If you sustain an injury while working on the job, worker’s compensation will cover your necessary medical treatment under certain conditions, including surgery.
You must follow the claim procedures to recover under a worker’s compensation policy, but you also might have the option of filing a third-party liability lawsuit.
Coverage of medical treatment
To have your surgery covered by worker’s compensation, you must have gotten injured while performing your job duties. You will need to report your injury to your employer and include all relevant details that show the condition occurred due to your job.
After providing notification of the injury, you will need to see a physician from the approved doctors given to you by your employer. You must coordinate your care through the Authorized Treating Physician, who can determine if you need surgery or refer you to a specialist for further evaluation.
The worker’s compensation insurance company will review any proposed treatment and decide if they will cover it. The insurer does not have to pay for your surgery if another treatment option is available.
You can also seek to file a third-party liability claim against others responsible for your accident. This would not include your employer but can consist of the property owner or subcontractor on the job. Under a third-party lawsuit, you can seek damages for uncovered medical treatment, lost wages, and pain and suffering.
You may get worker’s compensation coverage for any necessary surgery, but you might have to file a third-party lawsuit to get fully compensated.