Can I File a Workers’ Compensation Claim for a Pre-Existing Condition?

Most Pennsylvania employers must offer their employees Workers’ Compensation benefits. These benefits go into effect after an employee has been injured in a workplace accident. They cover a portion of the employee’s salary and all medical bills related to the accident.

Workers who have been hurt must file a claim to start the Workers’ Compensation process. However, getting a Workers’ Compensation claim approved can sometimes be challenging. This is especially true if the workplace accident aggravated a pre-existing condition. It is not uncommon for insurance representatives to deny those types of Workers’ Compensation claims.

Any condition a worker had before filing a claim is considered pre-existing. Some common pre-existing conditions include back problems, neck issues, migraines or headaches, asthma, knee problems, osteoporosis, and muscular problems. All conditions or diseases an employee experiences before being hurt at work can fall into this category.

Just because a worker had a pre-existing condition does not exempt them from receiving Workers’ Compensation benefits.

However, when a Workers’ Compensation claim reveals that a worker’s accident caused a flare-up or exacerbation of a pre-existing condition, the claim is more likely to be denied. It may be argued that the condition was diagnosed before the on-the-job injury and does not qualify for Workers’ Compensation coverage.

Evidence for a Pre-Existing Condition

Workers should be ready to supply key evidence to improve the chances of getting Workers’ Compensation benefits for a claim that includes a pre-existing condition. Some critical pieces of evidence include:

• Medical records: It is essential for all workers who file Workers’ Compensation claims to be seen by certified medical professionals. Depending on the state, you might have to see an employer-approved doctor. A medical professional’s notes, diagnosis, and treatment plan can indicate that the pre-existing injury did not arise for any reason other than the on-the-job accident.
• Diagnostic scans: X-rays, CT scans, and other diagnostic images can support a medical professional’s findings.

Other Considerations

In addition to gathering and providing evidence that an accident caused a pre-existing condition to worsen, employees must follow proper guidelines when seeking an appeal. These include filing within a specific timeline and completing all the paperwork correctly. Getting representation from a Workers’ Compensation lawyer is essential. In some cases, it may be required.

Philadelphia Workers’ Compensation Lawyers at Freedman & Lorry, P.C. Help Employees With Pre-Existing Conditions

It can be challenging to navigate the Workers’ Compensation process for a worsened pre-existing condition. For legal help, contact our Philadelphia Workers’ Compensation lawyers at Freedman & Lorry, P.C. Call us at 888-999-1962 or contact us online to schedule a free consultation. Located in Philadelphia and Cherry Hill, New Jersey, we serve clients in Pennsylvania, and New Jersey.