Back surgery after a work injury didn’t work? Learn how failed back surgery affects your Missouri workers’ comp claim, future medical, and settlement. Free consultation: (314) 361-4300.
Here’s what injured workers are rarely told: When the insurer’s doctor performed or authorized that surgery, the insurance company paid for it. That makes your claim accepted. It does not make it protected. The same doctor who operated on you may soon write a report saying you have reached maximum medical improvement, need no restrictions, and need no future care. The pain does not go away. On paper, the insurer’s responsibility does.
What “failed back surgery” means for a Missouri claim
A failed fusion, laminectomy, or discectomy does not close your workers’ compensation claim. In many cases, it changes what the claim is really about.
Before surgery, the question was whether the injury happened at work and whether treatment was needed. After a failed surgery, the questions become harder and more expensive to answer:
- Is the ongoing pain related to the original work injury, the surgery, or both?
- Does the worker need a second surgery, a spinal cord stimulator, injections, or long-term pain management?
- What permanent restrictions are medically appropriate?
- Can the worker return to the same job, any job, or no job at all?
- What future medical care is reasonably required, and for how long?
Each of those questions has a dollar value attached to it. Each is also an opinion, and the first opinion on the record usually comes from a doctor the insurance company chooses and pays for.
How the insurer’s doctor typically closes a failed back surgery case
The pattern is familiar in the cases this office handles. The authorized surgeon performs the procedure. Post-operative visits are brief. At some point, often six to twelve months after surgery, the worker is told the fusion “looks solid on imaging” or the “hardware is in good position.” Pain is described as expected or as something the worker will need to live with.
Then the release comes: maximum medical improvement, no restrictions or light restrictions, a low permanent partial disability rating, and no recommendation for future care. Sometimes the report suggests the ongoing pain is degenerative, pre-existing, or out of proportion to the findings.
Once that report is in the file, the insurer’s settlement offer follows it. If nothing challenges the report, the offer becomes the ceiling on your case. The company doctor is not your doctor. Understanding that is the first step to protecting a claim after surgery has failed.
What a failed back surgery claim may actually include
Missouri law allows an injured worker to recover medical care that is reasonably required to cure and relieve the effects of the injury. That doesn’t end at MMI, and it doesn’t end because the first surgery didn’t work. Depending on the facts, a failed back surgery claim may involve:
- Additional surgery. Revision fusion, hardware removal, or adjacent-level surgery when the segment above or below a fusion breaks down.
- Spinal cord stimulator. Trial and permanent implant, plus battery replacement over a lifetime.
- Long-term pain management. Injections, medication management, physical therapy, and monitoring for years, not months.
- Permanent restrictions. Lifting, bending, sitting, and standing limits that may permanently take a worker out of a trade.
- Permanent total disability. When the combination of pain, restrictions, age, and work history means no employer in the open labor market would reasonably be expected to hire the worker.
- Home modification and daily living support. In severe cases, this can include adaptive equipment, transportation, or in-home assistance.
The insurer’s doctor is unlikely to put any of these in writing without being pushed. Proving them is your attorney’s job, and it costs money.
What to do now if your back surgery did not work
- Keep every appointment and report every symptom. Gaps in treatment and undocumented pain are used against workers.
- Do not accept “no restrictions” as final. Ask the doctor to put your actual limitations in writing. If they refuse, note the date.
- Get a second opinion before you settle. Get a second opinion from another doctor.
- Do not sign a settlement that closes future medical without understanding what a second surgery or a stimulator would cost you out of pocket.
- Call before the release becomes the record. The earlier an attorney is involved, the more evidence exists when the insurer’s doctor writes the final report.
Talk to a Missouri workers’ compensation attorney
If your back surgery did not fix the problem and the insurer’s doctor is preparing to release you anyway, the next few months matter. The Law Office of James M. Hoffmann has represented injured Missouri workers for more than 30 years and has recovered over $100,000,000 for its clients. You will talk directly with Attorney James M. Hoffmann, and the consultation is free.