A chipped or broken tooth might not be the first thing that comes to mind when you think of a workplace injury, but the truth is that dental injuries can be painful and extremely expensive to treat.
Even worse, trauma to your mouth, teeth, and jaws could hamper your ability to bite, chew, speak, and even work.
Fortunately, dental injuries are generally covered by workers’ compensation. The problem is that these types of claims can be more challenging to prove than your average workplace injury.
What Are Workers’ Compensation Benefits?
Every state has its own workers’ compensation system that applies to private employers and their employees. While there are nuances from state to state, the fundamental principles and policies are similar in all jurisdictions.
The purpose of workers’ compensation is to compensate employees who incur medical bills, wage loss, and rehabilitation expenses caused by work-related accidents and diseases. Death benefits are also available for the families of employees who suffer fatal injuries at work.
Dental Injuries: What's Covered?
If you suffer an injury to your mouth, jaw, or teeth at work, you need to seek treatment from a dentist as soon as possible.
An experienced dentist will be able to determine whether routine dental care will do the trick or whether a specialist must be consulted. Common types of injuries to teeth include:
- chips,
- fracture
- dislocations, and
- avulsions.
Depending on the nature and severity of the injury, treatment can range from a simple filling to a complete crown or root canal. In some cases, a tooth that was knocked out can be replanted while other injuries might require extractions, gum surgery, or implants.
A preexisting dental condition or an infection can cause further complications to your dental injury. Depending on the nature of the injury, specialists you might need to consult include:
- periodontists,
- endodontists, and
- oral or maxillofacial surgeons.
In general, periodontists specialize in complex problems with the gums and bones supporting the teeth. Endodontists handle injuries to the pulp of the tooth and are especially skilled at performing root canals, and oral surgeons are better equipped to deal with broader injuries to the mouth and jaw.
Temporomandibular Joint Disorder
Temporomandibular joint disorder (TMJ) is a condition that causes pain and discomfort in the muscles and joints of the face, jaw, and neck. In more serious cases, a patient’s jaw might not open or close completely and simple tasks such as biting and chewing can become extremely painful and difficult to perform.
Although TMJ is not always thought of as your typical work injury, it can result from a blow or hard impact. Treatment ranges from more routine dental work such as inserting bridges and crowns, to arthroscopic surgery or even joint replacement.
If you can prove that TMJ resulted from a workplace accident, it should be covered my most workers’ compensation statutes. But it might be worth hiring a lawyer to help with your case, because TMJ injuries are notoriously hard to prove.
Choosing Your Treating Physician
As discussed above, each state has its own workers’ compensation statute that dictates how claims move through the system. Some states use what is known as a Managed Care Organization (MCO) to manage medical care and the costs associated with workers’ comp claims.
In these states, the injured worker might be limited to choosing a physician who is a member of the MCO’s medical provider network, which is a group of physicians specifically selected to treat occupational injuries. These physicians are contracted by the MCO and are generally effective at reducing medical costs.
That is not to suggest that these physicians are less qualified or will not provide appropriate care, but just be aware that you might not get your top choice.
Dental Work Injuries are Uncommon
The rarity of employment-related dental injuries might make your claim more difficult than you would expect. According to the U.S. Bureau of Labor Statistics, of the 900,380 injuries that caused employees to miss work in 2018, only 2,480 involved mouth-related trauma. Of those, 1,160 were related directly to teeth.
To put this in perspective, there were 77,660 head injuries and 142,230 back injuries. The truth is that most workers’ compensation insurance adjusters have far less experience with dental claims, and some may have no experience at all.
If you live in a state where you can choose your dentist, one way to increase your chances of success is to find a one who has treated traumatic dental injuries and is familiar with the workers’ compensation system. This will help keep your claim on track.
Get Legal Help
If you have a workers' comp claim for a dental injury, don't feel like you have to go it alone. While some employees can file their initial claims without any help, a workers' comp attorney is a must if you have to appeal. That's because the workers' comp system is complex and contains rigid, often very short deadlines.
An attorney can help you document the extent of your injuries and prove that they were related to your job, while meeting the strict deadlines set by law. Even better, most workers' comp lawyers charge a fee only if you win your case.