Can a Pre-Existing Condition Affect My Workers’ Compensation Claim?

Workers’ compensation provides essential financial and medical benefits for employees who have suffered work-related injuries. However, pre-existing medical conditions raise questions about how they may affect a workers’ compensation claim. This article will explore the implications of pre-existing conditions on workers’ compensation claims, the legal considerations involved, and how these cases are evaluated.

Understanding Pre-Existing Conditions

A pre-existing condition refers to an individual’s medical condition or injury before the work-related incident occurred. Pre-existing conditions can vary widely, from chronic illnesses to prior injuries that have healed but may still affect a person’s overall health. The presence of such conditions can complicate the process of attributing an injury solely to a workplace accident.

The Aggravation Rule

In workers’ compensation cases, the “aggravation rule” is frequently applied when a pre-existing condition is involved. This rule recognizes that a workplace injury or accident may exacerbate or worsen a pre-existing condition. Under this rule, the injured employee may be eligible for benefits if the work-related incident contributed to the aggravation of the pre-existing condition, resulting in additional medical treatment, disability, or loss of earning capacity.

Determining Causation and Compensation

Determining the causation of an injury when a pre-existing condition is involved can be complex. Medical records, diagnostic tests, and expert testimony may be required to establish a causal link between the workplace accident and the worsening of the pre-existing condition. Additionally, the jurisdiction’s laws and regulations regarding workers’ compensation and pre-existing conditions play a significant role in the outcome of the claim. The compensation amount may be adjusted to reflect the extent to which the pre-existing condition was aggravated.

Employer and Insurer Defenses

Employers and insurance companies may raise defenses when a pre-existing condition is identified. They may argue that the workplace incident did not solely cause the injury or that the pre-existing condition was not aggravated. Employers may also claim that the employee failed to disclose the pre-existing condition when hired, potentially impacting the validity of the workers’ compensation claim.

Seeking Legal Representation

Navigating the complexities of workers’ compensation claims involving pre-existing conditions often requires legal expertise. Hiring an experienced workers’ compensation attorney can increase the likelihood of a successful claim. An attorney can help gather and present relevant evidence, address employer or insurer defenses, and get fair compensation for the injured employee.