Will My Pre-Existing Injury Impact My Workers' Compensation Claim?
According to the Social Security Office of Retirement and Disability Policy, approximately 129.6 million American workers are covered by either state or federally-funded workers' compensation policies. Depending on your industry, as a worker, you are entitled to receive workers' compensation coverage if you are injured while performing your regular duties at your job.
However, what if you have a pre-existing medical condition and are injured at work? Here is some valuable information about how pre-existing conditions can impact your workers' comp claim and how to successfully file your claim.
Workers' Comp and Your Pre-Existing Condition
In the case of a workers' compensation claim, a pre-existing condition refers to any medical condition or injury you suffered before the injury occurred at work or before you filed a claim. The pre-existing condition can be an acute injury, such as a back injury sustained during a car accident, or an on-going condition, including arthritis or a degenerative disc disease.
The insurance company will consider the type of work-related injury, how the work-related injury occurred, and if the injury aggravated the pre-existing condition. For example, if the worker suffered a back injury and received proper treatment before they started their job, and the worker slipped and fell on a slippery front stairs during winter, the pre-existing injury was aggravated by the negligence of their employer.
Employees cannot claim workers' compensation benefits if the injury occurred outside their workplace or after working hours, whether they have a pre-existing condition or not.
The Workers' Compensation Application
Filling out a workers' compensation claim accurately, thoroughly, and truthfully is vital to getting your claim accepted, including if you have a pre-existing condition. The claim paperwork will ask you about any pre-existing conditions that could have impacted the injury. Be completely honest about the pre-existing condition.
For example, include the date an acute injury occurred, any treatments or surgeries associated with the injury or condition, and specific symptoms associated with the injury or condition.
Never lie about your condition on the claim paperwork, even if you believe the pre-existing condition will impact the success of your claim. If the lie is discovered, your claim will instantly be denied.
Write down the specifics of when and how the injury occurred and what pain or symptoms you experienced. Include how the pain has exacerbated the pre-existing condition and the symptoms that do not have any bearing on your pre-existing condition. The more precise you are about the accident and aftermath, the more you can prove that the accident did not occur because of the pre-existing condition.
If Your Workers' Compensation Claim Is Denied
Unfortunately, if you have a pre-existing condition, there is a strong chance your initial workers' compensation claim will be denied. Hire an attorney immediately to help you strengthen your case before the appeal. For example, your attorney might recommend gathering medical documents concerning your pre-existing condition.
Statements from your doctors will also strengthen your case and help prove that your accident was not caused by the pre-existing condition but, instead, made the symptoms associated with the pre-existing condition worse. Your attorney may also hire a medical investigator and medical experts to testify on your behalf.
While you wait for your appeal, your attorney can help file a claim of temporary disability benefits. These benefits help workers or disabled individuals who need immediate help and cannot afford to work or pay their bills while they wait to receive their full workers' compensation benefits.
Your pre-existing condition should not stand in the way of receiving the workers' compensation benefits you are entitled to. Talk to a workers' comp lawyer if your initial workers' compensation claim is denied or if you have any other questions.