Jan 17, 2022

Pre-Existing Conditions & Workers’ Compensation Injuries

Using workers’ compensation, you can recover more comfortably after suffering an injury at work or while completing a work-related duty. What happens when your injury wasn’t necessarily caused by your recent work accident because you have a pre-existing condition? Can you still get workers’ compensation benefits in these cases?

Pre-existing medical conditions can be covered by workers’ compensation. You are not disqualified from workers’ compensation coverage just because you have a pre-existing condition. Also, you can get workers’ compensation if a workplace accident exacerbates or worsens a pre-existing condition.

Even though your pre-existing conditions are technically covered by workers’ compensation, you shouldn’t be surprised if the insurance company pushed back against your claim. Insurers like to deny claims due to pre-existing conditions, so they won’t be happy if you list one in your claim after a workplace accident. The insurance adjuster will try to find a way to say that your condition was actually not related to the accident or that it was exacerbated due to a separate set of circumstances.

For example, the insurer might try to argue that:

  • You engaged in activities outside of work that worsened your pre-existing condition.
  • You were not injured in a way that affected your pre-existing condition.
  • Your pre-existing condition is not covered by workers’ compensation due to a specific exclusion.

The goal of the insurer is to provide you with as few workers’ compensation benefits as possible. It would prefer to pay for treatments related to a new injury and not a pre-existing one. To counteract the efforts of the insurer, you should work with a workers’ compensation attorney who knows how to utilize medical evidence that proves your pre-existing condition was worsened due to your work or a work accident.