Can the disability insurance company require me to have surgery in order to collect disability benefits?
Disability attorney Gregory Dell discusses whether a disability insurance company can require a claimant to undergo surgery in order to collect disability benefits.
The disability carrier cannot require you to undergo surgery. There is always the exception of some disability carriers that might cite some random case where a particular claimant didn’t undergo some kind of procedure and the disability carrier is trying to make it as if that was a surgery. For example, you have a back problem and a neurosurgeon or an orthopedic surgeon has recommended you for back surgery, and you don’t want to take the risk to go for surgery, that’s perfectly understandable and reasonable, and there’s no way that the disability carrier can deny your benefits for not undergoing a surgery. Certainly, if there’s some kind of other procedure that your doctor’s recommended and you’re on disability now and you’re concerned about that, you should call us to discuss that and we’ll let you know our opinion on that issue.
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I had arthroscopy surgey 06/29/2010 for knee pain, then synvisc injections from 10/20/2010 to 11/04/2010 I had no releif from pain in my knee joint, I can’t walk or stand for more than 20 minutes, I’m recieving long term disabilty payments now, and my doctor requested I have total knee replacement surgery, he also stated I have a knee of a 65 year old man, and Im 45, I dont want this surgery, after all the horror stories I’ve read, once its done no going back, I can live with my pain and discomfort for now, can they stop my benifits if I refuse the surgery?
Thomas, the disability insurance companies could attempt to deny your claim for not having a total knee replacement surgery, but it would be unreasonable and outrageous. There are many cases that state that an insurance company cannot deny disability benefits due to a claimant’s failure to submit for a major surgery.
I have spoke with them today about this matter they said Im not required to get surgery,but they also stated that if my doctor says Im not totaly disabled they would cut benefits immediatly. And after 09/11/2012 then any occupation will kick in which means I’m cut off for good. My job dissciption says I have to pass a fitness test push & pull 50lbs to 120lbs, kneel squat climb latters stand walk twist, even after surgery I wouldnt be able to do all functions. What can I do before they cut my benefits?
Thomas, in the event that you do not recover, you need to continue to see your treating physician at least once every two months. You need to make sure that your doctors continue to documents your restrictions and limitations. You need to be honest with the insurance company about your abilities and never exaggerate your symptoms. When you get into the “any occupation” stage your restrictions and limitations will dictate whether there is any other job you can perform.