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Pre-Existing Conditions and Workers’ Compensation

September 8th, 2021
pre-existing conditions and workers' compensation

When you are injured on the job, you are entitled to workers’ compensation benefits in the state of Pennsylvania. But what happens when an occupational injury aggravates a pre-existing condition? Your employer and its insurance company may try to deny benefits, however, if your pre-existing injury is worsened by your job activities, you may be eligible for workers’ comp.

What are some examples of pre-existing conditions that can be worsened by a work accident? And what can you do to protect your rights if your work-related injury aggravated a pre-existing condition? It’s important to understand how workers’ comp is affected by a pre-existing condition and how the entire process works to make sure you get the benefits you deserve.

Pre-Existing Conditions and Workers’ Compensation

According to a study from the Department of Health and Human Services, 50-129 million (19-50%) of non-elderly Americans have some type of pre-existing condition. A pre-existing condition is a current injury or illness not related to employment. Even if you have a pre-existing condition, you may still be eligible for workers’ comp if a work accident or your work environment makes your existing injury worse.

Some common pre-existing conditions that can be worsened by a work injury include:

  • Asthma: Asthma is one of the most common pre-existing conditions, affecting about 1 in 13 Americans. Workers without proper respiratory protection can experience worsened cases of asthma.
  • Back injuries: Back injuries can result in years of pain and physical therapy. Some pre-existing back injuries can get worse after a work accident. For example, if a box fell on an employee while at work and made a current back injury worse, they may be eligible for benefits.
  • Knee injuries: Like back injuries, knee injuries can be chronic. A slip and fall at work can make things even worse and aggravate a pre-existing condition.
  • Degenerative disc disease: As people age, their joints tend to wear out, sometimes for no good reason. Mature workers may have degenerative disc disease that can flare up when injured on the job. If you have degenerative disc disease and are hurt at work, you should still file a workers’ comp claim for your injury.

If you suffered a workplace injury that has caused an old injury to worsen, you may be entitled to workers’ compensation to cover medical expenses, lost wages, and related costs. Get a workers’ compensation attorney on your side to ensure your rights are protected. Many workers’ comp claims are denied, so it’s important to get legal counsel as soon as possible.

Protect Your Rights After a Work-Related Injury

Some insurance companies will look for any reason to deny a workers’ comp claim. The insurance adjuster on a worker’s comp case will investigate the claim, along with the injured employee’s medical history and background. If the adjuster discovers a documented sports injury, an injury from a car accident, or another injury not related to work, they may deny the claim based on the employee’s pre-existing condition.

If you were injured on the job and your injury has aggravated a pre-existing condition, what can you do to protect your rights and have the best chance at receiving workers’ comp benefits? Here are the steps you should take:

  • Notify your employer of your accident and file your workers’ comp claim as soon as possible. This is critical – don’t wait to start the process. In PA, you have 21 days to report your injury to your employer to receive full benefits. After day 21, you can still report your injury, however, benefit eligibility begins on the date you notified your employer. Some workplace accidents may not immediately result in an apparent injury, with symptoms surfacing after a week or more. If you wait until you are experiencing pain or challenges related to your pre-existing condition, the insurance adjuster may claim you are exaggerating your injury.
  • Seek medical treatment and be honest about your medical history. Be upfront with the medical provider about your pre-existing condition. If you try to hide it, you may be denied benefits. Tell the doctor about the difference in pain or discomfort before and after the work injury, and how the accident changed your condition. If you are required to see different doctors, or if you must attend an independent medical exam, be sure you are consistent with your report of your injury.
  • Differentiate your current injury from your pre-existing condition. As much as possible, be specific with the difference in your condition after the work accident from before the accident. If you threw your back out while lifting inventory at work, but had an old sports injury from high school, an insurance adjuster may claim your current back injury was not related to work, but rather from your high school athletic days.
  • Consult with a workers’ compensation lawyer. Workers’ comp cases are complicated, especially for cases where an injured worker has a pre-existing condition. The best chance at receiving workers’ comp benefits is having an experienced attorney fight for your rights. A workers’ comp law firm understands how to navigate the legal process to get you the benefits you deserve.

Your Workers’ Comp Injury Law Firm in Central Pennsylvania

Understanding the workers’ compensation benefits system in Pennsylvania for work-related injuries can be overwhelming and time-consuming, especially if you have a pre-existing condition. Having a partner like Dale E. Anstine Personal Injury Law Firm on your side can help relieve the stress and burden of the process while getting you the compensation you deserve for your medical care, lost wages, and related expenses.

If you’ve suffered an injury on the job or experienced other illnesses or injuries as a result of your work, reach out today. Consultations are always free, and there is no fee unless we win for you! We have been fighting for the rights of injured workers in Central Pennsylvania for decades – put our expertise to work for you!