Can I receive workers’ comp benefits if I have a pre-existing condition?

Workers' Compensation Pre-Existing Condition StickerFew of us are lucky enough to get through life without any medical injuries or conditions. Even if our illnesses or previous injuries are under control, they may make us more likely to be hurt in future accidents.

Your pre-existing conditions do not, however, prevent you from getting fair workers’ compensation benefits if you are hurt at work in Massachusetts.

What Is a Pre-existing Condition?

As the term suggests, a pre-existing condition is any illness or injury that you had before getting hurt at work. Some examples of pre-existing conditions that may be made worse by your regular work responsibilities or a workplace accident include:

  • Carpal tunnel syndrome
  • Back injuries
  • Shoulder injuries
  • Neck injuries
  • Arm or hand injuries
  • Leg or foot injuries
  • Knee or elbow injuries
  • Mental health conditions including anxiety and depression
  • Hearing loss
  • Vision loss
  • Arthritis

Your employer’s workers’ compensation insurer will likely try to deny paying you the workers’ compensation benefits that you deserve if you have one of these, or any other, pre-existing condition.

You Can Recover for Your Work-Related Injury

Massachusetts law allows most workers to recover for work-related injuries. To protect your recovery, however, it is essential to understand your rights. Massachusetts workers have the right to recover for work-related injuries regardless of whether they have pre-existing conditions, but the cause of your pre-existing condition is important. Specifically:

  • If your pre-existing condition is a work-related injury that was compensable under Massachusetts workers’ compensation law, then you are eligible for workers’ compensation even if you aggravate that injury at a new job.
  • If your pre-existing condition is not a work-related injury, then you are eligible for workers’ compensation benefits if your subsequent work injury is a major cause of your current injury, disability, and need for medical attention. A major cause does not have to be a predominant cause. Workers’ compensation will pay only for your work-related injury and not for any disability or medical attention that you need because of your pre-existing condition.

Figuring out how much of your current condition is due to the new work-related injury rather than a pre-existing condition is often challenging. You will need evidence, including medical records, to convince the workers’ compensation insurance company that you deserve compensation for your injuries.

Why You Need a Workers’ Compensation Lawyer in Massachusetts

You have a lot at stake. Workers’ compensation may pay a portion of your lost income, all of your medical bills, and provide other benefits. Without workers’ compensation, you are on your own for all of these costs.

Since you had a pre-existing condition at the time of your work-related injury, you should expect the following potential complications in your current workers’ comp case:

  • The workers’ compensation insurance company may request an independent medical examination. You must comply with the insurance company’s request, but you should not stop seeing your own doctor for treatment.
  • The workers’ compensation insurer may say that you have a combination injury. A combination injury is one that includes both a pre-existing condition and your current work-related injury. If this happens, then you have the burden to prove that your work-related accident was a major reason for your current disability and medical care so that you can receive compensation.
  • Your workers’ comp claim may be denied. If this happens to you, then you should be ready to file a workers’ compensation appeal. Appeals can be complicated and may include different stages such as conciliation, conference, hearing, Reviewing Board proceedings, and an appeal to the Massachusetts Court of Appeals.

Our experienced Massachusetts workers’ comp lawyers will gather all evidence including but not limited to emergency room records, medical records, employment records, and incident reports. We will make persuasive arguments to help you get the benefits that you deserve either in negotiations with the workers’ comp insurer or through a formal appeal, if necessary.

Call us or fill out our online contact form to have us contact you today. Let us schedule a free consultation and discuss how to protect your rights.

 

John L. Keefe
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Founding Attorney, Massachusetts Social Security Disability Lawyer