Unlike other injuries, there are certain rules with respect to medical care and compensation for hernias. The Workers’ Compensation Act devoted an entire separate section just to hernias. Additionally, unlike other injuries, a hernia may be compensable even though it did not result from an accidental injury, but merely from a strain arising out of and in the course of employment. The injured worker must prove that the hernia did not exist prior to the injury or strain, or, if it did, that the pre-existing hernia became so strangulated or aggravated that an immediate operation was necessary.
The injured worker must also prove that the hernia was reported to the employer within 30 days after its occurrence.
When an Injured Worker has Surgery
Whenever practical, a hernia that is proven to be the result of an accidental work-related injury shall be treated by surgery. If the injured worker does sustain a compensable hernia that requires surgery, the injured worker is entitled to compensation only for lost time from work. Any time lost by the injured worker resulting from a delay in holding a hearing to determine whether the hernia is a compensable injury is not counted as lost time if the delay occurred at the request of the injured worker.
If, after a special examination, it is shown that an injured worker who suffered from a compensable hernia, and underwent surgery, has a permanent partial, permanent total, or temporary total disability, the employer/insurer will pay compensation to the injured worker in accordance with the provisions established for other injuries.
If an injured worker who suffered a compensable hernia dies as a result of surgery, the death will be deemed to be the result of the accidental injury that caused the hernia and the employer or insurer will provide death benefits in accordance with the provisions for other injuries.
When an Injured Worker Refuses to have Surgery
If an injured worker who suffers from a compensable hernia refuses to have surgery, the employer/insurer is only required to pay the injured worker compensation for 7.5 weeks. The Commission may excuse an injured worker’s refusal to undergo surgery if the employee proves to the Commission that undergoing surgery would be unsafe because of the injured worker’s age or prior physical condition.
If the Commission excuses the injured worker’s refusal to undergo surgery for the compensable surgery, the employer/insurer is required to pay the injured worker compensation for 52 weeks.
If the injured worker refuses to have surgery, whether or not that refusal is excused, the injured worker is not entitled to any other compensation than that listed above.
(Rated: 3.58
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