What If Surgery Doesn’t Work?

For certain conditions, surgery may be required if symptoms are severe. And surgery can be an effective treatment for many conditions. For example carpal tunnel syndrome. But what if surgery doesn’t work? If a dentist or physician hasn’t planned for this, it can be a challenging time.

There can be numerous reasons why surgery doesn’t work – including a botched procedure or waiting too long to have the surgery.  In the carpal tunnel example, symptoms can be due to something else or a co-morbid condition (e.g. cubital tunnel syndrome, arthritis, cervical radiculopathy).

With disability insurance claims, insurers will often recognize a recovery period for something like carpal tunnel surgery as a period of disability. However, they also have limits on how long that period can last (sometime called “durational guidelines”).

Once this recovery period is up, insurers often begin to push you to go back to work – even if you are not ready. For example, they may call your doctor and press for a firm “return to work” date. Or, they may request an Independent Medical Evaluation (IME).

It can be difficult to prove that a surgery didn’t work. Particularly if your ongoing symptoms are largely subjective in nature (for example pain or numbness). Without evidence of continued symptoms or a diagnosis of co-morbid conditions, a claim may be denied or terminated. Consequently, the fight to maintain benefits most often comes after surgery.

Each case individual case is different.  If you’ve had or are planning on surgery, and are concerned about its impact on your claim, please feel free to reach out to one of our attorneys directly.

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