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How Do Pre-Existing Conditions Impact Workers’ Comp in Georgia?

On Behalf of | Apr 27, 2021 | Workers' Compensation

Pre-existing conditions are common among workers in Georgia. Thousands of employees go to work every day with pre-existing back pain, chronic pain, prior concussions or other previously healed injuries. Unfortunately, having a pre-existing condition or injury can lead to a more difficult workers’ compensation insurance process in Georgia.

An insurance company will look for any reason to deny a claim, including a pre-existing condition. This is why it is important to hire a workers’ compensation attorney if you have a complicated claim involving a pre-existing injury. An attorney can help you obtain the benefits you deserve after a work-related injury.

How Do Insurance Companies Handle Claims With Pre-Existing Conditions?

A pre-existing condition can describe any medical condition you had at the time of your workplace accident, injury or illness. A pre-existing condition could be an old injury, health condition or genetic predisposition. Common examples include herniated spinal cord disks, neck pain, high blood pressure and diabetes.

There are two ways in which a pre-existing condition could affect a workers’ compensation claim in Georgia:

  • A work injury aggravating a pre-existing condition. An accident that happens at work could aggravate a pre-existing condition. An example is if you already had back pain and a work accident herniated a disk fully or caused another spinal cord injury, resulting in greater pain, more required medical care and more time away from work to recover.
  • A pre-existing condition increasing the damage of a work injury. The second scenario is a pre-existing condition making your workplace injury worse than it might have otherwise been. If you have a history of concussions and suffer another concussion at work, for example, your traumatic brain injury could be worse than an employee who did not have prior concussions.
  • Georgia’s workers’ compensation law states that an insurance company has to take a claimant in the state he or she was in at the time of the work accident. This means you can still qualify for workers’ compensation benefits despite a pre-existing condition affecting your injury claim. It can be more difficult, however, to convince an insurance company to offer a fair settlement if you are a worker with a pre-existing condition.

    How to Deal With a Workers’ Compensation Insurance Company

    During your workers’ compensation claim, the insurance company’s goal is to protect its own profits by minimizing or eliminating your financial recovery. That company is likely to use your pre-existing condition to deny coverage, even if this is not a valid reason. Keep this in mind when negotiating with the insurance claims adjuster assigned to your case. Be careful not to make common mistakes, such as accepting the first settlement offered to you. The first offer may not adequately compensate you for your past and future needs based on Georgia’s workers’ comp laws.

    You may need a workers’ compensation attorney in Georgia to help you prove your case. You may need a lawyer, for example, to help you gather medical documents that prove your pre-existing condition has something to do with your new work-related injuries. Otherwise, the insurance company may argue that the two are not related and that your payout should not be affected by your pre-existing condition.

    If the insurance company tries to wrongfully deny benefits based on an issue related to your pre-existing condition, contact an attorney for assistance. An attorney can help you request an internal review of the insurance company’s decision. If this does not end with a reversal, your attorney can help you file an official appeal and a third party will review the decision.

    While you focus on healing and recovering, a lawyer in Atlanta can handle the complicated aspects of your workers’ compensation claim in Georgia, including a pre-existing condition. A lawyer will fight for maximum recovery on your behalf.