When a workers’ compensation doctor recommends surgery, you may feel pressured to agree right away. The insurer may push you to sign forms or pick a date for the procedure. Still, no one can legally force you to undergo surgery against your will.
Your right to refuse medical treatment is a basic protection. This rule applies to all medical care, including procedures recommended through the workers’ comp system.
Valid reasons to decline surgery
You may refuse surgery for several legitimate reasons:
- Medical concerns: The risks are too high for your specific condition.
- Second opinion needed: You want another doctor to review the recommendation.
- Alternative treatments: Less invasive options might work just as well.
- Personal health factors: Other health conditions make surgery too dangerous.
- Religious beliefs: Your faith does not allow certain medical procedures.
- Quality of life concerns: The recovery process or expected outcomes do not fit your needs.
Illinois courts understand that surgery involves serious risks. They look at each case individually instead of automatically siding with insurance companies.
Consequences of refusing surgery
Declining surgery can affect your workers’ comp benefits. Insurers may argue that refusing treatment prevents your recovery. Under state law, the company can ask to suspend or reduce your benefits if you refuse “reasonable” medical care.
The insurance company must prove your refusal is “unreasonable.” If a surgery is major or poses a threat to your life, the courts usually deem your refusal justified.
The insurer, however, may use an Independent Medical Examination (IME) to challenge your decision. They often use these exams to build a case to cut off your benefits.
Protecting your rights and benefits
Before you accept or decline surgery, it is best to get a second opinion from a doctor who does not work for the insurance company. Keep records of all conversations with your doctors and the insurance adjuster. Ask questions about the procedure’s success rate, recovery time and other options.
If the insurance company threatens to cut your benefits because you refuse surgery, you need help determining whether the recommended surgery is truly reasonable and necessary. An experienced workers’ compensation attorney can protect your benefits and ensure you receive fair treatment under state law.
