There are many instances where a work accident leads to a doctor recommending surgery. Obviously, no one wants surgery . . . but do you have to have surgery if it’s recommended for your work-related injuries? The simple answer is “no” – no one can ever force you to have any surgery or treatment you do not want to undergo. However, there may be consequences to refusing surgery in some instances.
Under the South Carolina Workers Compensation Act, “[t]he refusal of an employee to accept any medical, hospital, surgical, or other treatment or evaluation when provided by the employer or ordered by the commission bars the employee from further compensation until the refusal ceases and compensation is not paid for the period of refusal unless in the opinion of the commission the circumstances justified the refusal, in which case the commission may order a change in the medical or hospital service. S.C. Code Ann. § 42-15-60 (emphasis added). In other words, if an injured worker refuses a recommended surgery and that refusal is not justified, weekly benefits can be stopped until the refusal ceases. If the refusal does not end, the Commission may consider whether the refusal of surgical treatment creates more disability than would be present had the injured worker undergone the surgery, which could potentially have a negative affect on the final award.
The standard adopted by the Commission in determining whether refusal of a recommended surgery is justified is a reasonableness standard (i.e., is there a good reason for refusing the surgery). There is no set list of considerations that have been identified by the courts or the Commission as to what constitutes a reasonable refusal, and these issues are always handled on a case by case basis. Some examples that may be accepted as constituting a reasonable refusal of surgery include, but are not limited to, the following:
- Doctor offers surgery but is unable to state that the surgery is more likely than not to be helpful
- Age or other health issues make surgery potentially dangerous
- Prior similar surgery performed by same doctor on the same injured worker was unsuccessful
- Another doctor authorized by the defendants disagrees with the initial doctor’s surgical recommendation
Because this is by no means an exhaustive list, whether a refusal of surgery in a given situation is reasonable is something that should be discussed as soon as possible with an attorney. Ultimately, the decision regarding whether to have surgery is always an intensely personal decision that should be made with the doctor, giving the person’s health and welfare priority over everything else. That stated, how this decision impacts workers' compensation benefits is important to know and understand.
If you have questions regarding any surgical recommendation a doctor has given to you – or for any other issues in connection with a workers’ compensation claim – please contact me, Jeremy Dantin, at KD Trial Lawyers (by phone at 864-585-5100 or by email at jdantin@spartanlaw.com). Consultations are free so get your questions answered.