There are certain factors that can complicate a workers’ compensation claim. Having a pre-existing condition is one of those things. Can you still file a claim and receive compensation? The following are three scenarios to give you an idea, but you should work with a lawyer to get a more accurate picture of what you’re entitled to.

Conditions Related to a Previous Claim

If your injury is something that you previously received compensation for through another workers’ comp claim, the amount you are eligible for now may be slightly reduced. Your employer will only be responsible to pay additional compensation for the additional medical bills and treatment. If the employer is already paying for a previous claim, and your new expenses are added to that, the employer is typically only responsible for the increase that your expenses see.

For example, your doctor may conclude that you have a permanent impairment that should get you a $20,000 award. From your previous claim, you already received $15,000. The increase would be $5,000, so that is what you would receive this time.

Conditions Not Related to a Previous Claim

If your injury or condition is pre-existing, but you have never received workers’ compensation for it, you may only be eligible to receive compensation to pay for the worsening of the condition. For example, if you previously suffered a back injury in a car accident, and then your job aggravated the injury after daily lifting of heavy items, the doctor would need to determine to what extent the injury was aggravated beyond the initial car accident injury. If the individual already did weekly physical therapy, and there was no additional therapy required after the workplace injury, workers’ compensation probably wouldn’t have to cover the therapy.

If the individual did physical therapy once per week, and the doctor recommends the individual now does it twice per week due to the new injury, that could be a game changer. The employer might be responsible for paying the costs of the additional therapy sessions.

Unrelated Conditions

If you are seeing a doctor after ACL surgery on your left leg due to an athletic injury, and you end up with carpal tunnel syndrome from typing all day long at your job, they are two completely unrelated conditions. One would not affect the other when it comes to workers’ compensation. You would still use your health insurance to pay for your ACL-related appointments, and workers’ comp would typically cover medical appointments related to your carpal tunnel syndrome.

Understanding Your Rights

Workers’ compensation can get complicated when you have a pre-existing condition. To learn more about what your rights are, contact a workers’ comp attorney in Newark today.



Thanks to Rispoli & Borneo, P.C. for their insight into workers compensation and aggravating a condition.