Many times, working conditions will aggravate a preexisting condition – such as a “bad back” or “weak knees.” Conversely, in other cases, the preexisting condition itself can make a work injury worse – for example when diabetes prevents a wound received at work from healing.
In such case our workers compensation attorneys are often asked: “Are pre-existing conditions covered under workers comp?” However, the answer to this important question is a bit complex. In this article, our skilled workers comp lawyers answer in detail the questions surrounding workers compensation and re-existing conditions.
The Workers’ Comp General Rule on Preexisting Conditions
The general rule is that workers’ compensation benefits are only paid for injuries or illnesses related to one’s job. However, if a worker is already suffering from a pre-existing medical condition, and that conditioned is worsened because of their job, the employee may be entitled to workers’ comp benefits.
Similarly, a worker cannot be denied workers comp benefits if they suffer a job-related injury or illness, and their preexisting condition makes the injury or illness worse.
Employers Must Accept Their Workers “As They Are”
There is a rule in workers compensation that employers must accept their employees “as they are”. In other words, when paying workers comp benefits, an employer can make no distinction between employees who are physically healthy and those who came to the job with a pre-existing weakness that made them more likely to suffer long-term injury due to a workplace accident or due to normal job duties.
Therefore, the aggravation or acceleration of a preexisting condition by any workplace activity entitles the affected employee to workers comp benefits – even IF a healthy individual would not have been harmed (or harmed as badly) by the same incident or occurrences.
Example of “As They Are” Workers Comp Claims
As an example, if an employee was hired who had a condition called osteopenia (bones more susceptible to breakages) she would be entitled to workers’ compensation if she suffered a fracture in her leg when a box fell on her, even if someone who did not suffer from osteopenia would not have been injured at all when the box fell.
Another example would be a diabetic employee who cuts their toe on a piece of metal in the workplace. For most people a wound will recover quickly and may not even lead to a work injury case. However, a diabetic worker may not recover from the wound, and could need prolonged medical care – even requiring amputation. In that case, the employer is still responsible for all workers comp benefits – even though a non-diabetic people would have likely recovered rather quickly without complications.
Denial of Workers Comp Claims for Preexisting Conditions
While an injured worker is entitled to workers’ compensation for the worsening of a pre-existing condition, these types of claims are routinely denied by employers and their insurance companies. Often, the employer will contend that the condition preventing you from working is only your pre-existing condition, and not anything work-related.
Unfortunately, some insurance companies can be less than honest about how the law actually applies to preexisting conditions and will try to save money by denying treatment by saying something related to a preexisting condition is not covered, when it is.
And in many cases, it can be difficult for a sick or injured employee to prove that their pre-existing condition was actually aggravated or exacerbated by workplace activities.
Workers Comp for Preexisting Conditions
If you are an injured employee whose workers’ comp claim was denied for the worsening of a pre-existing condition a workers’ compensation attorney can help “prove” the facts surrounding your incident, and gather the necessary documentation to show that your condition is work-related.
The bottom line is that having a preexisting condition is not something that Workers’ Compensation laws should not punish you for – even though the insurance company may try to avoid workers comp payments on the basis of a pre-existing condition.
If you were injured or made ill in the workplace, and you have a preexisting condition we recommend that you speak with one of our experienced workers’ comp attorneys immediately. An experienced workers compensation lawyer can help you identify minor issues before they become major problems – and make sure that you not only receive your benefits now, but for years to come.
Your consultation with our workers’ comp attorneys is 100% confidential, and neither your employer nor your insurance company will be notified that you requested a consultation with us. Our lawyers will help you understand your rights and work tirelessly to ensure that you receive the maximum workers’ comp benefits for which you qualify.
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