How Pre-Existing Conditions Affect Workers' Compensation Cases

When you’ve been injured at work, you may already be under a lot of stress trying to recover and manage your medical care. If you also have a pre-existing condition, you might be worried about how this could affect your workers’ compensation case.

These concerns are common, and rightfully so—pre-existing conditions can impact how your claim is handled, how long the process takes, and the overall outcome. While it can feel like an uphill battle, having an experienced and compassionate lawyer on your side can make all the difference.

Let’s explore how pre-existing conditions can affect your workers' compensation case, especially here in Kent, Washington, and why having a knowledgeable lawyer who understands the details is crucial for success. Working with an experienced attorney like James W. Armstrong, Jr. Attorney at Law is only to your advantage in these types of cases.

What Is Workers' Compensation?

Before we look into how pre-existing conditions come into play, it’s helpful to understand what workers' compensation is and how it works. Workers' compensation is a system designed to provide benefits to employees who suffer work-related injuries or illnesses. These benefits can include medical treatment, wage replacement, and compensation for permanent disabilities.

In Washington State, workers’ compensation is generally handled through the Department of Labor and Industries (L&I). When you file a claim, your employer and their insurance company are typically responsible for covering these costs. However, it’s not always as straightforward as it sounds, especially when pre-existing conditions are involved.

How Pre-Existing Conditions Come Into Play

Pre-existing conditions can complicate a workers' compensation case in a few different ways. These are some of the primary issues that could arise:

1. The Aggravation of a Pre-Existing Condition

In many workers' compensation cases, especially if the injury happens in a situation that directly impacts a pre-existing condition, the injury can worsen that condition. For example, if you have an existing back issue and you lift something heavy at work, causing more pain to your back, your workers' compensation claim could address the aggravation of the pre-existing condition.

However, proving that your work injury aggravated the existing condition can be a challenge. Insurers might argue that your condition was always going to get worse on its own, regardless of the work incident. This is where an experienced workers' compensation lawyer can be incredibly helpful in gathering the necessary medical evidence to support your case.

2. The “Pre-Existing” Defense From Insurance Companies

One of the most common ways insurance companies attempt to limit their liability in workers' compensation cases is by arguing that a pre-existing condition is the true cause of your current injury or disability. In some cases, they may even try to deny your claim entirely, claiming the injury is unrelated to your work at all.

For instance, if you have a knee injury that predates your work accident, the insurance company might suggest that the knee injury was a result of your pre-existing condition and not your workplace accident. This is a tactic used to reduce or eliminate the amount of benefits they need to pay.

In Washington State, however, the law provides a safeguard against this tactic. According to L&I regulations, you can still receive workers' compensation benefits for a work-related injury that worsens or exacerbates a pre-existing condition.

As long as there’s a direct connection between the workplace incident and the worsening of the condition, the insurance company can’t simply deny your claim based on the pre-existence of an injury.

3. The Impact on Medical Treatment

When you have a pre-existing condition, the course of your medical treatment could be more complicated. Doctors may need to treat both the pre-existing condition and the new work injury simultaneously, which can make the recovery process longer and more involved. The medical bills for both conditions can also add up, which may affect your workers' compensation claim.

Additionally, if you’ve had previous treatment for the same condition, your doctors might need to differentiate between the effects of the new injury and any lingering effects from the pre-existing condition. This can sometimes lead to confusion or disagreements between medical professionals and the insurance company, which may cause delays in receiving benefits.

Having a workers' compensation lawyer who understands how to manage these medical issues can be crucial. They can work with your medical providers and make sure that all the necessary documentation is provided to L&I to demonstrate the impact of the work injury on your pre-existing condition.

4. Wage Loss Benefits and Pre-Existing Conditions

If your injury results in missed time at work, you may be entitled to wage replacement benefits. However, if you have a pre-existing condition that caused you to miss work before the new injury occurred, the insurance company might argue that your lost wages are not entirely due to the work injury.

For example, let’s say you had a shoulder condition that led to time off work a few months before your workplace injury. If that injury is now aggravated by the work incident, the insurance company may try to offset your lost wages, arguing that part of the missed time was due to the pre-existing issue, not the new injury.

Again, this is where an experienced lawyer can help. By carefully documenting your medical history and working with experts who can attest to the impact of the new injury on your ability to work, a dedicated lawyer can make sure you receive compensation.

Washington State Law and Pre-Existing Conditions

Washington state law provides protections for workers with pre-existing conditions. According to the Department of Labor and Industries, if a work injury causes a pre-existing condition to become worse, you are still entitled to benefits, even if the pre-existing condition contributed in some way to the injury.

This is often referred to as the "aggravation rule." Under this rule, workers’ compensation benefits can be awarded for the aggravation of a pre-existing condition, provided that the workplace injury is a direct contributing factor.

For example, if you have a herniated disc in your spine and your work accident worsens the condition, you may still be eligible for workers' compensation benefits related to the aggravation of that condition. Washington law makes it clear that workers are entitled to compensation for the full extent of the injury, even if a pre-existing condition played a role.

According to the National Institute for Occupational Safety and Health, workers with pre-existing conditions are more likely to experience long-term disability following an injury. Workers who already have musculoskeletal conditions, such as back or joint problems, are therefore at an increased risk of more severe injuries and longer recovery when experiencing trauma at work.

This underscores the importance of addressing pre-existing conditions in workers' compensation claims and assuring that these factors are properly considered.

Why a Compassionate Workers' Compensation Lawyer Makes a Difference

While the issues surrounding pre-existing conditions in workers' compensation claims can be intimidating, having the right legal representation can help you achieve a fair outcome. A compassionate lawyer understands the physical, emotional, and financial toll that a work injury can take on you and your family.

They’ll work tirelessly to make sure that your case is handled with care, paying close attention to the specifics of your condition and how it impacts your ability to work and your recovery process. Here’s how a dedicated lawyer can assist you throughout your case.

1. Protecting Your Rights

Your lawyer will make sure that your workers' compensation claim is filed properly and on time. They’ll make sure that all medical records and documentation are submitted accurately to demonstrate the extent of both your pre-existing condition and the new injury.

2. Negotiating With Insurance Companies

Insurance companies will do everything they can to minimize the amount they have to pay. A skilled lawyer will handle these negotiations, fighting to make sure that the insurance company recognizes the full scope of your injury, including how it’s related to your pre-existing condition. This allows you to focus on recovering while your lawyer works on securing fair compensation.

3. Providing Emotional Support

Work injuries can be emotionally taxing, especially when there’s uncertainty surrounding your recovery and finances. A compassionate lawyer will provide emotional support throughout the process, answering your questions and helping you feel empowered as you move forward with your case.

4. Assuring Fair Compensation

Your lawyer will work to make sure that you’re compensated for all aspects of your injury, including medical costs, lost wages, and any long-term disability. With their guidance, you can feel confident that you’re receiving benefits, even if pre-existing conditions are involved.

Reach Out Today

If you’re dealing with a work injury in Kent, Washington, and you have a pre-existing condition, it’s crucial to understand how this affects your workers' compensation case. With the right legal help, you can fight well for compensation.

Having a dedicated and compassionate lawyer on your side can make all the difference in ensuring that your case is handled properly. Contact Armstrong Law Offices, P.S. today for a consultation.