Workers’ Comp Reimburses Burst Implant in NC

Work-related injuries are usually covered by workers’ compensation. But what happens when your elective cosmetic surgery is affected by said injuries? According to a ruling by the North Carolina Court of Appeals, a burst breast implant that is a result of a work-related injury should be reimbursed by workers’ compensation.

In 2001, home-care nurse Penny Richardson suffered one burst and one rippled implant as a result of a motor vehicle accident. Richardson was retrieving food for a patient at the time of the accident.

Following the incident, one of her five-year-old breast implants had burst while the other showed signs of rippling. Richardson’s plastic surgeon not only replaced the burst implant, he also replaced the rippled implant for ensured symmetry.

Richardson’s employer and insurance company initially denied to her workers’ compensation claim for the replacement of both implants. When the case was appealed, the plastic surgeon testified that the cause of the rippled implant was questionable, however, that the ruptured implant was a direct result of the automobile accident.

Whether Richardson had the implants removed or replaced following the injury, she would have been personally responsible for the medical fees. The court’s final judgment was that the insurance company was responsible solely for the costs of the ruptured implant.

“Although this court has not addressed the issue of compensability of damage to breast implants, we have affirmed workers’ compensation awards for cosmetic surgery. Breast implants satisfy the statutory requirement as a compensable prosthetic device that functions as part of the body,” the court declared.

The ruling from the court came in 2008, seven years following Richardson’s injuries. Since each jurisdiction’s workers’ compensation laws vary, the ruling could have been quite different had this case been presented somewhere else. While Richardson did receive partial reimbursement for her medical fees, we are still left to question whether the time spent and legal fees involved made it worth going to trial for the patient.

To Your Health & Beauty,
Kent V. Hasen, M.D.

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