WORKERS COMP PRE-EXISTING CONDITIONS

Pre-Existing Conditions and Worker’s Compensation Injuries 

workers compensation fell off ladder

If you have a preexisting condition, you must show that the work accident exacerbated or aggravated it and that the work accident is the major contributing cause for your need for treatment.  Major contributing cause (MCC) means more than 50 percent. Therefore, in order to successfully pursue a workers’ compensation claim if you have a pre-existing condition in Florida, you and your West Palm Beach work comp lawyer must prove that the work accident was 51% the cause when compared to all other causes combined.

For example, if you previously had a knee, shoulder, back, or neck injury that required treatment a couple of years before your recent work accident, you must show that the work accident is the major contributing cause for your current need for treatment. Generally speaking, if your work accident made an old condition worse, then you should be covered under work comp. If the employer/carrier is denying medical treatment due to a pre-existing condition, you should contact the West Palm Beach work injury attorneys at Vassallo, Bilotta and Davis who can pursue workers’ compensation benefits on your behalf. Often, injured workers have some kind of pre-existing condition. Let us help you get the benefits you’re entitled to.  

Pre-Existing Condition Examples

A pre-existing condition is any injury, illness, or condition that you had before you were injured at work. Some pre-existing conditions are unrelated to your work accident and injuries. Other pre-existing conditions are directly related to your on the job accident and injury. For example, if you fell at work and injured your back, it’s unlikely that a prior shoulder tear would cause your claim being denied. On the other hand, if you were in a prior motor vehicle accident and injured your back and neck, there will likely be a common diagnoses between your current condition and your pre-existing condition that can cause challenges when seeking workers’ compensation benefits: 

  • Back injuries

  • Neck injuries

  • Knee injuries

  • Shoulder injures

  • Degenerative disc disease

  • Degenerative joint disease

  • Chronic back conditions

  • Chronic headaches

  • Carpal tunnel syndrome

For example, if you have suffered prior back injuries and received prior medical treatment and then you injure your back while lifting a heavy box at work, you will need to show that the work accident is the major contributing cause for your current need for medical treatment and that it was not a result of your prior pre-existing injury. This can be complicated but as a general rule, if the work accident made your complaints of pain worse, you should be covered under workers’ compensation – even if it’s just for a temporary basis until your condition returns to baseline. There are also pre-existing conditions that are unrelated to your work accident and injury but that are a hindrance to the treatment and your recovery from your work related injuries.

For example, if you injured your back and surgery is recommended but you are unable to undergo back surgery due to your preexisting diabetes, workers’ comp will be responsible to treat your diabetes until such time you are able to have the recommended lumbar spine surgery and your diabetes/A1C level is no longer a hindrance to your recovery. Diabetes often will hinder an injured workers ability to have surgery that will help the injured worker recover from the on the job injury.

In these cases, the employer/carrier must provide the injured employee with an authorized doctor to treat the claimant’s diabetes for so long as it remains a hindrance to recovery. We recommend that you work with an experienced West Palm Beach pre-existing injury work comp attorney to ensure that your claim is successful. 

Pre-Existing Conditions and Workers Compensation in Florida 

Even if you have a pre-existing condition or injury, you may still be entitled to workers’ compensation benefits. Although preexisting conditions may sometimes make securing work comp medical and compensation benefits more difficult, you are likely entitled to these benefits. It is important that you disclose all of your pre-existing conditions and medical treatment. If you do not, the employer/carrier is likely to raise a fraud or misrepresentation defense against your work comp claim and deny benefits for that reason alone. An experienced work comp attorney can assist in filing your workers’ compensation claim to increase the likelihood of your claim being approved. When you work with a West Palm Beach worker injury attorney we will:

Be candid about your pre-existing condition. Any attempt to conceal your pre-existing condition can result in the denial of your entire claim and prevent you from receiving the benefits you deserve.

Provide details. The more details you provide the better and the more likely your claim will be successful. Remember, if you have more pain after the work accident than you did before the on the job injury, your preexisting condition was exacerbated or aggravated and should be covered. Your medical records which will be obtained
by the employer/carrier will establish your prior conditions. Your current complaints will show how your pre-existing condition was exacerbated or aggravated by your work accident and injury.

Avoid inconsistencies. Do not attempt to down-play your pre-existing condition. Your medical records will be secured by the workers’ compensation carrier and their attorneys. If you are inconsistent or do not disclose your prior injuries, your claim is likely to be denied. Consistency and full disclosure of your pre-existing condition and medical treatment is very important to securing benefits and getting you the work comp benefits you deserve. Pre-existing conditions are very common and your medical records will become evidence. An increase in pain from the work accident is often all it takes to secure medical treatment from the most recent work accident.

A West Palm Beach workers’ comp injury attorney can work with you and your prior physicians or current authorized medical providers to help you with any potential issues regarding your pre-existing condition.

Contact a West Palm Beach Pre-Existing Injury Attorney at Vassallo, Bilotta and Davis

Your pre-existing condition doesn’t mean you are not eligible to receive workers’ compensation benefits. An experienced West Palm Beach workers’ comp injury attorney can help you successfully navigate the work comp system. At Vassallo, Bilotta and Davis, we’ve been helping sick and injured workers in West Palm Beach and throughout Florida get the benefits they need since 1978.  If you’d like to discuss how we can help you, please call us at 561-471-2800 or contact us online to schedule a free consultation.