A lot of people believe that they can’t claim workers’ compensation if there’s a pre-existing condition involved — and employers and insurers aren’t generally in a hurry to set the record straight.
That’s why it’s important to educate yourself about your rights when it comes to workers’ compensation claims.
What is a pre-existing condition?
A pre-existing condition, for the purposes of workers’ comp, is any prior injury or medical issue already present that is somehow aggravated or worsened by an on-the-job injury. It doesn’t matter if that condition was from an injury or simply one of the many conditions that people commonly develop as they age.
How do they affect your claim?
As long as you can draw a line between how you were faring with your condition prior to your on-the-job injury and after, an existing medical condition is no barrier to workers’ comp claims.
For example, imagine that you catch the heel of your shoe on torn carpeting in the office and fall, injuring your back. After you have x-rays, the doctor determines that you’ve had a couple worn or bulging discs in your spine that have probably been damaged for years. The fall aggravated those discs, and you developed serious pain — a condition you never had before. In fact, you didn’t even know there was anything wrong with your back!
What do you have to prove?
In a situation like we described, it’s often easy to show that the accident at work caused your current distress. Other times, there’s a lot of gray areas involved. For example, if you sought treatment for a back injury several years ago but your condition had been constant and stable before the fall, it’s important to make sure that your doctor understands the distinction between your prior condition and your current one. Otherwise, you may find that your employer’s insurer is reluctant to pay the claim based on the idea that you were secretly nursing your back injury all along and merely waiting for an opportunity to blame it on something at work.
If you’ve been denied workers’ comp due to a pre-existing condition, talk to an attorney. For more information on how our firm can help with workers’ compensation denials, please visit our page.