Coverage for second knee injury caused by first knee injury?
by Tom (Honey Brook, Pennsylvania)
In November 2012 I hurt my right knee on the job. I tore my meniscus and had a partial tear of my ACL. My employer did not argue or try to deny the claim and it was immediately accepted as a workers compensation claim. I had the surgery and was out of work for 10 weeks.
While I was recovering my knee would continuously fill up with fluid. I had it drained a number of times by the same doctor who did the surgery, but could not find out why it was happening. I got a second opinion and it turns out that the doctor who did the surgery failed to recognize the limited amount of cartilage left in my knee when he cut out the piece of meniscus.
I have been seeing a pain management Dr. to get the pain under control. I have been favoring the other knee so much it is starting to hurt a great deal. Will workers compensation cover the doctor to examine and or treat the other knee because I've been over compensating? Can they force me to have another surgery on my right knee? I fear that another surgery and more time out of work will cause me to lose my job. Thanks for any information you can give.
Disclaimer: Information provided in our response is NOT formal legal advice. It is generic legal information based on the very limited information provided. Under no circumstances should the information in our response, or anywhere else on this site be relied upon when deciding the proper course of a legal matter. Our response does NOT create an attorney-client relationship. Always get a formal case review from a licensed attorney in your area.
ANSWER for "Coverage for second knee injury caused by first knee injury?":
Tom (Honey Brook, Pennsylvania):
The workers compensation insurance company cannot force you to have additional surgery. That decision will be up to you and your doctor.
It’s not your fault your right knee is still causing you pain and discomfort. It is more likely workers comp will pay for the medical care you need to treat the pain and discomfort resulting from the initial surgery. Continued difficulty with your right knee is inarguably directly related to your initial injury.
Unfortunately, similar to back injuries, there may come a time where you have reached a level of Maximum Medical Improvement (MMI). That maximum level may not include total elimination of the continued pain and discomfort in your right knee.
It is less likely workers compensation will pay for medical care related to your left knee. To convince workers comp to pay for that care is a stretch. WC is more likely to first pay for the treatment you require for your right knee. They may take the position that once the injury to your right knee is fully treated, you will not have to compensate with your left knee.
The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.
The accuracy of information provided on this site is not guaranteed. It is generic information for informal purposes only. It is NOT formal legal advice. Your use of this site does NOT create an attorney-client relationship. Before relying on any information found in this site you should consult with a licensed attorney in your state. If you are currently represented by an attorney, you should strictly abide by his/her counsel.