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May 14, 2012

Is Cosmetic or Plastic Surgery Covered Under Workers Compensation?

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Posted in Legal Advice

What is Cosmetic or Plastic Surgery?

It is surgery that is intended to modify or improve the appearance of a physical feature, irregularity, or defect.

Is Cosmetic or Plastic Surgery Covered under Workers Compensation in Wisconsin?

Yes. If your doctor indicates that the recommended surgery is “work-related” or needed as a result of a work-related injury, it may be covered under Workers Compensation. However, it is not covered under Workers Compensation if your doctor does not believe that the work injury caused the need to have cosmetic surgery.

Examples of situations in which Cosmetic or Plastic Surgery was covered under Workers Compensation:

1) Betty is a 31 year old woman that had breast enlargement surgery in the summer of 2010. In January of 2011, she was in a work-related car accident. On impact, the airbag hit Betty directly in the chest causing her right breast to rupture. As a result, her doctor indicated that she needed cosmetic surgery to repair her ruptured breast. Betty’s doctor provided the necessary report to the court, stating that “additional, cosmetic surgery needed to be completed because of the work-related car accident.” Thus, the Workers Compensation carrier paid for Betty’s reconstructive surgery.

2) John is a 53 year old man that worked for a well-known, Wisconsin chemical company for a little over 20 years. In the summer of 2011, an explosion occurred, causing his face and arms to catch fire. John suffered from third degree burns and needed multiple cosmetic surgeries. The Workers Compensation carrier paid for John’s surgeries because his doctor agreed that they all needed to be completed as a result of the work-related injury.

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