Can Pre-Existing Injuries Lead to a Denial of a Workers’ Comp Claim?

Life presents its share of challenges, yet millions of hardworking people push forward each day to provide for their families. Through pain, stress, and adversity, the daily grind continues. Bills need to be paid, children need caring for, and work demands our presence. Many power through existing injuries or health conditions to maintain their livelihood. However, when a workplace injury occurs, questions arise about how previous conditions might affect a workers’ compensation claim. The fear of claim denial due to pre-existing conditions adds another layer of worry to an already stressful situation.

How Pre-Existing Conditions Impact Workers’ Compensation Claims in Pennsylvania

Pennsylvania workers’ compensation law recognizes that employees may have prior injuries or health conditions when starting a job. The critical factor in these cases focuses on whether the work-related injury aggravated, accelerated, or combined with the pre-existing condition to create a new or worsened disability. For instance, if you had a previous back injury and a workplace accident makes it significantly worse, you’re entitled to worker’s comp benefits for the additional damage and disability since this would be considered a new injury. The worker’s compensation system doesn’t expect people to arrive at their jobs in perfect health — it protects workers when job duties harm them, regardless of prior medical conditions.

Common Reasons for Workers’ Compensation Claim Denials

Workers’ compensation benefits can be denied for legitimate reasons, but they are frequently denied for questionable and improper reasons. Insurance carriers might claim insufficient evidence linking the injury to work activities, late reporting of the incident, or dispute that an injury happened in the first place.

However, a pre-existing condition alone should not result in automatic denial. Pennsylvania worker’s compensation law specifically protects injured workers who experience an aggravation of a pre-existing condition. When insurance companies attempt to use your medical history against you, they often overlook or misapply the law. Your previous injury or prior workers’ compensation claim shouldn’t prevent you from receiving workers’ compensation benefits for a new work-related injury.

Fighting a Denial Based on Pre-Existing Conditions

When facing a denial due to a pre-existing condition, several legal options exist to challenge the decision. A worker’s compensation lawyer can help gather medical evidence showing how the workplace injury differs from or worsens your prior injury. Medical treatment records documenting the change in your condition prove crucial. Your worker’s compensation attorney can also secure expert testimony from doctors to establish the causal connection between your work duties and the aggravation of your pre-existing injury.

Many successful workers’ compensation cases involve people with previous injuries who suffered new damage or deterioration due to their job requirements. The key lies in presenting clear medical evidence and expert opinion to support your workers’ compensation case.

Documentation and Medical Evidence: Building Your Case

Strong documentation forms the foundation of successful workers’ compensation claims involving pre-existing conditions. Keep detailed records of all medical expenses and treatment related to both your previous injury and the new work-related injury. Request copies of medical records showing your condition before and after the workplace injury. Ask your doctor to clearly document how your current condition differs from or exceeds your prior condition.

Your worker’s comp benefits depend heavily on establishing this distinction. Pennsylvania worker’s compensation law requires objective evidence — your medical documentation tells the story of how your condition changed due to work activities.

We Stand Ready to Protect Your Rights

The stress of dealing with a workers’ compensation claim while managing pain and disability can overwhelm anyone. When insurance carriers deny claims based on pre-existing conditions, it adds unnecessary burden to an already challenging situation.

Our attorneys at Liever, Hyman & Potter, P.C., focus on providing clear direction through the workers’ compensation system. We’ve helped countless injured workers overcome claim denials related to prior injuries. We will educate you on how pre-existing conditions affect your case while aggressively pursuing the benefits you deserve, as seen within our previous history with work injury claims. Let us evaluate your situation and develop a strategy to address any unjust denial of your workers’ compensation claim.

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