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Are Hernias Covered Under Workers’ Compensation?

Notifying your employer as soon as possible after experiencing a hernia is crucial.


Injuries sustained on the job, including hernias, are generally covered under workers’ compensation. However, it’s not uncommon for insurance companies to deny claims for various reasons. To counter such challenges and secure the benefits you deserve, having an experienced workers’ compensation attorney by your side is often crucial.

Key Points in Managing Work-Related Injury Claims:

  • Legal Support: An experienced attorney can help navigate the complexities of your claim, ensuring that you have strong representation to contest any denials and push for rightful compensation.
  • Proof of Injury: For your claim to be successful, you must demonstrate that the injury is directly related to your work duties or occurred at work. The required evidence can include medical records, witness testimonies, and documentation of the workplace environment.
  • State Laws: The specifics of proving that an injury is work-related vary significantly depending on state laws. In some states, it’s sufficient to show that the condition is work-related, while in others, the injury must have occurred during work hours and on work premises.

Challenges with Insurance Companies:

  • Insurance companies often scrutinize claims to find reasons for denial, such as suggesting that the injury was preexisting or occurred outside of work.
  • They may also assess your overall health and lifestyle choices, arguing that poor fitness or dietary habits contributed to the injury.

Understanding the nuances of workers’ compensation laws in your state and having professional legal guidance is crucial to effectively handling the claims process and overcoming obstacles set by insurance companies. This comprehensive approach increases the likelihood of receiving the appropriate compensation and support for recovery.

What Are Hernias?

When dealing with insurance claims for workplace injuries such as hernias, employees may face challenges from insurance companies denying claims based on the argument that the condition is preexisting or unrelated to work. Here are key steps and considerations for handling such a situation:

Key Considerations for Hernia Claims:

  • Documentation: The employee must prove that the hernia is related to work activities, especially in jobs requiring heavy lifting.
  • Medical Support: A trusted doctor’s opinion that links the hernia to work activities is essential.
  • Legal Assistance: An experienced workers’ comp attorney can be invaluable, particularly in navigating the complexities of insurance claims and requirements.

Understanding Hernias:

  • Cause: Hernias often occur from lifting heavy objects, which can stress weakened areas of the abdominal wall.
  • Treatment: Surgery is typically required to repair the hernia, with the complexity of the surgery depending on the extent of the injury and the tear.

Insurance Challenges:

  • Lifestyle Factors: Insurance companies might examine personal habits like diet, exercise, smoking, or drinking to attribute the cause of the hernia to non-work-related activities.
  • State Laws: Some states have specific regulations regarding workers’ compensation for hernias, making it essential to consult a lawyer familiar with local laws.

Successfully managing a claim for a work-related hernia injury involves a holistic approach that includes gathering medical evidence, applying legal expertise, and understanding insurance protocols.

What To Do If You Experience a Hernia At Work

If you experience a hernia at work, following specific steps is essential. It’s important to know if you’re covered under workers’ compensation. Here’s a concise guide on what to do:

Immediate Actions:

  • Notify Your Employer: Inform your employer as soon as possible. You must do this within 30 days of the incident to be eligible for workers’ compensation benefits.
  • Seek Medical Treatment: Prompt treatment is crucial, as untreated hernias can lead to severe complications.

Understanding Coverage and Claims:

  • Surgery and Recovery: Workers’ compensation should cover any necessary surgery and the recovery period, including days off work.
  • Complex Cases: If a hernia is not immediately diagnosed or is misdiagnosed, and the diagnosis comes after the time window for reporting, this can complicate claims. Insurance may deny coverage if the reporting deadline is missed.

Navigating hernia cases at work requires prompt medical action and communication with your employer to help you receive the appropriate benefits and care.

Missouri Workers Compensation Attorney

Our legal team has a strong history of helping injured workers get the medical attention and financial compensation they need. Contact our St. Louis, Missouri, worker’s compensation law firm to help safeguard your rights. Please call (314) 361-4300.

Work-Related Injuries

Updated: May 6, 2024