Surgeons perform more than 350,000 spinal fusion procedures yearly. And the number of cervical and lumbar fusion surgeries continues to grow.
These operations are expensive, often costing $50,000 or more. Indeed, we regularly see six-figure charges for spinal fusions in workers compensation and car accident cases.
But this is not the only cost you may face if you have a neck or back injury that herniates a disc, aggravates or exacerbates preexisting degenerative disc disease, such as spinal stenosis, and requires a single-level or multi-level fusion.
You may also have permanent restrictions after spinal fusion. And these limitations from spinal cord injury may cause long-lasting disability from work.
This article examines the likelihood of receiving permanent restrictions after spinal fusion and the return-to-work issues you may have after one of these operations to treat a back injury or degenerative disc disease.
The extent of disability after a fusion determines the settlement value of your workers comp case or car accident claim and the strength of your Social Security disability claim.
Keep reading for more information about your potential limitations after spinal fusion.
And call us if you want to speak with one of Virginia’s best personal injury and tort lawyers: 804-251-1620 or 757-810-5614.
The healing and recovery process differs for everyone. But spinal fusion surgery often requires an extended healing period, and the data and our experience provide a general recovery timeline.
First, you will likely spend a few days in the hospital after the fusion procedure. The exact length depends on whether you have surgical complications and your support system at home. For example, you will go home sooner if someone is available to drive you, pick up your prescription medications, or help with daily living activities.
After discharge from the hospital, your orthopedic surgeon will likely disable you from all work for one to three months. The goal during this period is to let you rest so the vertebrae fuse.
At some point, your doctor will prescribe physical therapy and gentle exercises. You may, however, continue to be disabled from all forms of work so you are not in a situation where you have to drive, bend, twist, or lift.
Once you approach the six-month mark post-fusion, your doctor may release you to light-duty work if they have not already. Usually the vertebrae have fused by this time (if the surgery is successful). Common light-duty restrictions from months six to nine include sedentary work (seated work primarily), limited driving (no more than 30 minutes at a time), no twisting or bending, and lifting no more than 20 pounds occasionally.
The fused bone continues to solidify from eight to 18 months after the fusion. At this point, your doctor may declare that you have reached maximum medical improvement (MMI) and refer you for a functional capacity evaluation (FCE) to determine your level of permanent impairment and life-long restrictions.
In our experience, many doctors would rather avoid assessing work restrictions and limitations because they need more training in this area, and their opinion may create conflict with the patient. This preference explains why FCEs are so prevalent in workers compensation cases.
But for those physicians that wade into determining permanent restrictions, “[t]he American Medical Association [AMA} encourages physicians everywhere to advise patients to return to work at the earliest date compatible with health and safety and recognizes that physicians can, through their care, facilitate patients’ return to work.”
We agree with and understand the desire to return patients to work. Indeed, most (if not all) of our clients want to return to work and put the industrial accident or occupational illness behind them. And earning a living can improve mental health.
But we fear that blind adherence to this principle may result in physicians releasing spinal fusion patients back to full duty too soon, leading to re-injury and more significant disability from work.
The AMA instructs physicians to consider three factors when assessing a patient’s ability to work: risk, capacity, and tolerance.
From there, your doctor will say what limitations (activities you cannot do because of the fusion) and restrictions (things you can do but should not because of the injury) you have.
Perceived tolerance for work causes the most disputes between insurers, employers, injured workers, and doctors. And your physician’s ability to stay strong and provide permanent restrictions after spinal fusion that you are comfortable with, as opposed to the nurse case manager or claims adjuster, often determines your case’s trajectory.
Several variables affect your permanent restrictions after spinal fusion, if any.
These factors include the following:
Considering the above variables, this section looks at common work restrictions that spinal fusion patients receive in workers comp and motor vehicle collision cases.
Employers, insurers, and third-party claim administrators such as Sedgwick, Gallagher Basset, and ESIS know the data shows the percentage of workers who successfully return to the labor force significantly drops after six months of absence/disability from work. And that employees out of work for more than one year are more likely to remain unemployed than they are to return to work.
Statistics like these are why insurance defense attorneys, claims adjusters, and nurse case managers often push doctors to push patients back to work before they are physically or mentally ready.
These efforts often succeed because many doctors are uncomfortable with return-to-work issues. Indeed, your physician may have yet to receive any training on assessing work restrictions and limitations.
But you do not have to accept the defendants’ behavior and efforts to prey on physicians’ lack of familiarity with assessing work status.
Instead, hire a skilled attorney to ensure you receive accurate and complete permanent restrictions after spinal fusion and only return to a job you can perform without risk of re-injury. Then create an action plan to scare the insurance adjuster into increasing claim reserves and offering a fair settlement.
Call us today to get started: 804-251-1620 or 757-810-5614.