Does a Pre-Existing Condition Affect My Workers’ Comp Benefits?
Pre-existing conditions make even simple claims complex. So, you need an experienced Florida workers’ compensation attorney on your side.
We hear this question a lot. Approximately a quarter of Florida workers have a partial disability, usually due to an old injury or a chronic medical condition. Typically, disability is not a legal disability that is permanent and prevents the person from working. But it does restrict everyday activities. Asthmatics cannot walk long distances. People with bad knees cannot do so either, at least not without serious pain.
As outlined below, the law is clear in these situations. But this law could be applied in several different ways. Insurance companies often use pre-existing or non-work-related conditions to reduce or deny benefits to victims. This strategy usually works unless a Tampa workers’ compensation lawyer blocks this effort. Attorneys understand that work injury victims need every penny of their available lost wage replacement and medical bill payment benefits.
Florida Workers’ Compensation and Pre-Existing Conditions
Schoolyard bullies often pick on students who are weak in some way. It is wrong for schoolyard bullies to behave this way. It is also wrong for insurance companies to take advantage of physically or emotionally weak people and reduce their workers’ compensation benefits.
Pre-existing conditions affect both lost wage replacement and medical bill payment benefits. Work injury victims with pre-existing conditions usually cannot return to work as quickly, so they are entitled to additional lost wages. Furthermore, pre-existing conditions usually increase the severity of an injury, leading to higher medical bills.
Non-work-related or pre-existing conditions usually do not affect benefit levels. If a victim falls into one of these categories, a Tampa workers’ compensation lawyer can still obtain maximum benefits if the non-work-related condition:
- Does not materially affect the job-related illness or injury, or
- Is less than 50% responsible for the work-related condition.
Assume an explosion at a chemical plant causes multiple serious burns and other serious injuries. Jim has a bad knee, so he could not move fast enough to escape the blast range. His bad knee marginally contributed to the work-related injuries but did not substantially contribute to those injuries. Even if he was fully mobile, he might have been caught in the blast zone.
Admittedly, that is a very fine line. The case is even tougher if Jim’s bad knee caused him to lose his balance on an unsteady walkway, and he fell. Jim’s Tampa workers’ compensation lawyer must prove that the unsteady walkway, not the bad knee, substantially caused the fall. His case would be stronger if other workers, who had two good knees, also fell on that walkway.
According to the Florida Division of Workers’ Compensation (DWC), pre-existing condition workers’ compensation claims are also easier to establish if any one of the following factors is present:
- Employer knew about the condition,
- A doctor cleared the victim to return to work,
- Medical professionals, like doctors or physical therapists, managed the condition, and/or
- Victims took additional precautions to protect themselves.
Be aware that under any circumstances, it is a common tactic for insurers to attempt to deny or downplay injuries to avoid paying out on claims. If a pre-existing condition aggravated a work-related injury and a DWC Claims Examiner denies your request for benefits, you have the right to appeal that decision.
Count on a Hillsborough County Workers Compensation Lawyer
Injured workers have important legal and financial rights in Florida. For a free consultation with an experienced workers’ compensation lawyer in Tampa, contact the Rooth Law Firm. We routinely handle matters in Pinellas County and nearby jurisdictions.