Midland, TX asked in Workers' Compensation, Health Care Law and Insurance Defense for Texas

Q: If I return to full duty at work, is the responsibility of the insurance carrier over?

I injured my right knee during a slip and fall at work. The injuries are a complete tear of the ACL, partial tear of the MCL and buckling of the PCL. I have arthritis in me knee and the only surgery that me doctor will do is a complete knee replacement. The Worker’s Comp insurance carrier said that they will not pay for a knee replacement.

1. Are they required to pay for the knee replacement to get my knee back to where it was prior to the injury?

2. If I am released back to original duty (heavy equipment operator), is the medical liability of the insurance carrier over?

I want to go back to operating equipment as soon as I can.

1 Lawyer Answer
S. Michael Graham
PREMIUM
Answered

A: It is very difficult to prove a total keen replacement is due to your work related injury. You will need an expert medical opinion to state all the conditions for which you need the total knee replacement are a result of the work injury within a reasonable medical probability. If you prove this, then you would be entitled to off work benefits provided you have not already been placed at MMI or have reached statutory MMI.

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