Can You Get Workers’ Compensation If You Aggravate a Preexisting Condition?

Life brings experience, and with it, a litany of illnesses and injuries. The term “preexisting conditions” has a negative connotation to it, and you’ll often find health insurance providers rushing to deny claims based on a preexisting condition. However, how does that work when it comes to workers’ compensation?

If you’ve had a preexisting condition worsened by your work conditions, you’re likely entitled to compensation. Learn more about your legal options now by calling Thiry & Caddell at 251-478-8880.

Don’t Expect the Truth from Your Workers’ Compensation Insurance Provider

If you’ve already submitted a claim for your workplace injury, you might be discouraged to already have a denial letter from the company that provides your workers’ compensation insurance. For most people, this is where it ends. They assume that insurance won’t pick up the tab, so they seek coverage under their own health insurance. This often costs them thousands of dollars.

However, you have to go further and push harder if you really want the workers’ compensation benefits you deserve. Insurance companies do not have your best interests in mind—they want to maximize their own profit margins and make their shareholders happy. Injured employees often bear the burden here, absorbing unpaid claims that stretch their budgets even further. Since you can’t trust the insurance company to do what is right for you, you need an advocate who can get to the bottom of the matter and figure out if you should be receiving benefits.

Preexisting Injuries Do Not Disqualify You from Benefits

The main lie told by workers’ comp providers is that they do not cover preexisting conditions. In one way, this is true. Imagine you have a preexisting leg injury that flares up in certain weather conditions or work conditions. If that condition comes back when you are working, but not because of the work you’re doing, workers’ compensation will not pay for that. The condition would have come back whether or not you were at work.

However, if your condition worsens because of the work that you do and the type of pressure your work puts on your body, they are obligated to pay partial income replacement and cover your medical bills. Consider another scenario—you have a back injury that causes severe pain in certain work conditions. You are lifting boxes for work when you pull a muscle that causes severe spasming pain.

Even though your injury might be worse because of your preexisting condition, workers’ compensation should still pay for the treatment you need due to your work. The injury would not have happened if you had not been at work, so workers’ compensation should pay for it.

Proving Your Workers’ Comp Claim

What are the next steps to proving your claim and getting the benefits you deserve? Follow these tips:

• Report the incident immediately. People with preexisting conditions sometimes wait to report a workplace injury. They may want to make sure that their pain is caused by work, and not their preexisting condition. However, the longer you wait to report a work injury, the easier it is for workers’ compensation to deny your claim and say that it happened outside of work. As soon as you get hurt, report it to your supervisor and follow your company’s policies for on-the-job injuries.
• Seek treatment promptly. If you wait too long to go to a doctor after a workplace injury, it can be hard to prove that your injury was caused by your work. This gives workers’ compensation plenty of room to deny your claim. Following the policies of your place of employment, seek medical care from an approved doctor and report your injuries.
• Don’t hide your preexisting injury. Hiding your condition may make you look guilty. This could raise a red flag with your workers’ compensation insurance provider, and they might claim that you are simply trying to get your workplace to pay for treatment for an unrelated injury. Honesty is crucial throughout this process.

Call Thiry & Caddell to Get Started

Are you having trouble getting your workplace injury paid for by workers’ comp? The team at Thiry & Caddell is here to help. Find out how we can help you now by calling us at 251-478-8880 or getting in touch with us online.