COMMON MISCONCEPTIONS: I HAD A PRE-EXISTING CONDITION, SO I’M NOT COVERED?

A Pre-Existing Condition Doesn’t Automatically Mean Your Work Injury Isn’t Covered

The Myth: If medical records show that you already had an injury, arthritis, or another condition in the same part of your body, workers compensation can simply blame your symptoms on that condition and deny your claim.

The Truth: A pre-existing condition does not automatically end a workers compensation claim.

David’s case is a good example. When he finally received medical care for his ankle, imaging showed something that could easily complicate a workers compensation claim: there were signs of an underlying ankle condition. X-rays showed evidence of an older ligament injury and a small osteochondral lesion, and he was later diagnosed with several ankle problems, including osteoarthritis.

That raised an important question: Was David’s ankle hurting because of the accident at work… or because of a condition that was already there?

One physician concluded that David’s work accident had aggravated a pre-existing osteochondral lesion. Later, a medical panel examined David and reviewed the relevant medical records. Their conclusion provided an important distinction: The underlying condition may have existed before the accident, but it had not been causing symptoms. According to the medical panel, the work accident made that previously non-symptomatic condition symptomatic, resulting in a chronic ankle lesion and subsequent degenerative joint disease. The judge ultimately accepted the panel’s conclusions and found that medical causation had been established.

That doesn’t mean every pre-existing condition will be covered by workers compensation simply because something happens at work. The important question is what the work accident actually did.

• Did you have a condition that wasn’t causing problems before the accident?
• Did your symptoms begin or become worse afterward?
• Did the accident aggravate an underlying condition?
• What do your medical records and doctors say about the connection?

Those details can matter. So if an insurance company points to arthritis, an old injury, or another pre-existing condition, don’t automatically assume that means your workers compensation claim is over. Sometimes a condition can exist quietly for years until a workplace accident changes it. And when that happens, understanding the difference between “this condition already existed” and “this condition was already causing these symptoms” can become an important part of understanding your claim.

If you have questions about a work injury involving a pre-existing condition, Just Work Comp Law is here to help. We’re happy to answer your questions, help you understand your options, and we’ll even tell you if you don’t need an attorney.

• Call us today: 801.849.3999
• Email: info@davis-sanchez.com
• Visit: justworkcomplaw.com