Severe back pain that persists, radiating pain and numbness in your arms or legs, or loss of bowel or bladder control are symptoms you may experience after a work injury. You could need an epidural injection—a powerful anti-inflammatory medication delivered directly to the irritated spinal nerves—to treat it. But will workers' compensation cover it?
The short answer: Yes, epidural injections can absolutely be covered under a Georgia workers' compensation claim stemming from an on-the-job injury.
However, as with any medical treatment, the insurance company may seek reasons to deny coverage. Here's what you need to know about your rights and how our experienced Georgia workers' comp attorney at Rechtman & Spevak can help you obtain the workers' compensation benefits you deserve.
What Are Epidural Injections Used For?
Epidural injections contain a corticosteroid medication that's injected into the outermost part of the spinal canal called the epidural space. This space sits just outside the dural membrane that surrounds the spinal cord and nerves.
The medication reduces inflammation, swelling, and pain in the affected area. For some patients, epidural injections provide enough relief to continue working or start physical therapy. Others may need a series of injections for longer-lasting results. Some common conditions treated with epidural injections include:
- Spinal stenosis. This is a narrowing of the spinal canal that compresses the nerves and causes pain, numbness, and difficulty walking.
- Herniated discs. Bulging or ruptured discs can press on surrounding nerves, causing pain and difficulty moving.
- Sciatica. Symptoms of sciatica can include pain radiating along the sciatic nerve due to compression of the spinal nerve, causing discomfort and mobility problems.
- Chronic back and neck pain. Work-related injuries can cause long-term back and neck pain, characterized by symptoms such as pain, numbness, stiffness, and headaches.
When Does Workers' Compensation Cover Epidural Injections for Job Injuries in Georgia?
Generally, if your on-the-job duties caused or significantly aggravated your condition, you should be eligible for workers’ compensation benefits. All necessary medical treatment, including epidural injections, should be covered by workers' compensation. Many different workplace injuries require epidural injections, including, but not limited to:
- Falling from heights or being struck by falling objects.
- Motor vehicle accidents while performing job duties.
- Heavy lifting, bending, and twisting motions.
- Long periods of sitting, standing, or repetitive reaching overhead.
- Slip and fall accidents on unsafe surfaces.
Basically, if your doctor says you need an epidural injection to treat pain from an accepted workers' comp injury, the insurance company should cover it. But as you might expect, it's not always the case.
What’s the Process for Obtaining Epidural Injection Coverage Through Workers' Comp?
You must follow a specific process when filing a claim for workers’ comp benefits. Our Georgia workers’ comp attorney recommends you take these key steps to pursue coverage for epidural injections under your Georgia workers' compensation claim:
- Report the injury. Notify your employer in writing as soon as possible after the work accident or onset of symptoms. This has to be done within 30 days of the injury under O.C.GA § 34-9-80.
- Get medical care. See an approved workers' comp doctor and discuss whether epidural injections are right for your condition.
- Document the link. Have your physician clearly explain in their medical notes how the injections relate to your on-the-job injury.
- Wait for approval. The insurer then reviews the request and issues a decision. If approved, schedule the procedure.
- File an appeal if needed. If the injections are denied, file a claim with the Georgia State Board of Workers’ Compensation.
- Retain a lawyer. Hire Rechtman & Spevak to help you appeal the denial and fight for the epidural injections and other medical treatment you need.
Remember, if the injection is authorized, workers' comp insurance should cover all related costs, including the procedure itself, any missed work time, and travel to and from appointments. It’s that simple.
What Obstacles Could You Face Getting Epidural Injections Approved?
Even when the treatment is clearly necessary for your recovery, the workers' compensation insurance company may look for any reason to deny coverage, and you’re facing an uphill battle. Tactics include:
- Sending you to their doctor. The workers' comp insurer may require you to see one of its preferred physicians, who could downplay the severity of your injury or argue the injections aren't necessary because of their relationship with the insurance company.
- Disputing the cause of your pain. If you have any history of back problems or other preexisting conditions, the insurance company may claim your pain wasn't actually caused by your work duties.
- Demanding excessive proof. The insurer may make unreasonable requests for medical evidence or expert opinions, with the goal of prolonging the process until you give up.
- Rushing your recovery. An adjuster may pressure you to return to work before you've reached maximum medical improvement, arguing you don't need additional treatment.
- Offering a lowball payment. The insurance company may push you to accept a quick, minimal settlement and give up your right to future care—including epidural injections.
However, if your doctor says epidural injections are appropriate for your work injury, you have every right to hold the insurance company accountable for the care you need.
How Our Georgia Workers' Comp Attorney Can Help
Since 1995, attorney Jaret A. Spevak has fought for the rights of injured people seeking workers’ comp benefits. Here are some key ways he can assist you:
- Communicating with the insurer. He handles all dealings with the insurance company and makes sure your rights are protected.
- Gathering essential evidence. Our legal team works diligently to compile medical records, expert opinions, and other documentation to support your need for injections.
- Appealing denied treatment. If the insurer refuses to cover your epidural injections, we’ll mount a strong appeal and argue your case at any hearings.
- Maximizing your benefits. Jaret will fight for your right to obtain the full value of your claim, including all medical treatment and disability payments you're entitled to under the law.