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Does workers’ compensation cover my surgery?

On Behalf of | Feb 27, 2023 | Blog, Workers' Compensation

Workers’ compensation is an insurance program that benefits employees who suffer work-related injuries or illnesses. One benefit of workers’ compensation is coverage for medical expenses, including surgery.

The Department of Labor and Industry states that all Minnesota employers must provide insurance for their workers. However, whether you can rely solely on workers’ compensation to cover your surgery depends on several factors.

Is your surgery work related?

First, it is essential to note that workers’ compensation typically covers only medical treatment that is necessary and reasonable to treat a work-related injury or illness. This means that if your surgery is not directly related to your work injury, workers’ compensation may not cover it. Suppose you develop a medical condition unrelated to your job that requires surgery. In that case, you may need to rely on your private health insurance to cover the costs.

Does your policy cover specific treatments?

Second, the specific details of your workers’ compensation policy may impact whether workers’ compensation covers your surgery. Some policies may have limitations or exclusions for certain surgeries or medical treatments.

Do you have the necessary documentation?

Third, getting approval for surgery through workers’ compensation can be complex and time-consuming. You may need to provide extensive medical documentation and work with your employer and the workers’ compensation insurance provider to demonstrate that your surgery is necessary and reasonable. This can be frustrating and stressful, especially when dealing with a painful injury or illness.

Whether you can rely on workers’ compensation to cover your surgery depends on several factors. These include the nature of your injury or illness, the specific details of your workers’ compensation policy and the approval process for medical treatment.

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