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Are You Dealing with a Pre-Existing Condition and Workers’ Comp?
Workers’ compensation is meant to help workers injured on the job or those who develop an illness or condition due to ongoing adverse work conditions. When a worker with a pre-existing condition files a legitimate workers’ comp claim, they could face an uphill battle to collect workers’ compensation benefits. Employers and insurers may allege that a pre-existing condition is the cause of your injury to deny workers’ benefits.
If you find yourself in such an untenable situation, you must speak to an experienced Ohio workers’ compensation attorney from Schaffer & Associates. We have been helping people just like you for many years. We understand that absent from this current work injury, your pre-existing condition might never have been a significant problem in your life. We will fight for you and your future because we believe you deserve a strong advocate in your corner.
Could Your Toledo, OH Workers’ Compensation Claim Be Denied for a Pre-Existing Condition?
Any condition that pre-dates your work-related injury or illness may become an issue in your workers’ claim. As an example, suppose you have arthritis in your back that that you were not even aware of. You then sustained and slip and fall at work that causes the arthritis to become symptomatic.
Your workers’ compensation benefits will now be impacted on a much greater level than for a worker who had no history of back problems. The Bureau of Workers’ Compensation or your employer may argue that your condition is soley the result of arthritis and has nothing to do with your work-related injury.
A pre-existing condition is generally not covered under Ohio workers’ comp unless:
- Your pre-existing condition is “substantially aggravated” by your work injury. In this case, you must show that the aggravation is documented by objective diagnostic findings, objective test results or objective clinical findings. Such objective evidence includes the results from MRIs, Xrays, EMGs and other diagnostic tests. It can also include what your doctors finds during the course of the examination of you.
- Your pre-existing condition is accelerated by an injury. In this case, if you show that the pre-existing condition was made worse by an injury, then the pre-existing condition can be covered under your claim. For example, suppose you twist your knee at work that causes a meniscal tear that requires surgery for removal of a portion of the damaged meniscus. Your doctor will tell you that removing the meniscus will cause any underlying arthritis to be made much worse that will eventually require a knee replacement surgery. In this scenario, the arthritis was accelerated, or made much worse, that it ordinarily would have been.
As you can see, presenting evidence of a “substantial aggravation” can be complicated. You should never try to fight such a situation on your own—Schaffer & Associates can help you get the benefits you need and deserve.
How Could Work Aggravate a Pre-Existing Condition?
It is essential to understand that the mere present of a pre-existing condition doesn’t mean that the condition is causing your symptoms. For example, suppose you lift a heavy box that causes pain in your low back. You go to the emergency room and an Xray is done to make sure there are no broken bones but shows arthritis. Your doctor will typically diagnose you with a “low back strain” and not the arthritis. However, if you do not recover and develop pain that never goes away, then you may have aggravated the pre-existing arthritis. In this case, in order to have the arthritis covered you must not only show that your pain is now from the arthritis but also that the arthritis was aggravated and such aggravation is documented by objective diagnostic findings, test results or clinical findings.
What Does Aggravation of an Injury Mean?
Generally speaking, when the term “aggravation” of an injury is used in workers’ compensation claims, it means a pre-existing condition has been made worse by an injury. “Exacerbation” of a pre-existing condition means it is only temporarily made worse by the new injury—but that the worker will eventually be in the same physical condition they were before the new injury. “Recurrence” of a healed injury generally constitutes a separate workers’ compensation claim.
Aggravation of an injury means the new injury has worsened the underlying condition. Aggravation of an injury requires much more medical attention—and potentially be disabling. Because of this, a Bureau of Workers’ Compensation doctor or a doctor paid by your company to do an examination of you may argue the pre-existing condition was merely temporarily “exacerbated” rather than “aggravated.” The term “substantial aggravated” is defined by law. To win your case, as long as you show the aggravation is documented by objective diagnostic studies, objective test results, or objective clinical findings, the pre-existing condition will be covered under your claim.
What Should You Do if You Have a Pre-Existing Condition and Are Further Injured at Work?
While a pre-existing condition does not bar you from filing a workers’ compensation claim for a work-related injury or illness, it can make your claim much more complex. Since the Bureau of Workers’ Compensation and your employer are always looking for ways to deny or reduce a workers’ compensation claim, pre-existing conditions are one of the most common ways to deny a workers’ comp claim. To help ensure your workers’ comp benefits for a new work-related injury are not denied due to a pre-existing condition, make sure you do the following:
- Keep careful records of all medical treatments associated with your pre-existing condition as well as with your current workplace injury. You will likely be required to show that your new injury has made your pre-existing condition worse.
- Make sure you file your Toledo, Ohio workers’ compensation claim for your new injury promptly.
- If the Bureau of Workers Compensation or your employer require a medical examination, you must appear for the evaluation. If the Bureau of Workers’ Compensation or your employer require a medical release to obtain records of previous treatment, you are required to sign such a release. However, the Bureau of Workers’ Compensation and your employer are required to provide you with the medical records received pursuant to the release.
What Rights Do You Have as a Worker with a Pre-Existing Condition?
The most important right you have as a worker with a pre-existing condition in the state of Ohio is the right to have an experienced attorney help you get the benefits you are entitled to receive. While the state of Ohio typically rejects workers’ compensation claims related to a pre-existing condition, there are many variables involved. The highly skilled attorneys at Schaffer & Associates will work hard on your behalf to ensure your workers’ compensation claim is given the attention it deserves.
How Can a Schaffer & Associates Attorney Help with a Pre-Existing Condition and Workers’ Comp?
When you are dealing with a pre-existing condition and workers’ comp in Toledo, OH, you can find yourself hitting a brick wall at every turn. Speaking to our highly experienced Schaffer & Associates workers’ compensation attorneys as quickly as possible can put an entirely new light on your benefits claim. We will ensure you do not accidentally make a mistake that could put your workers’ comp benefits in jeopardy. We will carefully guide you through the entire process to ensure you receive the medical treatments and benefits you need and deserve. For a comprehensive evaluation of your Ohio workers’ compensation claim, contact Schaffer & Associates today!
