When a worker suffers an injury on the job, the Pennsylvania workers' compensation system is designed to help by providing medical benefits and wage replacement. However, if you have a pre-existing condition, you may wonder whether it will impact your workers' comp claim. Pre-existing conditions can make claims more difficult, but that doesn’t automatically disqualify you from receiving benefits. We explain how pre-existing conditions are treated under Pennsylvania workers' compensation laws and what you need to know to protect your rights.

For best practice, we encourage you to seek legal advice. Brandon J. Broderick, Attorney at Law has a team of Pennsylvania workers comp lawyers who can help you. Call us today to discuss your claim and injuries.

Understanding Pre-Existing Conditions in Workers' Compensation

What Is a Pre-Existing Condition?

A pre-existing condition is any medical issue or injury that existed before a new workplace injury occurred. This could include conditions like arthritis, prior back injuries, or chronic pain. When a worker with a pre-existing condition suffers a new injury or aggravates an existing injury on the job, questions can arise about the extent of the workplace's contribution to the injury and how much compensation should be provided.

How Workers’ Compensation in PA Deals with Pre-Existing Conditions

Pennsylvania's workers' compensation system is a no-fault system, meaning workers are entitled to benefits for work-related injuries regardless of who caused the injury. However, when it comes to pre-existing conditions, the key question is whether the work injury aggravated or worsened the pre-existing condition.

If the pre-existing condition was made worse by a work-related accident or activity, the injured worker may still be eligible for benefits. Pennsylvania workers' compensation law requires employers to provide benefits if an injury or medical condition was aggravated, accelerated, or exacerbated by work.

For example, if a worker has a history of back problems but experiences a new injury at work that worsens their condition, the worker may be eligible to receive workers' compensation benefits. The pre-existing condition does not bar them from filing a claim, but it does add complexity to proving the extent of the new injury.

Specific Pennsylvania Rules and Regulations

Aggravation of Pre-Existing Conditions

Under Pennsylvania law, workers are entitled to benefits if a work-related injury aggravates a pre-existing condition. This is known as the "aggravation rule." In these cases, the burden is on the injured worker to show that their workplace injury made the pre-existing condition worse.

A successful claim may require medical evidence demonstrating how the injury or work activity impacted the pre-existing condition. The aggravation must be significant enough that the worker requires medical treatment or is unable to work as a result.

Medical Evidence and Pre-Existing Conditions

When you have a pre-existing condition, one of the most important factors in your workers' compensation claim is medical evidence. Your doctor will play a key role in determining whether your workplace injury aggravated your pre-existing condition. Medical records, including both old and new records, will be used to establish the extent of the aggravation or worsening of your condition.

It's essential to be open and honest about your medical history when filing a workers' comp claim. Failing to disclose a pre-existing condition could lead to a denied claim or reduce your credibility in the eyes of your employer's insurance company. You should also ensure that your doctor provides clear documentation on how your workplace injury worsened your pre-existing condition.

Common Pre-Existing Conditions That Affect Claims

Some common pre-existing conditions that may come into play in workers' compensation claims include:

• Back injuries: Workers who have suffered from chronic back pain or previous back injuries often experience aggravation of these conditions due to lifting, bending, or falling at work.
• Arthritis: Employees with arthritis may experience flare-ups or worsening symptoms if their job requires repetitive movements or puts strain on their joints.
• Heart conditions: Pre-existing heart conditions can be aggravated by work stress or physical activity, particularly in high-stress or physically demanding jobs.

While these pre-existing conditions may complicate a workers' comp claim, they do not prevent you from receiving benefits if the condition was made worse by a work-related injury or activity.

Potential Challenges in Filing a Claim with a Pre-Existing Condition

Insurance Company Scrutiny

When a pre-existing condition is involved in a workers' compensation claim, insurance companies often scrutinize the circumstances more thoroughly. They may attempt to argue that the injury was caused solely by the pre-existing condition and not by any work-related activities. This could lead to delays, disputes, or even denials of your claim.

In these cases, having strong medical documentation and legal representation can help protect your rights. A workers' compensation attorney can help you gather the necessary evidence and advocate on your behalf if the insurance company disputes your claim.

Independent Medical Examinations (IMEs)

If your employer's insurance company disputes the extent of your injury, they may require you to undergo an Independent Medical Examination (IME). An IME is conducted by a doctor chosen by the insurance company and is used to evaluate the extent of your injury and the role of your pre-existing condition.

IMEs can be challenging, as the doctor performing the exam may not be impartial. It's essential to prepare for an IME and ensure that you have your own medical records and documentation that clearly demonstrate how your work injury aggravated your pre-existing condition.

Call Brandon J. Broderick For Legal Help

Navigating Pennsylvania workers’ comp claims can be challenging. Fortunately, you don't need to do it alone. The experienced workers comp lawyers at Brandon J. Broderick, Attorney at Law, are available 24/7 to help you understand your legal options, gather necessary evidence, and build a strong case to secure the settlement you deserve.

Contact us now for a free legal review.