Can I Get Workers’ Compensation Benefits For A Preexisting Condition?

The point of having a workers’ compensation system in the U.S. is to allow an injured employee to focus on healing instead of having to expend time and effort navigating the legal system to get their medical bills paid. If an injured worker meets the criteria for their injury to be compensable, they will usually receive benefits. However, if the new injury aggravates a preexisting condition, this can, and often does, complicate matters. The right legal help can protect your rights during what can be a time-consuming legal process.

The ‘Major Contributing Cause’

Workers’ compensation law explicitly states that benefits will only be granted for a new injury sustained while acting within the scope of the worker’s employment. However, it is sometimes possible for a worker to show that the new injury has aggravated a previous condition – for example, a neck injury may aggravate a past back injury, if both affect the spinal cord. In these cases, the issue is not whether the injury is compensable under workers’ compensation; rather, the issue is how much of the injury is compensable.

This is sometimes quite difficult to determine, because the state legislature’s intent is to grant benefits to those injured on the job – but how much of a specific injury occurred due to work, and how much was preexisting? The general rule is that if the “major contributing cause” (generally, more than 50 percent) of an employee’s incapacity is a work injury, that portion will be what an injured worker will use to claim benefits. How this percentage is determined can vary.

Medical Evidence Can Be Key

If an injured employee files a request for workers’ compensation benefits and it turns out they have a preexisting condition, it is likely that an independent medical examination will be required in order to determine the major contributing cause. It is possible to seek another opinion if need be, but it is best to have proof of one’s past medical history so that a clear link between the person’s preexisting condition and the new injury can be established.

If you are injured at work, in a part of your body that aggravates a preexisting condition, it is crucial to report the injury immediately. It is also highly recommended to be completely honest about any preexisting conditions; a failure to do so implies a lack of credibility. Cooperating fully is the best way to establish your case for compensation.

Contact An Orlando Workers’ Compensation Attorney

Workers’ compensation exists because neither workers nor employers want to argue about benefits in general, but neither will they grant benefits to those who do not have a work-related injury. If you have injured yourself on the job and are concerned about a preexisting condition, an Orlando workers’ compensation attorney from the Hornsby Law Group may be able to assist. Call our office today at (407) 499-8887 to schedule a consultation.

Source:

leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0440/Sections/0440.09.html