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How can a pre-existing condition affect my workers’ comp claim?

Posted on January 10, 2018 in

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Some businesses are not too keen on paying workers’ compensation benefits to their injured employees. In fact, a number of work comp insurance companies will deny rightful claims whenever they can.

One common way to avoid paying benefits is to say that a worker’s injury is not new. If the employer or the insurance carrier can prove that an employee’s injury is pre-existing, they may not have to pay any benefits. There are a few ways that employees can fight back.

What is a pre-existing condition?

As the name indicates, a pre-existing condition is a medical condition or injury that you had before the accident, injury or illness that your current claim is based on. Some pre-existing conditions may require that you not do certain activities, while others may flare up after strenuous activity.

Either way, make sure that your doctor is aware of any pre-existing conditions. This may help in how your medical provider documents your injury in the medical report, which is commonly a key consideration for the claim. For example, your doctor should clearly indicate how your current injury is different from your pre-existing condition or how your injury worsened or aggravated your condition.

When is a pre-existing condition covered?

Georgia’s workers’ compensation laws clearly outline which benefits are covered. It states that if an employee is able to show that the work incident exacerbated the pre-existing condition, then it may be covered. 

However, if you did not tell your employer about a physical limitation when you were hired or you hid details of a previous injury from a doctor, it may lead to a denial of your claim. 

This is just a brief overview of a few critical factors when dealing with pre-existing conditions and workplace injuries or illnesses. If you are injured while performing your work duties, learn about your legal options so that you can choose the best course of action for your claim.

Hilley & Frieder can handle all aspects of you case virtually from interview through conclusion. We are open and available to help you. Please view our complete COVID-19 statement to learn more about the steps we are taking to ensure that your case continues to move smoothly in this environment.