How Does My Pre-Existing Condition Contribute to My Workers’ Compensation Claim?

Your employer may have known about your prior health issues when choosing to hire you. While they accepted it at the time, they, or their insurance carrier, may now have a problem with it once you file a workers’ compensation claim. That is, they may attempt to argue that your claimed illness or injury cannot be attributable to a workplace accident or your work duties; rather, it is solely related to your underlying condition. If this is the roadblock you are currently facing, please read on to discover how your pre-existing condition inevitably affects your claim, and how a lawyer seasoned in qualifying Florida workers’ compensation injuries at The Law Firm of Kevin A. Moore can help you get the help you need.

What types of pre-existing conditions commonly arise in workers’ compensation claims?

Certain pre-existing conditions are generally easier for insurance companies to target as unrelated to a workplace accident or daily work activities, alleging that they would have worsened naturally over time regardless. They read as follows:

• Chronic back and neck issues (i.e., degenerative disc disease, herniated discs, etc).
• Joint and orthopedic issues (i.e., arthritis, knee or hip replacements, etc). 
• Repetitive strain issues (i.e., carpal tunnel syndrome, tendonitis, etc). 
• Chronic respiratory issues (i.e., asthma, chronic obstructive pulmonary disease, etc).
• Fracture issues (i.e., use of internal hardware, vertebral compression fractures, etc).

Why does an aggravation or progression matter in my workers’ compensation claim? 

When you submit a workers’ compensation claim with your employer’s insurance carrier, they will likely do a thorough investigation of your pre-existing condition to identify it as aggravated or progressive. How they view it may just make or break your eligibility to receive coverage and benefits. 

An aggravation means that your workplace accident or daily work activities worsened your prior health issue. This is while progression insinuates that your symptoms are simply the natural result of your pre-existing condition over time. Simply put, being labeled with the former may qualify you for benefits, while the latter may not. 

To use a specific example, say that you have arthritis in your knee. Well, this may be aggravated if you repetitively strain it from lifting heavy objects during your shift, or you slip and fall on it due to an unsafe condition in the workplace. However, even when none of these incidents occur, it may naturally progress or worsen due to age-related joint wear. 

Why must I disclose my pre-existing condition in my workers’ compensation claim?

Of course, you may worry that your pre-existing condition will do nothing but complicate your workers’ compensation claim and diminish its chances of approval. But this does not mean that you should hide it from your employer or their insurance carrier. Ultimately, they will do a deep dive into your medical history and unearth this fact anyway. 

So, with a failure to disclose or inconsistencies in your provided information, you may just jeopardize the very little credibility you held in the insurance carrier’s eyes. In other words, even if you would have otherwise qualified for workers’ compensation, your petition may be rejected outright because of this erroneous behavior. 

If you require assistance with establishing your claim, please do not hesitate to reach out to a lawyer competent in qualifying Florida workers’ compensation injuries from The Law Firm of Kevin A. Moore. It would be our pleasure to work alongside you.