If you have filed a workers compensation claim or are negotiating with your employer’s insurance company over benefits, you may be denied compensation or your claim may be devalued because of a pre existing condition. Unfortunately, this is an all too common tactic but should not stop you from pursuing the benefits you deserve. In order to be compensated, you need to prove that your injuries were caused by or made worse by a workplace accident or workplace conditions, which may require the help of a workers compensation lawyer.

Examples of Pre Existing Conditions Impacted by Workers Compensation Claims

The consequences of an injury can be severe. Whether it's a fall at work, a machinery accident or a chronic long term condition, a traumatic injury can cause a pre-existing condition to become much worse off. Some examples of pre-existing conditions that tend to be at issue in a workers compensation claim include:

  • Degenerative disc disease/Herniated disc
  • Broken bones that had previously healed
  • Lower back strains
  • Arthritis
  • Hernias
  • Shoulder and knee injuries
  • Concussions and other brain injuries
  • Fibromyalgia

Many people have underlying health conditions. But if a workplace accident or condition caused what was a manageable condition to worsen, you are entitled to workers compensation benefits for those exacerbated injuries. 

Proving Your Case

The crucial evidence you need to fight the workers compensation insurance companies on your pre-existing condition and devalued claim will come down to establishing the fact that you weren’t experiencing your current symptoms prior to the accident. The most important steps to follow after a workplace accident or as soon as you notice symptoms of a chronic conditions are:

  1. Report your injury to your employer. It's extremely important to report your injury to your employer as soon as possible after the injury or as soon as you develop symptoms. Many employers have a process to report injuries to your supervisor or appropriate role within your HR or safety department. Keep in mind, many states, like New Jersey, have a very short window to report your injury and start the claims process.
  2. Complete the necessary paperwork. Once you start the claims process, there will be a series of questions and paperwork you will need to fill out. It’s important to make sure to meet all deadlines, to avoid delays or even denials for your claim.
  3. Contact a workers compensation attorney. If you have a pre existing condition and/or a workers compensation claim has been denied, you should discuss your case with a workers compensation attorney. Many offer a free consultation and can offer guidance and what type of case you may have.

Independent Medical Exams and Pre Existing Conditions

As part of the workers compensation benefits process, your employer or its insurance company may require you to undergo an Independent Medical Exam (IME) by a doctor of their choosing. While you must comply with this request, keep in mind that the usual doctor-patient privilege does not apply.

Make sure to describe your injuries by differentiating between the current injury and previous one. Detail the frequency and intensity of the pain you may be experiencing because of the injury. Other tips for what to say to your workers compensation doctor include clearly and precisely describing limitations that exist now versus previously with the injury.

What to Do if Your Workers Comp Claim is Denied

Your employer or its workers compensation insurance provider may deny or devalue your claim by claiming you had a pre-existing condition, the injury isn’t as severe as you claim or that the injury isn’t work-related.

If your claim is fully or partially denied, you should contact a workers compensation lawyer to review your case. Many states, like New Jersey, have an informal and formal appeals process for situations where employers and employees are in a dispute about workers comp benefits. Having a skilled, experienced lawyer on your side can make all the difference in the outcome of your case.

Get Help for your Workers Compensation Claim

If your workers compensation claim has been denied or you need help with obtaining fair benefits due to a pre existing condition, we can help. At Brandon J. Broderick, Attorney at Law, our team offers expertise in workers compensation and employment law. Our compassionate client care and tenacious negotiation can get you the compensation you are entitled to.

Contact us immediately for a free consultation to understand your options.


Posted by: Brandon J. Bro…
Date: Thu, 04/07/2022 - 22:04

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