under state law, employers must provide workers' compensation insurance to cover medical expenses for employees who suffer job-related injuries. This includes necessary surgeries, such as arthroscopy, when recommended by an authorized treating physician. To be eligible for workers’ compensation benefits, you must demonstrate that your injury happened on the job. This means it occurred while performing your duties or as a result of your work environment. For example, you could suffer these injuries in a work accident:
- Slipping and falling on a wet floor, twisting your knee.
- Developing a rotator cuff tear from repetitive overhead lifting.
- Suffering a wrist ligament injury from a malfunctioning machine.
Once your injury is deemed compensable, workers' comp should cover all reasonable and necessary medical treatment, including:
- Doctor visits and physical exams
- Diagnostic imaging tests like X-rays and MRIs
- Arthroscopic surgery and associated costs
- Postoperative care and rehabilitation
- Prescription medications
- Travel expenses to and from medical appointments
Crucial Steps to Take to Ensure Your Arthroscopic Surgery Is Covered Under Georgia Workers’ Compensation
At Rechtman & Spevak, we recommend the following procedures when filing your workers’ comp claim:
- Report your injury promptly. Notify your employer about your workplace incident as soon as possible. Under O.C.G.A. § 34-9-80, you must report the injury no later than 30 days after the accident. Failing to report it within this timeframe could jeopardize your eligibility for benefits.
- Seek authorized medical treatment. Choose a doctor from your employer's posted panel of physicians or ask for a referral to an appropriate specialist. Receiving care from an authorized provider is essential for ensuring that your medical expenses, including arthroscopic surgery, are covered by workers' comp.
- Follow your treatment plan. Attend all scheduled doctor appointments and carefully follow the prescribed treatment plan. If your physician recommends arthroscopic surgery, make sure the workers' compensation insurance carrier properly pre-authorizes it before proceeding.
- Document everything. Keep detailed records of all medical care received, including dates of appointments, copies of bills and receipts, and any work absences due to your injury. Maintaining thorough documentation supports your claim for benefits and ensures that you will be reimbursed for all eligible expenses.
- Consult with a knowledgeable attorney. You should retain our skilled Atlanta workers' compensation lawyer, who will advocate for the benefits that are included as part of your employment.
Trust Us to Fight for Your Right to Workers' Comp Benefits
We're passionate about defending the rights of injured workers in Atlanta and throughout Georgia. We understand how a job-related injury or illness can profoundly impact your health, career, and your family's financial security. That's why we'll fight tirelessly to ensure that you receive the full workers' compensation benefits you deserve, including coverage for necessary medical treatments like arthroscopic surgery.
Jaret will be by your side if your claim is delayed or denied, represent you at hearings, and work to secure the maximum compensation available under the law. With our dedicated team in your corner, you can focus on your recovery with peace of mind, knowing your rights will be protected.