How Does Spinal Cord Stimulator (SCS) Implantation Affect a Workers Compensation Case?
Spinal cord stimulator’s effect on settlement value: Many lawsuits and insurance claims involving SCS trials and implantations settle for $150,000 or more. We explain why.
Your doctor may recommend a spinal cord stimulator (SCS) trial if you have chronic pain that fails to respond to less invasive treatments like prescription medication, epidural steroid injections, physical therapy, or psychological intervention.
If the SCS trial relieves your pain, you may undergo a permanent SCS implantation.
While SCSs can offer significant pain relief, they also present complex legal and financial challenges. Indeed, a doctor’s prescription for a spinal cord stimulator may prompt significant opposition from employers, third-party claim administrators, and insurance companies due to their high costs and their signal that you will have permanent restrictions preventing you from returning to many physically demanding jobs.
This article examines the costs and permanent restrictions associated with spinal cord stimulators and how your need for an SCS affects the settlement value of your workers compensation claim.
Call (804) 251-1620 or (757) 810-5614 or complete this online form if you have questions about your rights under workers compensation law. See why many publications name my law firm one of the best for injury victims and hurt employees year after year.
What is a Spinal Cord Stimulator?
Spinal cord stimulator devices, also called dorsal column stimulators, have three parts:
-
- An electrical pulse generator (battery pack): The doctor implants this component beneath the skin with wires connecting to the electrodes.
-
- Stimulating electrodes (leads): The surgeon will position the electrodes between the spinal cord and the vertebrae during implantation. These electrodes may be percutaneous (inserted through a needle) or plate-type (placed during surgery).
-
- Remote control: This device lets you decide when to send electricity to your spinal cord.
You use the remote control to send electrical impulses into the spinal cord to act directly on the nerves (neuromodulation), which can reduce your pain.
How Does an SCS Work?
The medical community does not entirely understand how or why spinal cord stimulation works.
However, the SCS may alter how your central nervous system processes nerve signals, masking pain. In addition, spinal cord stimulation may increase neurotransmitter levels (like GABA and serotonin), making you feel better.
What Does Spinal Cord Stimulator Implantation Involve?
SCS implantation occurs in three steps.
Psychological evaluation
First, you must undergo a psychological evaluation to ensure no other medical conditions will interfere with the spinal cord stimulator.
For example, uncontrolled mental health impairments (depression, schizophrenia, bipolar disorder, OCD, etc.) or a history of addiction problems may exclude an SCS as a prescribed treatment.
SCS trial
Second, you will undergo a spinal cord stimulator trial.
At this stage, your surgeon implants a temporary power device that requires fewer incisions.
Your SCS trial will last from a few days to three weeks.
The trial is successful if it reduces your pain by 50% or more.
Implantation
You will have a permanent implantation procedure if the spinal cord stimulator trial is successful.
This operation usually takes a couple of hours.
Potential complications from spinal cord stimulator implantation
Unfortunately, some of you will have complications from spinal cord stimulation.
These complications range from discomfort to infection to hematomas to cerebrospinal fluid (CSF) leaks to nerve damage to spinal cord injury causing paralysis.
In addition, you may have problems with the SCS unit’s hardware. For example, electrode lead migration is common. Similarly, a slip and fall may damage the SCS device.
Depending on the extent of the complication or damage, you may need follow-up surgery to reset, replace, or reposition the electrode or pulse generator.
When is Spinal Cord Stimulation Prescribed?
Physicians use spinal cord stimulators to treat more than spinal cord injuries.
Spinal cord stimulation can help a range of medical conditions that develop after an occupational injury or car crash, including:
-
- Complex regional pain syndrome (CRPS): This diagnosis, formerly known as reflex sympathetic dystrophy, is often made when a person has continuing pain out of proportion to the initial occupational injury, edema (swelling), and changes in skin sensations without the existence of another condition that could account for the degree of symptoms.
-
- Failed back syndrome: Your physician may prescribe an SCS if you continue to have pain after undergoing a discectomy or spinal fusion for your work-related back injury.
-
- Phantom limb pain: Spinal cord stimulation may ease pain in amputees who continue to have sensations related to the removed limb.
-
- Peripheral neuropathy: Radiating pain into the extremities (arms or legs) from nerve damage due to a crush injury or diabetes may respond to an SCS.
What Are the Medical Costs Associated with Spinal Cord Stimulators?
The significant all-in costs of spinal cord stimulators, including replacement costs, drive the workers comp settlement value of SCS cases.
First, the initial spinal cord stimulator implantation costs vary widely but often ranges from $20,000 to $60,000.
Several factors contribute to the overall medical expenses associated with spinal cord stimulators:
-
- Type:Several companies manufacture spinal cord stimulators. Medtronic’s Inceptiv neurostimulator, one of the more recent SCS units developed, can adjust dosing in real-time.
-
- Procedure:The complexity of the SCS surgery often depends on the type of device used. Plate electrodes provide stability and decrease the likelihood of dislodging. However, implanting this type of lead may cost more.
-
- Applicability of the medical fee schedule: Many states have medical fee schedules, including Virginia. These schedules tell medical providers how much they can charge for procedures like spinal cord stimulator implantation based on geographic location if the surgeon has no contract with the insurer or claim administrator.
In addition to the costs of the implantation, you will have the following medical expenses:
-
- Pre-surgical psychological clearances
-
- SCS trial procedure, including pre-and post-trial office visits
-
- Post-implantation recovery, including prescription medication
-
- Ongoing medication and palliative care
-
- Follow-up visits
-
- Diagnostic imaging to check the hardware
Further, you may require SCS battery replacement every two to five years, which can cost several thousand dollars per procedure. These costs can add up quickly if you are under 60 and have a long life expectancy.
In my experience, a prescription for a spinal cord stimulator adds approximately $100,000 (if you have Medicare) to $275,000 or more to the settlement value of your workers compensation case.
Will I Have Permanent Restrictions After Spinal Cord Stimulator Implantation?
Probably.
Indeed, many SCS patients find it difficult to return to work, mainly if their pre-injury job involves lifting, carrying, pushing, pulling, bending, stooping, or driving.
Though many patients report significant pain reduction after SCS implantation, in my experience, few injured employees report complete pain relief from the spinal cord stimulator. And this ongoing, intractable pain limits their work capabilities.
In addition, your doctor will likely recommend avoiding driving (which excludes tractor-trailer occupations), operating heavy machinery (like a forklift or crane), and overexertion that could dislodge the SCS device. These restrictions exclude many occupations.
Further, the spinal cord stimulator helps with pain, but the underlying occupational injury remains. This injury contributes to permanent restrictions after SCS implantation.
What is the Average Settlement for a Case Involving Spinal Cord Stimulator Implantation?
Based on my professional experience, the typical range for workers compensation settlements involving a spinal cord stimulator is $275,000 to $600,000.
This amount includes the costs of the SCS trial, implantation, and device replacement as you age, in addition to wage loss payments and compensation for permanent partial disability due to permanent impairment from the underlying injury.
However, the extent of your permanent restrictions, pre-injury average weekly wage (AWW), ability to return to work at or near your AWW, or existence of unfavorable medical evidence from an IME doctor may lower the SCS settlement range.
Do You Want to Close Your Case Before or After Spinal Cord Stimulator Implantation? Our Workers Comp Attorneys Can Help.
Spinal cord stimulators are controversial in workers compensation.
Although frequently prescribed for injured employees with chronic pain, insurance companies often argue that spinal cord stimulators are unreasonable, unnecessary, or unrelated to an occupational injury. They point to the high costs and high failure rate (when it comes to complete pain reduction) to support their defense.
If you have a permanent spinal cord stimulator or your doctor has recommended an SCS trial that you are hesitant to complete, now may be the time to settle your workers compensation case.
Our law firm can help you determine a fair settlement range for your spinal cord stimulator case and assess the likelihood of your qualifying for Social Security disability.
We want to help you protect yourself and your family.
- Will the Dollar Tree Store Closures Affect My Workers’ Compensation? - March 14, 2024
- SSA Proposes a Rule Change to Work History Evaluation - November 1, 2023
- VA Workers Comp Lawyer: We Win Work Injury Claims - May 8, 2017
