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Does a Pre-existing Condition Mean I Can't Get Workers' Comp?


    Do you have a pre-existing medical condition? Have you recently been injured at work? If you answered yes to both questions but are worried that you might not qualify for workers' comp, then don't worry, you aren't alone. Each day many workers throughout the United States struggle to understand whether they are entitled to workers' comp, especially when they have pre-existing medical conditions.


    In many states, employers are responsible only for the worsening of physical conditions that are caused by work-related injuries. If you do have a pre-existing condition and you are injured at work, then you need to work with your doctor and attorney to determine how your workers' compensation benefits might be impacted. Understanding how your pre-existing condition will impact your workers' comp claim will depend on the type of medical condition, as well as which of the following two categories it falls into.


    Category #1: Pre-existing Condition from A Previous Work-Related Injury


    This first category applies to individuals who have a pre-existing medical condition due to a previous work-related injury. If you are re-injured in another workplace accident, then your workers' comp benefits might be impacted. However, while your benefits might be reduced, it is important to note that you will still receive some form of benefit. For example, in most states, your employer will still be required to pay for any of the medical bills that are associated with the new work-related injury. Additionally, your employer will have to pay time-loss compensation benefits.


    One important thing to remember about this category is that you need to clearly define whether the new injury is an aggravation of your previous work-related injury or is a new work-related injury on the same body part. The difference is vital when it comes time to file the right type of workers' compensation claim. Work closely with your doctor to determine whether the condition is a continuation from a previous work-related injury is a new (entirely unrelated) injury on the same body part. If it is the latter, then you will need to file a new workers' comp claim.


    Category #2: Pre-Existing Condition Not Related to Prior Workers’ Comp Claim


    Many individuals have pre-existing medical conditions that are not related to their work. Often  these conditions can be aggravated due to a work-related injury. For example, you might have arthritis in your knee due to an old skiing accident. In the course of your time at work, you might further injure the knee due to lifting and carrying heavy boxes at work. It is important to note that in this case it is most likely that your workers' comp claim will be filed as a "worsening of the condition." Once again you will need to work with your doctor and your attorney to determine what type of workers' comp claim you should file. Keep in mind that the type of claim filed will directly impact the benefits that you receive.


    The Bottom Line: You May Be Eligible for Workers' Comp Even with Pre-existing Conditions


    Whether you have a pre-existing condition from a previous work-related injury or your pre-existing condition is not related to a previous work-related injury, you can still file a workers' comp claim if you are injured at work. If you do have a pre-existing condition, then you should thoroughly document your condition with your medical provider before you begin work. In the event of a work-related injury, this will help your medical provider better determine if your injury is new or if it has simply aggravated your pre-existing condition. Contact your trusted workers' compensation attorney to better understand when and how you can file a workers' comp claim with pre-existing conditions.