How Will My Pre-Existing Condition Affect My Workers’ Compensation Claim?

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Workplace accidents are difficult to deal with. They can endanger your very livelihood and your physical, emotional, and/or mental health. Oftentimes, navigating workers’ compensation laws can also be complex and confusing. This may be even truer if you have a pre-existing illness.

Depending on the type of condition you have, a pre-existing illness may affect the workers’ compensation benefits you receive. This is more likely to be true if your pre-existing condition is at all related to your workers’ compensation claim.

For example, imagine that you have a history of back problems. One day, you injure your back in a workplace accident. Because of this, your benefits may be more impacted than if you did not have any back problems prior to your accident.

In most states, your employer will not be held liable for the whole of your back problems. They will only be held liable for the worsening of the pre-existing condition. In order to prove this, your employer will have to gather as much evidence as possible that any permanent disabilities you have suffered were not a direct result of the injury. They will argue that any permanent disabilities came about as a result of your pre-existing condition instead.

What If My Pre-Existing Condition Was Caused by Another Workplace Accident?

If a new workplace accident has exacerbated another workplace injury, you should still expect your benefits for your current claim to be slightly reduced. This is done in order to account for the prior workers’ compensation claim you received.

However, your employer will still be required to pay for any and all medical expenses related to your new injury. They must also pay you any temporary disability benefits you are owed, such as time loss compensation benefits.

Despite all this, it is still important to keep in mind that your permanent disability benefits may be different by the time the claim closes. As a matter of fact, any compensation you receive will likely only be for the increase in your permanent impairment, if any exists. 

How Will My Pre-Existing Condition Affect My Worker's Compensation Claim?Imagine that you go to the doctor about your new injury. This injury has worsened a previous workplace injury you had. The doctor determines that the degree to which you have become permanently disabled entitles you to a $10,000 permanent impairment award. However, your previous workers’ compensation claim awarded you with an $8,000 permanent impairment award. Because of this, you will only be able to claim up to $2,000 for the most recent accident.

If your newest workplace injury has not permanently worsened your condition, then you will not receive any permanent partial disability award at all. You should also know that there is a difference between an aggravation of a previous workplace injury and a new workplace injury involving the same body parts. 

In order to get the most accurate possible valuation of your claim and of your injury, it is important that you tell your doctor about your previous workplace injury. The best and easiest way to do this is to provide them with a copy of all your medical records relating to your previous workers’ compensation claim.

From there, the doctor can evaluate your condition in order to determine whether or not it is a new injury or a continuation of the old workplace injury. In many states, the distinction between the two is important when it comes to claim processing and filing. You will want to have the assistance of your doctor, your employer, and your attorney throughout this process.

What If My Pre-Existing Condition Was Not Caused by Another Workplace Accident?

Of course, it is also possible that you have a pre-existing condition that is entirely not workplace-related. You may have had dislocated your knee on vacation several years ago, for example, and hurt your knee again in a workplace accident. In such cases, you should probably expect to only receive workers’ compensation benefits that cover the worsening of your condition.

You will still need to have your condition evaluated by a doctor, who will then determine whether or not your workplace accident has worsened your pre-existing injury. Your doctor will probably note whether or not this worsening will be permanent. You may want to consider seeking out a doctor who has experience treating injured workers. Such doctors will know exactly which sort of phrases and terminology to use to best describe your condition for your workers’ compensation claim.

Depending on the state, your employer may require you to see a specific physician for treatment. In such cases, you can rest easy knowing that your doctor will be fluent in workers’ compensation rules.

What If My Pre-Existing Condition Is Unrelated to My New Workplace Injury?

If you have a pre-existing condition that is unrelated to your new workplace injury, you may be wondering if this will be significant to your claim at all. The answer? Probably not. Your employer will still need to pay for all your workplace accident-related medical expenses, and your pre-existing health insurance coverage (or lack thereof) should still apply to your pre-existing condition. 

Because of this, you may need to see multiple healthcare providers; some will treat your pre-existing condition, while some will treat your workplace injury. This may be a bit troublesome. However, in the long run, it should still prove to help you avoid paying any unnecessary out-of-pocket costs.

Special circumstances, however, may be treated a little differently. If your pre-existing, unrelated condition is an important factor in the consideration of your total and permanent disability as a result of your new workplace injury, you may be eligible to receive a pension. If you feel that this describes your situation, it is in your best interests to contact an experienced workplace injury attorney as soon as possible.

Seeking Legal Help

We know that navigating workers’ compensation laws can be messy and complicated. You have already suffered enough. You do not want to go through this process alone. We at Injury Victim Law may be able to help. Though we are a Colorado-based firm, our team of experts and investigators is ready and available to assist victims all across the country. Contact us today to schedule an initial consultation with one of our hardworking nationwide workplace injury attorneys. We are on your side.

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