When you suffer a workplace injury, having a pre-existing injury can complicate your workers’ compensation claim. Often the insurance company for an employer will try to use a prior injury as a reason to deny a claim for workers’ comp benefits. In many cases, these injuries should be covered under Georgia law. If you suffered a pre-existing injury and are filing a workers’ compensation claim, hiring an experienced workers’ compensation attorney is essential if you want to receive the workers’ comp benefits you deserve.
What Is a Pre-Existing Injury?
For workers’ compensation benefit purposes, a pre-existing injury is a medical condition that existed before the workplace injury that causes a worker to file a claim for benefits. Under Georgia workers’ compensation law, the aggravation of a pre-existing injury is covered if it arose during the course of employment and is the cause of the workers’ disability. Pre-existing injuries can include a prior injury to the body part or a chronic disease that is aggravated. Common pre-existing injuries where workers can be entitled to workers’ compensation benefits include:
- Degenerative disc disease and herniated discs
- Forms of arthritis, such as in the knees, shoulders, and hands
- Back injuries
- Shoulder injuries
- Knee injuries
- Spine degeneration
- Broken bones
- Torn ligaments
How a Pre-Existing Injury Can Affect Your Workers’ Compensation Claim
If your employer denies your claim because of a pre-existing condition, the judge in your workers’ compensation case will make a determination as to whether the job injury was related to your pre-existing condition and to what extent. Your prior injury could affect your case in one of these ways:
Pre-existing injury related to prior claim.
Your current work injury may have aggravated a prior one that you received workers’ compensation benefits for. In this situation, you are entitled to benefits, but they may be reduced due to your prior claim. However, in some cases, the injury is really a new one and not an aggravation of a prior injury. Consulting with your doctor and an experienced workers’ compensation attorney can help you decide which category your injury falls into and whether to file a new injury or aggravated claim for benefits.
Pre-existing injury unrelated to prior claim.
You would have a non-related pre-existing condition if your job aggravated a prior injury not caused at work or a medical condition caused by normal aging. For example, if you injured your shoulder in a car accident in the past, you could aggravate it at work if your job entails heavy lifting. You could be entitled to workers’ compensation benefits, but only for the degree that your work caused a worsening of the condition.
Unrelated pre-existing injury.
In some cases, a pre-existing injury could have no relationship to your current workplace injury. For example, if you have osteoporosis, it should be unrelated to a claim for a broken bone caused by a fall at work. You should be entitled to full workers’ compensation benefits.
How to Build a Strong Claim When You Have a Pre-Existing Injury
While you cannot control whether or not your employer denies your workers’ comp claim, you can take steps that strengthen your claim when you have a pre-existing injury. Some ways to build a strong claim include:
If the doctor’s medical form asks about a pre-existing condition or he or his staff questions you about it, you need to answer honestly and disclose the pre-existing condition. Failing to disclose this may be grounds to deny your claim.
Give detailed information.
When speaking to your doctor about your current injury, you want to be clear on how your current level of pain and discomfort is different from any residual pain, if any, from your prior injury. If you have not experienced any symptoms from a pre-existing condition at the time of your injury, you need to make this clear to your doctor. You also want to explain in detail the level of pain and discomfort and limitations in your day-to-day activities that your current injury is causing.
You may be seen by more than one doctor, including during an independent medical examination, for your current workplace injury. You need to be consistent in discussing any pre-existing injury and your current symptoms, level of pain, and disabilities.
One of the most important steps to building a strong claim is to be proactive and retain an experienced attorney as soon as possible after your injury if you have a pre-existing condition.
Have You Been Injured At Work?
If you've been injured on the job you need to speak with an experienced workers' compensation lawyer as soon as possible. Contact us online or call our Augusta office directly at 706.863.6600 to schedule your free consultation.