Preexisting Conditions: They’re Almost Universal
One of the most common questions that arises with regard to work-related injury claims is whether a claim is barred because the injured worker has some sort of pre-existing condition. At the outset, it should be noted that, if every claim was barred where it turned out the worker had some sort of pre-existing condition, then almost no claims would be allowed, since almost everyone has some sort of pre-existing condition or another.
Overweight or Diabetic? The List of Pre-existing Conditions is Long
Are you 10 pounds overweight? Do you have mild hypertension or diabetes? Did you sprain an ankle a few years ago? Are you over the age of 50? Do you have heart disease in your family history? The list goes on and on. The first thing to remember, therefore, about pre-existing conditions is that they are common; almost everybody has one or two.
General Rule: Pre-existing Conditions do not Disqualify as a Workers’ Compensation Claim
Generally speaking, employers are responsible for treatment of a pre-existing condition that is “aggravated, accelerated, or combined” by a work accident or exposure.
Existence of Pre-existing Conditions May Make Your Claim More Difficult to Establish
The existence of a pre-existing or prior condition may, however, make your claim more difficult to prove or establish, due to the fact that it gives your employer’s insurance company “a hook” upon which they will try to hang their “denial hat.” They may argue that the difficulty – the disability – that you currently experience isn’t so much based on the work-related accident or incident, but rather is just due to the underlying condition that you’ve suffered from for some time. Particularly if you are over the age of 50, they may say that the problem is just part of the routine aging process.
Medical Evidence Connecting Your Current Disability to the Workplace is Crucial
Where pre-existing conditions are present for the workers’ compensation claimant, it is crucial that the worker present clear, strong, medical evidence that documents and describes how the current disability is tied to the work-related injury, and not just a feature of your pre-existing condition.
The Sexton Case
Consider a case from just a few years ago. The claimant was a nurse at a nursing home who contended that her pre-existing chronic obstructive pulmonary disease (COPD) was aggravated when she inhaled a particular perfume sprayed by a co-employee at the workplace on three occasions on the same day. The compensation judge indicated that, because the claimant’s reaction to the perfume was the result of a personal proclivity of the claimant, any aggravation of her pre-existing condition did not arise out of the employment. The judge denied her claim.
The appellate court disagreed and held that the aggravation of the claimant’s pre-existing COPD caused by inhaling the perfume sprayed into the air by the co-employee had a sufficient connection to the workplace to make her claim compensable. The court noted that the claimant would not have been exposed to the perfume, had it not been repeatedly sprayed at the workplace. That the perfume affected only her also made no difference to the court.
Don’t Be Discouraged By a Statement that You Have a Pre-existing Condition
Have you suffered a work-related injury and are concerned that your claim may be denied because of a pre-existing condition? While the existence of a pre-existing condition can complicate your claim and make it more difficult to establish, you need not give up. You do, however, need the help of skilled, experienced legal counsel to prove your claim. At Petro Cohen, P.C., we have helped many hard-working folks just like you. Call or contact us for a free consultation. Talk to an experienced lawyer who can help you sort out your rights. We can be reached by phone at 888-675-7607 or you can complete our online form. We look forward to discussing your situation with you.
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