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.
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Spinal cord stimulator devices, also called dorsal column stimulators, have three parts:
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.
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.
SCS implantation occurs in three steps.
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.
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.
You will have a permanent implantation procedure if the spinal cord stimulator trial is successful.
This operation usually takes a couple of hours.
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.
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:
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:
In addition to the costs of the implantation, you will have the following medical expenses:
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.
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.
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.
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.