Workers who suffer injuries or illnesses that are deemed compensable under workers’ comp may receive benefits to compensate for their losses. In many cases, however, insurance carriers will look for ways to deny such workers the benefits they deserve. Besides reasons like missed deadlines and employment status, pre-existing conditions can further complicate your claim, and could easily see it denied.
Most workers’ comp insurance companies are quick to outrightly deny claims made by workers with pre-existing conditions. Proving that your pre-existing condition was worsened by a workplace accident is crucial if you’re looking for benefits due to your current injury. However, this isn’t always easy, which is why most carriers will flatly deny claims involving pre-existing conditions and injuries.
If your pre-existing condition or injury has been worsened by your work activities, you may be eligible for workers’ comp benefits. Reach out for the legal assistance of our experienced lawyers at Work Injury Rights in Orlando to ensure that you receive your deserved rights. Call us today at 954-833-5226 to schedule a free case evaluation.
What are Pre-Existing Conditions and Injuries?
A pre-existing condition is a medical condition or injury that predates your workplace or industrial injury, and often has an impact on the workers’ compensation benefits you receive. These could be conditions that developed or injuries that occurred before you took up your current job.
A pre-existing condition could include bronchial asthma, which could be worsened by toxic exposure to chemicals, industrial solvents, and other allergens. If you suffer a slipped disc before starting your current employment, then you’re considered to have a pre-existing condition. The pain and discomfort due to the herniated disc could be worsened if your job involves heavy lifting.
Under Florida Laws, Do Pre-Existing Conditions or Injuries Bar You From Filing Workers’ Compensation Claims?
Claims involving pre-existing conditions are complicated, and it is understandable that most workers have questions regarding their eligibility for benefits if they carry pre-existing conditions or injuries. Generally, a pre-existing condition won’t prevent you from filing a workers’ compensation claim.
By themselves, pre-existing conditions and injuries aren’t covered under workers’ compensation. However, the on-work aggravation or worsening of pre-existing conditions and injuries by work-related activities is eligible for workers’ comp benefits. What’s more, you won’t be barred from filing a workers’ compensation claim if the workplace injury or illness you’ve currently suffered is unrelated to your pre-existing condition.
When filing your claim, it is important to keep in mind that you’ll need to prove that the “major contributing cause” (MCC) of your current injury is the workplace accident. Florida workers’ comp law requires you to show that the workplace accident is more than 50% responsible for your current injury or medical condition. Doing this helps separate your new work injury from your pre-existing condition, helping you receive benefits.
What Obstacles May I Face with My Workers’ Comp Claim When Trying to Prove a Pre-existing Condition Was Worsened?
It is not uncommon for individuals to carry pre-existing injuries or conditions before securing their current job. If this is the case, you can be certain that workers’ comp insurance companies will try to block you from claiming benefits after a workplace injury.
One thing the insurance carrier will try to establish is whether your pre-existing condition caused your current injury. Suppose a worker, who suffered a knee injury due to a heavy fall years before starting his current job, hurts his back while lifting a heavy box in a warehouse.
If the insurance carrier is aware of his pre-existing condition, they’ll want to know if the two injuries are related. This wouldn’t be necessary if the worker wasn’t carrying a knee injury. The carrier will argue that the injured knee gave out while the worker was lifting the box, twisting his back in the process. In that case, the carrier will argue that the pre-existing condition is what caused the current injury, and not the work-related activity itself.
You’re also likely to face difficulty claiming benefits if you have previously been compensated for the same injury, even if the old workers’ comp claim was filed with a different employer or insurance company. In such a case, you’re faced with the challenge of proving that your old injury was totally resolved, and that it is unrelated to your current injury.
In this instance, the law still requires that your employer covers all your medical costs for the treatment of your current work-related injury. However, you will likely have your benefits reduced significantly to account for the old workers’ comp claim.
How Can You Protect Your Workers’ Compensation Claim?
Under workers’ compensation laws, employers are obliged to accept employees “as they are.” If you have a pre-existing condition or injury, you should inform your employer about it as soon as possible. In the event of a workplace accident that aggravates your pre-existing condition, here’s what you can do to protect your right to claim workers’ comp benefits:
File Your Claim in a Timely Manner
In Florida, workers who suffer work-related injuries are required to report their workplace injury not later than 30 days from the date of the injury, or when their injury becomes apparent. Failure to observe this time limit, your employer’s insurance carrier will certainly deny your claim.
Keep Medical Records
If you have a pre-existing condition, it is imperative that you keep all the medical records of your previous condition or injury. Further, you should maintain medical records about your current workplace injury right from the moment you start to receive treatment. These records are invaluable in showing the difference between your pre-existing injury or condition and your current on-the-work injury.
Submit to a Medical Examination
In most cases, your employer’s workers’ comp insurer will request an independent medical examination (IME) where a physician of their choice will examine your current injury and closely go over your medical records. Failure to comply with a medical examination request, you risk having your claim denied.
Contact a Workers’ Compensation Attorney
In workers’ comp claims involving pre-existing conditions, insurance carriers will almost always deny the claims, and the burden of proof is placed on the injured worker. Our workers’ compensation lawyers at Work Injury Rights understand the laws regarding pre-existing conditions. They can prove that your current injury isn’t related to your pre-existing injury or is an aggravation of a previous injury, helping you receive the benefits you deserve.
When Filing for Workers’ Comp With Pre-Existing Injuries and Conditions in Orlando, Call Our Lawyers Today for a Free Consultation
Pre-existing conditions and injuries you’ve suffered previously may come in the way of receiving benefits in the event of a work-related injury. With your employer’s workers’ comp insurance company likely to deny your claim, working with an experienced attorney can help you receive benefits by proving that your current injury is unrelated to your pre-existing injury.