Pre-Existing Condition & Impact a Workers’ Comp Claims

A medical illness or injury that you have before you start a new health care plan may be considered a “pre-existing condition.” Conditions like diabetes, COPD, cancer, and sleep apnea, may be examples of pre-existing health conditions. They tend to be chronic or long-term. A pre-existing condition is typically one for which you have received treatment or diagnosis before you enrolled in a new health plan. Prior to 2010 and the passage of the Affordable Care Act (ACA), an insurance company would review your application for enrollment and if they determined you had a pre-existing condition, could deny you coverage or offer coverage at inflated rates.

If you are injured at work, you are eligible for Workers’ Compensation benefits, which will cover the costs associated with your injury. However, if you have a pre-existing condition, it could complicate your Workers’ Compensation claim. This is particularly true if your pre-existing condition is related to your workplace injury. Your employer is responsible only for the injury that you suffered at work. If your pre-existing injury affects the same body part that was injured at work, it may be difficult to prove that the injury was work-related. A skilled Workers’ Compensation lawyer will work closely with you to ensure that you receive the compensation you deserve.

If you injured your knee in a previous workplace accident, and you injured the same knee at your current job, the benefits you will be able to collect for the new injury will be reduced slightly to account for your previous Workers’ Compensation claim. Your employer will be responsible for paying for the medical costs, including temporary disability benefits, associated with your new injury. However, it is important to understand that your permanent disability benefits may cover only the increase in permanent impairment. For example, if you are eligible for a $10,000 permanent impairment award, but you received $8,000 from a previous award, you will likely only receive $2,000 for your new claim.

If the injury affected a body part that had been injured in a previous work accident, tell your doctor about both injuries and provide a copy of your medical records from the previous claim. Your doctor will review this information and determine whether the most recent injury is an aggravated injury or a new, but related, injury. From a Workers’ Compensation perspective, this is an important distinction because you will need to fill out different paperwork, depending on the type of injury.

In some cases, an existing injury may have little to no impact on a Workers’ Compensation claim. For example, if you dislocated your shoulder at a previous job, this would likely have no bearing on your current claim if your injury involved another body part, besides the shoulder that was already injured. You may be required to see multiple providers so that you can continue to collect compensation for both injuries. If the previous injury and the current one prevent you from being able to return to work, either temporarily or permanently, your employer will have to determine your eligibility for a pension.

Remember, each case is unique, so contact HURT-511 for more information on workers’ comp statute and our personal injury lawyers help injured workers recover the benefits to which they are entitled by law. For a free consultation with an experienced workers’ compensation lawyer, call us toll-free at 800-4878-511 or complete our online form. Our firm handles accident and injury claims throughout all five boroughs of New York.

HURT-511 operates in all boroughs of New York including all Bronx neighborhoods, namely: Bedford Park, Belmont, Fordham, Highbridge, Hunts Point, Jerome Park, Kingsbridge, Morris Park, Morrisania, Mott Haven, Parkchester, Riverdale, Spuyten Duyvil, Throgs Neck, University Heights and Woodlawn.