Will Ohio’s Workers’ Compensation System Pay For Your Back Surgery?

Will Ohio’s Workers’ Compensation System Pay For Your Back Surgery?

December 31, 2019 | By O'Connor Acciani & Levy
Will Ohio’s Workers’ Compensation System Pay For Your Back Surgery?

When the Ohio Bureau of Workers’ Compensation (BWC) implemented a new rule in 2018 for workers with a job-related back injury, the presumed goal was to reduce the number of injured employees gaining access to opioid prescriptions. However, critics may have questions about how this new rule may affect workers with a job-related back injury and how can they get the benefits they need? Our experienced attorneys discuss the strict limitations the BWC passed in 2018. If you sustained a job-related back injury, learn more about how our attorneys may be able to assist you by scheduling a free, no obligation consultation.

Does Ohio’s Workers’ Compensation System Cover Back Surgery?

Ohio workers’ compensation benefits are intended to cover surgical treatment for a back injury caused by a work-related accident or while performing your job duties. However, prior to receiving those benefits, the BWC requires you to complete alternate forms of therapy first.

How Does Ohio’s Restrictions On Opioid Prescriptions Affect My Treatment?

The Ohio Bureau of Workers’ Compensation guideline that went into place in January 2018 states that injured workers requiring spinal fusion surgery must complete a minimum of 60 days of alternative treatment before surgery can be considered, except in the most severe cases. Some remedies that may be prescribed include:
  • Physical therapy
  • Chiropractic care
  • Rest
  • Ice
  • Anti-inflammatory medications
  • Spinal injections
In most circumstances, Ohio’s BWC will only approve benefits to pay for back surgery and painkiller prescriptions after the injured worker has successfully completed at least 60 days of alternative treatment. Exceptions to this rule include cases where spinal surgery is required immediately for a worker suffering from a more serious condition, such as:
  • Tumor
  • Spinal fracture
  • Infections
  • Functional neurological deficit
  • Emergent back trauma requiring immediate surgery
  • Other catastrophic spinal occurrences
Doctors are discouraged from prescribing opioid medications during the 60-day time period. Advocates of the guideline hope that by reducing the number of injured workers undergoing back surgery, more people will be kept off post-surgical painkillers that are linked to addiction. Some physicians who back the 60-day waiting period claim non-invasive treatments have historically resulted in better long-term outcomes for injured workers with chronic back pain than those who received surgical treatment. Injured workers who have undergone spinal fusion surgery have been shown to have a higher risk of:
  • Failed back syndrome
  • Chronic opioid dependence
  • Increased disability
  • The need for additional surgeries
  • Psychiatric issues

What If I Am Denied Benefits For My Back Injury?

Medical professionals who believe the BWC’s new rule is too broad are concerned it may also be preventing patients from accessing treatment they genuinely need. The 60-day alternative therapy waiting period could force workers with a serious back injury to suffer unnecessarily, and a patient’s condition may worsen. Additionally, there is an increased recovery time for those who undergo more conservative care, and these injured employees end up being out of work longer. If your workers’ compensation claim has been denied, or if you are preparing your initial application for benefits, we encourage you to seek legal advice. Our experienced lawyers understand the documentation required to support a job-related back injury claim and how to build a strong argument for why a worker should receive benefits.

Contact Our Experienced Lawyers Today

At OAL Law, our knowledgeable Cincinnati workers’ compensation attorneys are here to protect your best interests and help you obtain the benefits you need. Request your free, no-obligation consultation today with a member of our legal team. We can review your potential claim and determine what legal options may be available to you. We do not charge upfront fees for a workers’ compensation claim, and payment is only due if we are successful in recovering benefits for you.