Pre-Existing Conditions, Older Workers, And The Right To Workers' Compensation

Are older employees at a disadvantage when it comes to filing for workers' compensation due to repetitive stress or back injuries? Aren't the aches and pains that a lot of workers experience just part of aging?

Not exactly. If you're an older worker, it's important to understand your rights to compensation when your job aggravates a pre-existing condition caused by your age. Here's what every older worker needs to know.

How does a pre-existing condition affect a workers' comp claim?

The general rule is that workers' compensation is only paid for injuries or illnesses that are directly related to work activity. However, when you already have a pre-existing condition that ends up aggravated or somehow worsened by your work activities, you may still be eligible for benefits.

You also can't be denied workers' comp benefits simply because you had a pre-existing condition that made you particularly susceptible to injury. For example, if you have age-related osteoarthritis, you may be more prone to back injuries than a younger, perfectly-healthy employee. However, if you injure your back lifting boxes at work, you can't be denied workers' comp because of your osteoarthritis.

Your employer or the insurance company may try to deny you benefits anyhow.

Unfortunately, not everyone follows the correct procedures for workers' comp claims. Many employers don't understand the law and will -- incorrectly -- tell employees that they aren't eligible for benefits if they have a pre-existing condition. That sometimes discourages employees from even filing a claim.

You can't count on your employer's insurance company to properly follow procedures either. Many valid workers' comp claims are denied when an insurance company incorrectly applies the rules regarding pre-existing conditions. Often, insurance companies will start out trying to uncover evidence of a pre-existing condition in order to claim that your injury had nothing to do with work.

For example, imagine that the worker in the example above had been treated for a back injury three years before the incident with the boxes caused the current injury. The insurance company might seize on that fact and try to unfairly claim that the current back injury had nothing to do with the employee's work activity.

Good records help prevent wrongful denials.

The best thing that you can do to prevent a wrongful denial of your workers' comp claim due to a pre-existing condition is to make sure that your physician is keeping good records. Every time you visit the doctor, you should receive a summary of your office visit. Make sure that you review it for inaccuracies. When you see your doctor regarding a new injury that has aggravated a pre-existing condition, make sure that you specifically tell your doctor how the condition became aggravated so that it is captured in your records.

Gaining approval for a workers' comp claim with a pre-existing condition can be stressful and difficult. If you are having problems, contact a law office like Prediletto, Halpin, Scharnikow & Nelson, P.S.

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