Knee Replacement Surgery Workers' Compensation FAQ

Knee replacement surgery workers' compensation.

Though any worker can suffer a knee injury, trauma to the lower extremities is most common in jobs where employees spend a majority of the workday on their feet. Construction workers, nurses, auto mechanics, delivery drivers, and kitchen staff are all at risk for knee sprains or damage to the protective cartilage. Because the knee is a load-bearing joint, these types of injuries can be particularly painful and difficult to make a full recovery from.

We often associate a knee injury with a single incident, like a slip and fall or collision with a hard surface. However, knee injuries can also happen over time if a worker’s job requires him or her to perform repetitive motions or awkward turns.

If you suffered a knee injury on the job and your doctor has determined you need a knee replacement, you may be concerned about whether workers’ compensation will cover such a serious surgery. Below, we answer some of our clients’ most frequently asked questions about knee replacement and workers’ compensation.

Is knee replacement covered by workers’ compensation?

Worker’s compensation must pay for all reasonable treatment you need because of a job-related injury. If your utilization review finds that a knee replacement is medically necessary, the surgery should be covered by workers’ compensation.

Why did the insurance company refuse to pay for my knee replacement?

The most common reason insurance companies fight paying for knee replacement surgery is because they claim a work injury didn’t cause the need for treatment. In other words, insurance companies often try to argue that a worker had a pre-existing knee condition before the work injury occurred. If your employer’s insurance company refused to pay for your knee replacement, the best course of action is to contact a workers’ compensation attorney who can review your case.

What does it mean when my doctor assigns me a permanent partial disability rating?

After your knee surgery, your doctor should assign you a permanent partial disability rating. The permanent disability rating system uses a complex formula to assign an injured worker a level of impairment. Workers with injuries considered to be severe receive higher disability ratings and are entitled to more benefits than those with lower ratings.

Can I go back to work after my knee replacement surgery?

If you are given a high permanent disability rating following your knee replacement, you may not be able to return to work. Or, you may be able to return to work, but not to your former job. Your employer may assign you to a new position that accommodates your limitations. If that isn’t possible, or if there are no openings at your current company, you may have to look for new employment.

Were you denied workers’ compensation benefits for your knee replacement?

When a work-related accident causes an existing knee condition to worsen, all medically necessary treatment should be covered by worker’s compensation – including knee replacement. If you have suffered a work injury that requires knee surgery and the insurance company is refusing to pay, it’s time to contact a workers’ compensation attorney.

At the Law Office of Gerald Brody & Associates, we know every trick insurance companies pull to deny paying workers’ compensation benefits. Unfortunately, knee replacement is an expensive surgery, giving insurers all the more reason to place the blame on your age or a previous condition. The bottom line is this: if your knee injury is work-related, our attorneys will do everything in their power to make sure you don’t have to shoulder the cost of surgery. Give us a call to schedule a free case evaluation at (619) 345-5317.