When you suffer an injury on the job, or are inflicted with an occupational illness, you are entitled to workers' compensation benefits to cover the cost of your medical treatment and to provide partial wage replacement. But what about pre-existing conditions?
The general rule is that workers' comp benefits are only for injuries and illnesses related to job activities. However, when an employee is already suffering from a pre-existing condition that is worsened because of job activities, the victim may be owed workers' compensation benefits.
Employers must take workers as they are
Employers must accept their employees "as they are" when it comes to workers' compensation. When paying benefits, employers may make no distinction between employees who are physically sound and those who came to the job with some structural weakness that made them more likely to suffer long-term injury from a workplace accident or the normal duties of the job. Therefore, the aggravation, acceleration or "lighting up" of a preexisting infirmity by workplace activity may entitle the affected worker to benefits even though the incident would not have harmed a perfectly healthy individual.
For example, imagine an employee was hired who had osteopenia, a condition that makes bones more susceptible to breakage. Her employer would not be required to grant workers' compensation benefits for any required treatment or time off needed to address symptoms of the original condition, as these would be nonwork-related. If, however, the employee suffers a severe fracture in her leg when a box she was asked to get off a top shelf by her employer falls on her, she would be entitled to workers' compensation, even if someone who did not suffer from osteopenia would have walked away from the incident unscathed.
Even more common in exacerbation and aggravation claims are compensable injuries that arise not after an isolated accident, but after repetitive movements or the repeated stress of lifting heavy objects at the workplace. Previously treated lower back, shoulder, knee or joint injuries are particularly likely to be worsened by workplace activity.
Workers' comp claims often denied when a pre-existing condition is involved
While you may be entitled to workers' compensation for the worsening of a pre-existing condition, these types of claims are routinely denied. Often, an employer will claim that the symptoms preventing you from working are simply attributable to your pre-existing condition, not anything work-related; it can be difficult to prove that the pre-existing condition was actually aggravated or exacerbated by workplace activities.
If you're facing a workers' comp claim denial for the worsening of a pre-existing condition, you need to fight for the benefits you deserve with a strong legal argument. Your workers' compensation attorney can ascertain the facts surrounding your incident and will gather all the necessary documentation to show that your condition is work-related. Talk to a workers' comp attorney today to begin building your case.