How do pre-existing conditions affect workers’ compensation?

On Behalf of | Jan 29, 2025 | Workers' Compensation |

Workers’ compensation helps employees get benefits if they get hurt at work. However, if someone has a pre-existing condition, it can make the claims process harder. It’s important for workers and employers to understand how these conditions affect workers’ compensation claims.

What is a pre-existing condition?

A pre-existing condition is any health problem a worker had before getting hurt at work. This could be a past injury, a long-term illness, or any health issue that existed before the accident. These conditions might not cause the new injury, but they can affect how the injury heals or what kind of treatment is needed.

How do pre-existing conditions affect workers’ compensation?

When a worker has a pre-existing condition, insurance companies or employers might say that the condition, not the workplace injury, is causing the current problem. This can make it harder for the worker to prove that the injury happened at work, which might lead to delays or even denials of the claim.

If the workplace injury makes the pre-existing condition worse, the worker may still be able to get benefits. However, the insurance company might try to lower the compensation by showing that the pre-existing condition is affecting the worker’s disability. Sometimes, a doctor will need to show that the injury is only from the workplace accident and not related to the pre-existing condition.

Can you still receive benefits?

Even if a worker has a pre-existing condition, they can still qualify for workers’ compensation benefits. It’s important to tell the employer and insurance company about any pre-existing conditions right away. Giving the right information can help avoid problems and make the claim process go more smoothly. Workers should also ask for legal help if their claim is denied or delayed because of a pre-existing condition.

Even though dealing with a workers’ compensation claim and a pre-existing condition can be difficult, workers can protect their rights and get the benefits they deserve by understanding how these conditions affect their claims and making sure all the paperwork is correct. Legal help can also be useful if problems come up during the process.

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