Pre-existing conditions make workers’ compensation claims harder to win, and anyone hurt in a workplace accident should contact an attorney quickly to discuss their case. Your employer or their insurer might argue that your pain and disability really stem from the prior accident, so your claim is denied. That would mean no benefits when you need them the most. Reach out to a Greenwood workers’ compensation lawyer to discuss your injury and what steps to take next. It is possible to receive benefits, but you should work with a law firm you can trust to submit a strong claim.
What to Know About Pre-Existing Conditions Workers’ Compensation Claims
Workers’ compensation benefits in South Carolina help workers who are injured on the job. Many of our clients are hurt in dramatic accidents, such as falling off a roof or getting burned in an explosion.
Others receive benefits because they came down with an occupational illness, such as respiratory problems.
However, pre-existing injuries make these claims more complicated. A question arises: Is the pain you feel the result of your present work conditions or a lingering effect of the prior injury? The answer matters when it comes to determining if you can receive workers’ compensation benefits.
Your employer is not responsible for paying compensation if you were hurt outside of work or before you started working for them. That is why your medical history matters.
When making a claim, your employer’s insurer will probably want to go over your medical history.
They might request 10 or even 20 years’ worth of records. The insurer will then go over your history with a magnifying glass to see if you suffered a similar injury before.
Does Workers Compensation Cover Pre-Existing Conditions?
Yes, but only in certain situations. Under South Carolina Code § 42-9-35, a worker must show that the subsequent injury aggravated their pre-existing condition, or that the pre-existing condition made the current injury worse. The standard of proof is by “preponderance of the evidence,” meaning it is more likely true than not.
Here are some common situations:
- You suffered a knee injury in a car accident while on vacation, and you feel lingering pain. However, when you fall at work, you slam the same knee into the ground. Now your pain is ten times worse, and you cannot even bend your knee or put any weight on the leg.
- You suffered a concussion a few years ago while playing soccer with your friends on the weekend. At work, an object falls off a shelf and lands on your head, causing a second concussion. You now have second impact syndrome, and your symptoms are much more intense. In fact, you can’t leave the house for months.
- You suffer from osteoporosis, which is a weakening of the bones. When you fall at work, you suffer multiple fractures that take a long time to heal.
In each of these examples, a workplace injury aggravated a pre-existing condition, or your pre-existing condition made it harder to heal after a workplace accident. These are situations where workers typically can receive workers’ compensation benefits despite a prior condition.
Why Was My Workers’ Comp Pre-Existing Condition Claim Denied?
Most likely, the insurer does not believe that your current pain and limitations are the result of the most recent workplace injury. Instead, they believe you are injured by the prior, pre-existing injury or condition and will deny your claim.
For example, they might dispute that you were even hurt in an accident at work. You will need additional documentation to prove that the accident happened the way you claimed, and your injuries are a result of this most recent accident. Talk with an attorney. We can help you find supporting witnesses and search for employer video of the workplace. This evidence can back up your story that a recent accident has aggravated the prior injury.
We might also dispute that you even had a pre-existing injury. For example, you could have wrenched your back 20 years ago, but it has fully healed. Your employer cannot continue to blame the injury from 20 years ago for why you feel pain today.
Pre-Existing Conditions and Healing from a Workplace Accident
Some pre-existing conditions make workers more susceptible to injury. These conditions also delay recovery.
For example, you might have suffered a concussion a couple of years earlier. Now you suffer a second concussion. People often have much more dramatic symptoms after a second brain injury.
Your medical team might be skeptical that you are not recovering as quickly as other people with similar injuries. They might even allege you are exaggerating your pain and try to force you back to work. Some workers are forced onto light duty even though they suffer from ongoing limitations and pain.
In situations like this, we might find medical evidence to show how your prior condition delays healing. That would mean improving your odds of receiving workers’ comp and increasing the duration for receiving necessary benefits.
How to Strengthen Your Workers’ Comp Claim
Your best strategy is to stay organized. Keep all medical records for your most recent workplace accident or illness. Also, write down any previous injuries you suffered in your life, whether at home or in previous jobs, and share this list with your lawyer.
Avoid hiding previous injuries, because the insurance companies will probably find out about them.
Instead, let your legal team review whether you can still receive benefits. We might want to see old medical records to fully understand the previous injuries you have suffered.
Speak with a Greenwood Workers’ Compensation Lawyer in a Free Consultation
Pre-existing conditions do not prevent workers from receiving benefits. However, many people do find the process more complicated, and too many watch as their claims are denied. McCravy, Newlon, Sturkie & Clardy is an experienced law firm with decades of workers’ compensation experience. We can help anyone making a pre-existing conditions workers’ compensation claim in South Carolina. Let us review your medical records and develop a strategy for maximizing the benefits you receive. Our consultations are free.