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Is a Knee Replacement Covered by Workers’ Compensation?

Home > Is a Knee Replacement Covered by Workers’ Compensation?
May 17, 2023 | Petro Cohen | Read Time: 3 minutes

Knee injuries are prevalent in the workplace, especially in industries such as construction, agriculture, and manufacturing. Some knee injuries are severe enough to require surgical knee replacement. If your knee injury is a result of your occupation or an injury sustained during the course of your employment, it should be covered by workers’ compensation insurance.

However, work-related knee injuries can be difficult to prove, and insurance carriers often challenge causation and compensability. If you believe you may need a total knee replacement due to a work injury, you should seek legal advice immediately.

Workers’ Compensation for Knee Replacements

If you can prove your work-related knee injury requires knee replacement, the procedure should be covered by your employer’s workers’ comp carrier. Like most legal matters, it is not always straightforward, and there are often reasons the insurance company will challenge your claim.

Pre-Existing Injury

Workers’ comp carriers often deny a claim alleging the injury is pre-existing. In other words, the insurance company will argue that the injury was caused by something prior and unrelated to your workplace accident. However, if you can prove your knee injury happened at work or was aggravated by a workplace accident or job duties, you will be entitled to compensation.

Wear-and-Tear Injury

Wear-and-tear injuries, as they sound, result from the repetitive use of a particular body part, including the knees. For instance, if you are a floor installer, the repetitive and constant pressure from kneeling for multiple hours daily can lead to a wear-and-tear knee injury. These injuries are more challenging to prove because they do not happen suddenly. Examples of wear-and-tear knee injuries include tendonitis, osteoarthritis, and bursitis.

Remember, just because proving your knee injury may be complex does not mean it’s impossible. A sharp, experienced attorney will fight for the compensation you deserve. Upon meeting with our team, we will discuss the strategy and all available options for your case.

Am I Responsible for Paying for My Knee Replacement Surgery?

You will not have to pay for your knee replacement surgery if you are eligible for workers’ comp benefits. One of the primary purposes of workers’ compensation insurance is to alleviate the cost to the injured worker. In addition to compensation for medical expenses, including surgery, doctor visits, rehabilitation, and prescriptions, you may qualify for benefits to cover your lost wages while you cannot work.

Depending on the severity of your knee injury, you may qualify for the following:

· Temporary Disability – If you are temporarily disabled due to your injury, you may be eligible to receive up to 70% of your average weekly wage.

· Permanent Disability – If your injury is so severe that you are permanently disabled and unable to work in the future, you may qualify for partial or total permanent disability benefits.

At Petro Cohen, one of our workers’ compensation lawyers can help you determine what you might be eligible to receive.

Common Workplace Knee Injuries

Many types of knee injuries can occur at the workplace and often depend on specific industries and job duties. However, common types of on-the-job knee injuries include the following:

· Dislocation,

· Tendon injuries,

· Meniscus tears,

· Ligament injuries,

· Sprain,

· Fractured patella (kneecap), and

· Torn anterior cruciate ligament (ACL) injuries.

Some of these injuries occur immediately after an accident. The cause of the injury is acute and easy to identify. But other injuries are more subtle in nature as they develop and manifest over time. No matter the cause or the injury, if it happened at work and as a result of your job functions, you may be eligible for workers’ comp benefits, including knee replacement.

Suffering from a knee injury and the possibility of a total knee replacement can be scary and daunting. The last thing you should be worried about is whether workers’ compensation insurance will cover your surgery. A workers’ comp attorney can alleviate this concern by helping you show that your injury arose out of the course of your employment.

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