Plastic or Cosmetic Surgery Claims After an Accident in Maryland

Any accident can cause devastating injuries, but some more serious accidents may result in scarring or severe bodily or facial disfigurement. In such cases, the consequences can extend beyond physical pain. Injuries that affect your appearance can also affect you emotionally since your self-esteem, confidence, and mental well-being are often closely tied to how you present yourself to the world. In some cases, severe scarring or disfigurement can even impact your job.

Fortunately, Maryland law does allow injury victims to recover compensation for “plastic” or reconstructive surgery in some cases. However, these claims differ from medical procedures strictly focused on your life or physical health. There can be considerable challenges in getting the negligent party’s insurance company to pay. Some answers to common questions about plastic and cosmetic surgery may be useful in navigating these cases.

What is the difference between plastic surgery & cosmetic surgery? 

Though people often use the terms interchangeably, plastic and cosmetic surgery are distinct by definition. Some of the confusion may result from the fact that many medical specialists practice both because the required skills are similar. According to the American Board of Cosmetic Surgery, cosmetic surgery concentrates on enhancing appearance. A cosmetic procedure is generally never required, by its strict definition, because the subject body part already functions properly. Common examples include breast augmentation, a face-lift, liposuction, or Botox. Such procedures are generally thought of as “elective” and, as such, are routinely not covered by health insurance.

On the other hand, plastic surgery (otherwise termed reconstructive surgery) is dedicated to repairing defects, restoring function, and reinstating normal physical appearance. Reconstructive surgeons tend to focus on facial and body features that were deformed or impaired due to a birth defect, burns, disease, or trauma.

What does Maryland law say about surgery after an accident? 

A Maryland accident victim may be entitled to recover for injuries requiring reconstruction where such injuries stem from another’s negligence. Typically, the aggrieved seek economic and non-economic damages. Economic damages mostly include such losses as medical bills and lost wages and other out-of-pocket costs that can be documented, while non-economic damages typically involve pain, suffering, emotional distress, scarring, disfigurement, and diminished quality of life. Non-economic damages are, by definition, much harder to quantify.

In general, if you have sustained an injury requiring a reparative surgery, assuming various provable facts, you might be able to recover compensation for the surgery where it is medically necessary to return you to health. In such cases, compensation is usually sought for the injured victim to cover the cost of the surgical procedure. You may also be entitled to an award for the pain and suffering, scarring, disfigurement, and emotional distress caused by undergoing surgery. Depending on the circumstances, a needed medical procedure may touch on both economic and non-economic damages.

Is cosmetic surgery included in my potential compensation? 

Based upon the above distinction between the different types of procedures, cosmetic surgery, in most cases, would not be compensable. There might be some exceptions, such as where it could be shown to be medically necessary. However, plastic surgery, on the other hand, would generally be easier to relate to trauma, where it is restorative. In either case, the issue would generally turn on whether or not the surgical procedure is necessary to restore normal function.

What types of accidents allow me to seek damage for reconstructive surgery? 

Almost all personal injury incidents involving negligence would qualify for potential compensation for restorative plastic surgery, including:

• Auto, truck, motorcycle, and other motor vehicle crashes
• Bicycle, scooter, and pedestrian accidents
• Slip and fall incidents and other injuries resulting from dangerous conditions on a property
• Medical malpractice
• Injuries due to dangerous products especially burns and amputations
• Only a medical professional can tell you exactly what procedures you may require to regain function and normal appearance. 

What are some types of reconstructive surgery I might need? 

Only a medical professional can tell you exactly what procedures you may require to regain function and normal appearance. Examples of common plastic surgeries include:

• Facial Reconstructive Surgery: There are 14 separate bones in your face. A procedure may be necessary to repair broken bones, such as the chin, jawline, cheekbones, brows, nose, or ears.
• Dental Reconstructive Surgery: If your teeth were lost or damaged in an accident, a specialist might provide restoration services or implants, such as crowns, veneers, or dentures.
• Skin Grafting: You may need a skin graft for serious accident-related burns, especially third-degree burns that penetrate the deepest layers of skin and nerves. During such a procedure, skin is removed from healthy areas of your body and surgically attached to a damaged area.
• Scar Revision Surgery: If you suffered serious scarring after an accident, you may require a surgical procedure to minimize the appearance of the damage.

In short, the mechanism of injury is not generally relevant to the issue of whether the injury is compensable except insofar as it affects liability factors, such as who was at fault.

How does a claim for reconstructive surgery work?

Seeking compensation for plastic surgery is similar to filing a claim for other types of medical injury. You need to consult your doctor about whether you are a candidate for the relevant procedures. Only a qualified physician can explain the process, risks, and benefits and make appropriate medical recommendations. A reconstructive surgeon is generally an expert in their medical field and would be in a good position to determine whether the procedure is necessary to restore normal function and appearance.

You or your lawyer would typically assert a claim against the responsible party to recover compensation for your damages. The reconstructive surgery costs would be included in your claim for economic damages, specifically medical expenses. You may also request relevant non-economic damages from pain, scarring, emotional distress, and other subjective losses.

However, there can be challenges in obtaining compensation for plastic surgery. As you might expect, opposing insurance companies may question whether the procedure is medically necessary. Sometimes, adverse insurance carriers utilize doctors to conduct peer review reports or independent medical examinations to determine whether a procedure is medically necessary. As you can imagine, any non-essential procedures would likely be rejected outright. If the insurer disputes reconstructive surgery and refuses to pay, you could face a long battle negotiating a settlement or litigating the matter in court.

What if my claim for plastic surgery is denied? 

If the insurance company denies your claim completely or partially, you may have additional remedies under Maryland law. Many injury victims successfully file lawsuits against the person or entity that caused their harm and litigate their cases in court to recover compensation for the same damages that were the subject of your insurance claim. In many cases, it might be possible to convince a judge or a jury that your plastic surgery is related to an injury that the Defendant caused and is therefore compensable and obtain a court order to this effect.

Discuss Your Post-Accident Surgical Options with an Experienced Personal Injury Lawyer

If you were injured in an accident through no fault of your own and now need plastic surgery, cosmetic surgery, or reconstructive surgery, please contact the Baltimore office of Bob Katz Law. Our attorneys have experience handling these types of cases. We can custom-tailor a strategy to your particular situation to recover reasonable compensation based on the injuries you have suffered. If we are unable to negotiate an out-of-court settlement, we are, in most cases, willing to fight the matter in court. 

We can tell you more about your legal remedies after conducting a consultation regarding your circumstances, so call 410-576-4287 to schedule your free appointment today.