When filing for workers’ compensation for medical coverage and lost wages after a workplace accident, the presence of a pre-existing condition can make the claims process more complicated.
A pre-existing condition is any medical condition in the employee’s background that might be somehow related to their current, work-related injury. Some common types of pre-existing conditions include arthritis, carpal tunnel syndrome and torn ligaments. When an injured worker has these (and many other conditions) in their medical records, insurers may try to reduce the benefits a worker receives or deny the claim altogether.
However, that doesn’t mean you should give up on your claim – because the issue is not as cut-and-dried as some insurers and employers might have you believe.
Your claim can still be approved due to aggravation or exacerbation
If you have a pre-existing condition that was aggravated or exacerbated by your workplace activity, you are still entitled to workers’ comp, just like any other injured worker – but you can expect your claim to undergo a lot of scrutiny. You will be asked to prove that your job is what ultimately worsened your condition. For example, if you have an old back injury that had long been stable, but was aggravated when you lifted some file boxes from the floor of the office, that’s still a legitimate claim.
To make your claim as strong as possible, it can help to:
- Immediately report the work injury to your employer. Do it in writing.
- Seek medical attention right away. You need to connect the injury to your work, so don’t try to manage your symptoms on your own.
- Make sure that you are transparent about your pre-existing condition to the doctor and why you believe that your work activity aggravated it.
- Keep detailed documentation of everything that happens, including communications with your employer and medical providers.
- Follow your doctor’s orders. Even if you have doubts about the efficacy of a treatment plan, it is important to be compliant to support your claim.
In general, the burden of proving that your condition worsened because of work activity – rather than being something that just happened – falls on you. That can make it essential to seek legal guidance. An experienced attorney can help injured workers fight for their workers’ compensation benefits when claims are unfairly denied.