If you’re hurt while doing your job, you could be entitled to workers’ compensation regardless of fault — you could have been exposed to dangerous gases, acquired carpal tunnel syndrome, or suffered some other type of on-the-job injury.
When a workplace injury is connected to a pre-existing condition, though, the waters become murky, and your case can get complicated. You may have to answer some rather in-depth and sometimes confusing questions from doctors, insurance adjusters, and others before your claim will be paid.
In theory, the goal of these questions is to determine if the new injury is related to your pre-existing condition, and if so, how? If your pre-existing condition was aggravated by a job-related task, it’s a job-related injury and you could receive compensation (although they might toss up hurdles to claim approval anyway). When the pre-existing injury is reaggravated and it’s not clear a work-related task contributed, your claim gets much more complicated.
Unrelated Pre-Existing Conditions
Imagine that you injured your elbow in a softball game a few years ago and needed reconstructive surgery. After the surgery and physical therapy, your elbow function returned to nearly 100 percent, and it didn’t affect your ability to perform your job.
Now imagine that after your elbow has fully healed, you trip and fall over a pallet at work and blow out your knee. These two injuries should be determined to be unrelated and the new injury would be what is called “fully compensable.” In other words, you’d probably eligible to receive the full value of your claim — assuming there weren’t any hurdles in the claims process.
Partially Related Pre-Existing Conditions
Now let’s imagine you sustained the same softball injury, but the injury at work involved your elbow. This time, instead of tripping over a pallet, you were lifting a very heavy object, and when you lifted it off the ground, you felt a sharp pain in your elbow, and twisted your back to compensate, causing a lower back strain.
Now, your workplace injury is related to your previous elbow injury. Consequently, your claim could be more likely to be denied. You’ll likely have to fight tooth and nail to receive all the workers’ compensation benefits you’re entitled to and which you need — you’d require an advocate on your side to get financially whole.
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