How Pre-Existing Conditions Can Impact a Workers’ Compensation Claim

For most people, a long-term physical condition, such as achy joints or a back issue, does not mean they cannot work. However, you may wonder, “What if my job aggravates the condition or makes it worse?”

Can you receive workers’ compensation in this situation?

Some people automatically believe the answer to this is “no.” If you believe this, you may be trying to “push through the pain” and continue working.

However, pre-existing conditions do not disqualify you from recovering workers’ compensation benefits. At Jonathan Perkins Injury Lawyers, our Connecticut work injury lawyers understand that these conditions can worsen because of your job duties. If this happens, we encourage you to contact our office to learn about your rights and legal options.

Understanding Connecticut Workers’ Compensation Claims

Workers’ compensation is a state-regulated insurance program that provides financial assistance and medical treatment to injured employees. It ensures that workers receive proper care and financial support during their recovery without the burden of medical bills.

In Connecticut, employers must carry workers’ compensation insurance, covering medical expenses and a portion of lost wages for injured workers. The state’s system is designed to benefit both employers and employees by providing prompt medical care and financial relief, eliminating the need for prolonged litigation.

To initiate a workers’ compensation claim in Connecticut, the injured worker must promptly notify their employer about the injury. The employer is then responsible for providing medical care and starting the claim process.

What is a Pre-existing Condition?

A pre-existing condition refers to a medical ailment or injury that an individual had before a specific event, such as a workplace accident or the start of an insurance policy. It can range from chronic diseases like diabetes or heart conditions to previous injuries like fractures or sprains.

Impact on Insurance and Claims

Often, pre-existing conditions become focal points in insurance discussions and claims. For instance, insurance companies might have specific stipulations regarding coverage for conditions before the policy begins. In workers’ compensation cases, a pre-existing condition can influence the evaluation of a claim.

Connecticut Law on Pre-existing Conditions

Connecticut law, especially regarding workers’ compensation, acknowledges pre-existing conditions. The essential criterion is whether a workplace injury “materially and substantially” aggravated the pre-existing condition. If a work-related accident exacerbates a prior condition significantly, the affected individual might be eligible for compensation for that aggravation, not the original condition itself.

The Challenge of Proving Aggravation

The primary challenge with pre-existing conditions in a workers’ compensation claim is proving that the workplace accident aggravated the condition. This is where medical evidence becomes crucial. Workers often need to provide the following:

• Medical records highlighting the status of the pre-existing condition before the workplace accident.
• Expert testimonials from physicians explaining how the work injury aggravated the pre-existing condition.

The Impact on Compensation Amounts

It’s important to note that pre-existing conditions don’t mean you won’t receive compensation. However, it might affect the amount you receive. Compensation will typically cover the aggravation or exacerbation of the condition, not the condition itself.

For example, if you had minor back pain previously and a workplace fall resulted in severe back issues, the workers’ compensation claim would cover the difference between your initial minor pain and the intensified pain post-accident.

Protecting Your Claim

If you have a pre-existing condition and are worried about its impact on your workers’ compensation claim in Connecticut, take these steps:

• Full Disclosure: Always be upfront about your medical history. Hiding it can jeopardize your claim.
• Seek Medical Evaluation: Immediately after a workplace injury, see a physician to document any changes or aggravations to your condition.
• Consult with an Expert: Consider working with a legal expert familiar with Connecticut’s workers’ compensation claim laws. They can guide you in presenting your claim, ensuring your rights are protected.

Understanding Your Rights to Workers’ Compensation with a Pre-Existing Condition

In Connecticut, while a pre-existing condition can add a layer of complexity to a workers’ compensation claim, it doesn’t necessarily bar you from receiving compensation. The key is understanding the nuances of the law and ensuring that you have the right evidence to support your claim.

At Jonathan Perkins Injury Lawyers, our workers’ compensation attorneys can review your situation and help you recover the benefits you are entitled to. The first step is contacting our office for a free initial consultation.