How to Navigate Needing Surgery During your North Carolina Workers’ Compensation Case

Suffering a workplace injury can be overwhelming, and the prospect of needing surgery adds another layer of complexity to your recovery. If you are facing surgery while navigating a workers’ compensation case in North Carolina, understanding your rights and the process can help ensure you receive the medical care and financial support you deserve.

At Ramsay Law Firm, our Charlotte workers’ compensation attorneys are dedicated to guiding injured workers through this challenging time.

Does Workers’ Compensation Cover Surgery in North Carolina?

North Carolina workers’ compensation laws require employers and insurance carriers to cover all necessary medical treatment related to workplace injuries, including surgery. However, getting approval for surgery can sometimes be complicated due to delays, disputes, or insurance company denials.

Steps to Take if You Need Surgery for a Workplace Injury

If your doctor recommends surgery as part of your recovery, follow these steps to ensure that your workers’ compensation benefits cover the procedure and any related expenses:

• Obtain Approval from the Insurance Carrier

Workers’ compensation insurers must approve all medical treatments before they are performed. Your treating physician will submit an authorization request. You may need to appeal the decision if the insurance company denies or delays approval.

• Follow the Recommended Medical Process

Your authorized treating physician must determine that surgery is medically necessary. If an independent medical examination (IME) is required, attend and follow all recommendations to avoid delays in your claim.

• Understand Your Temporary Disability Benefits

If your surgery prevents you from working for an extended period, you may qualify for temporary total disability (TTD) benefits, which provide wage replacement while you recover.

• Prepare for Potential Disputes

Insurance companies often challenge the necessity of surgery, arguing that:

• Less invasive treatments should be attempted first.
• The surgery is related to a pre-existing condition rather than a workplace injury.
• The injury is not severe enough to warrant surgical intervention.

You can appeal with the North Carolina Industrial Commission (NCIC) if your surgery is denied. Our attorneys are experienced at obtaining surgery approvals.

What Happens After Surgery?

Once your surgery is complete, recovery and return to work are critical to maintaining your workers’ compensation benefits.

• Follow Your Doctor’s Orders

Adhering to your post-surgical treatment plan, including physical therapy and follow-up appointments, is essential to protecting your claim.

• Monitor Your Disability Status

Depending on your recovery, your doctor may place you on light-duty work or determine that you are temporarily or permanently disabled. If your condition prevents you from returning to your previous job, you may qualify for permanent partial disability (PPD) benefits or vocational rehabilitation.

• Avoid Returning to Work Too Soon

Employers and insurance companies may pressure injured workers to return before fully healing. If you feel that returning too soon could jeopardize your recovery, consult an attorney before making any decisions.

How Ramsay Law Firm Can Help

Navigating a workers’ compensation case while facing surgery can be stressful, but you don’t have to do it alone. At Ramsay Law Firm, we fight to ensure that injured workers throughout North Carolina receive the medical care and financial benefits they deserve.

If your surgery has been denied, delayed, or disputed, contact our Mecklenburg County workers’ compensation attorneys at 704-376-1616 or online today for a free consultation. We are here to protect your rights and help you recover without unnecessary financial burdens.

A Voice For The Injured.  Here Every Step of The Way.