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Can Workers’ Compensation Cover Cosmetic Surgery?Workers’ compensation benefits are meant to pay for medical treatment for your work-related injury. When a claim is filed, insurance companies often argue with workers about whether injuries are related to the work incident and whether the treatment is necessary for recovery. Cosmetic surgery is a gray area in workers’ compensation that may not seem like it would fall in the category of necessary treatment. However, a scar from an injury can degrade your quality of life, making corrective treatment appropriate as a workers’ compensation expense.

Disfigurement

An injury or a related medical procedure can leave a permanent visible mark, known as a disfigurement. In terms of workers’ compensation law, disfigurement is cosmetic damage to the body that does not affect your ability to perform your work. Visible scars and lost teeth are common examples of disfigurement. Insurers often argue against paying for corrective surgery on a disfigurement because they believe it goes beyond the treatment that is necessary to physically function. However, a disfigurement can affect your quality of life and, by extension, your work performance:

  • Scars on normally visible places of the body can cause embarrassment and distress; and
  • A scar may cause pain or itching, which a cosmetic surgery could fix.

Receiving Compensation

It may take several months after your injury to determine whether you have a disfigurement. Surgery may leave a scar, and you need time to see whether your scar will heal. Whether your disfigurement qualifies for workers’ compensation benefits and how much you receive depends on the size and location of the disfigurement. Surgery to correct a small scar may not be covered, but an arbitrator or the Illinois Workers’ Compensation Commission may award you additional compensation for cosmetic surgery if you have a noticeable scar on your:

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