Can a Pre-Existing Injury Affect My Workers Comp Claim?

On Behalf of Rosenthal, Levy, Simon & Sosa | November 27, 2022 | Workers' Compensation

In most cases, handling a workers’ compensation claim can be difficult. However, if you suffer from a preexisting condition, your workers’ compensation claim may be more challenging to navigate, especially if your injury is associated with your current claim. But it’s crucial to point out that having a preexisting injury doesn’t necessarily disqualify you from pursuing workers’ compensation benefits. It does, however, make your claim harder to prove.

How a Preexisting Injury Can Prevent You From Obtaining Workers’ Compensation Benefits

Workers’ compensation insurance covers the losses an employee incurs when they get injured at work. This no-fault insurance system is designed to prevent employees from suing employers for workplace accidents and providing medical treatment, lost wages, and other benefits to injured employees while they recover from their work injuries. The entire workers’ compensation claim process is also designed to be straightforward, but it is often not.

This is because insurance providers will try to look for ways to undervalue or deny proper benefits, and they usually use the preexisting injury defense to do so. If the insurer can blame a preexisting injury or illness, it can argue that your work injury resulted from your previous injury, not a workplace accident.

Under the law, when an injured employee has a preexisting injury, courts must determine the major contributing cause (MCC). This will help them determine if the employee’s injury qualifies for workers’ compensation coverage. To qualify for coverage, you must prove your work injury is more than 50% responsible for your current injury or condition. Put simply, your preexisting injury must not be the MCC of your current injury or condition, and the MCC must be the injury you suffered at work.

Likewise, you can pursue workers’ compensation benefits if your work injury aggravates or accelerates your preexisting injury. This means that even if your preexisting injury and your work injury are similar, the insurance provider cannot deny you benefits. The insurer must prove that your preexisting injury is more than 50% of the cause of your work injury to deny you workers’ comp coverage.

How You Can Protect Your Workers’ Compensation Claim

You must follow the guidelines for reporting the injury to your employer and get medical attention from a doctor authorized by your employer or their insurance provider. Gather documentation and information about your preexisting injury and make copies of the medical records about your work injury.

Because handling a workers’ comp claim involving a preexisting injury or illness can be complex, you should also discuss your situation with a Port St. Lucie workers’ compensation attorney to learn how you could further protect your claim and secure the benefits you deserve.

Consult With a Skilled Port St. Lucie Workers’ Compensation Attorney Today

You should be prepared that the insurer will dispute your claim to avoid paying you fair compensation or deny your claim altogether. Don’t let your employer and their insurer deny you the benefits you are legally entitled to because of your preexisting injury. Call Rosenthal, Levy, Simon & Sosa at 772-878-3880 or send us an online message to set up your complimentary consultation with our Port St. Lucie workers’ compensation attorney.