How Do Pre-Existing Conditions Affect Your Workers’ Compensation Claim?

Workers’ compensation is designed to provide money if you get hurt while working. Unfortunately, a preexisting condition can affect your settlement. If you have been hurt at work, and your workers’ compensation insurance is giving you a hard time, keep reading to learn more about pre-existing conditions and workers’ compensation claims.

What Is a Pre-Existing Condition?

A pre-existing condition is some type of past injury for which you have received treatment. Even if you haven’t received treatment but have been diagnosed, you may be told you have a pre-existing condition when you submit your workers’ compensation claim.

Luckily, the Affordable Care Act prohibited insurance companies from denying you coverage or charging you high-interest rates because of pre-existing conditions. Unfortunately, while a pre-existing condition won’t affect your ability to qualify for workers’ compensation or other insurance, it can affect whether or not your claim is approved.

Pre-existing conditions come in many shapes and forms. You may have had a previous back or knee injury, but pre-existing conditions also include depression, diabetes, cancer, epilepsy, and many other conditions that you can’t control.

What if the Condition Is Related to Your Injury?

If you have a pre-existing condition that is related to the injury you received at work, your benefits will probably be reduced. If your pre-existing condition was caused by a previous work injury, the insurance carrier will consider how much they have already paid you.

For example, if you hurt yourself at work, and your medical bills/partially lost income totaled $1,000, workers’ compensation will likely pay the full $1,000. However, if you get hurt again, and it worsens the injury, the insurance carrier will subtract $1,000 from any settlement they think is fair.

Therefore, if your new injury cost you $2,000 in medical bills and partial lost wages, you may not get the full $2,000. The insurance carrier may only award you the $1,000 because you already got some money for the same condition. Keep in mind that if the new injury did not worsen your existing condition, you may not get any money.

Similarly, if you have a non-work-related injury, your settlement will probably be reduced. Your claim will only be approved if you can prove the work accident worsened the condition, and the settlement you get will be based only on the new symptoms.

What if the Condition Isn’t Related to Your Injury?

You can also have a pre-existing condition that isn’t related to your injury. Perhaps you suffer from depression or you have a bad leg, but you injured your back at work. How will your pre-existing conditions affect your settlement?

For the most part, they shouldn’t affect your claim at all. As long as the injuries are totally unrelated, you should get the full amount you deserve.

In some cases, even though your new injury may have nothing to do with your pre-existing condition, the combination of both injuries can make you permanently disabled.

For example, if you already had a bad back, but then also hurt your knees at work, you may not be able to work anymore. In this case, workers’ compensation may not be enough. Talk to your lawyer and employer about your pension or other solutions.

Getting hurt at work is never fun, and if your claim gets denied, it can make life stressful. If you have a pre-existing condition, the insurance company may try to deny your claim or reduce your settlement. For this reason, you need a skilled workers’ compensation attorney in your corner. For more information about how we can help, contact us at Stafford, Neal & Soule, S.C., today.