Employees often go to work while managing or treating various injuries or conditions developed outside of work. However, a workplace incident or occupational exposure can exacerbate an employee’s existing injury or medical condition, including by intensifying pain or disability or necessitating prolonged or more intensive treatment. For example, a worker with mild back pain may suffer a herniated disc while at work, or they may tear a surgically repaired ligament.
Although injured employees may still qualify for workers’ compensation benefits for a condition aggravated by a workplace injury, obtaining benefits can become a more challenging process. That is especially true when insurers deny that the worker’s job played a role in worsening their pre-existing condition.
For more clarity, discuss your pre-existing injuries and workers’ compensation claim with a knowledgeable attorney at Kornbluth Ginsberg Law Group, P.A.
What Are the Rules for Pre-Existing Conditions?
Under North Carolina’s workers’ compensation system, an employee who reinjures or aggravates a pre-existing condition on the job may have the right to workers’ comp benefits. Pre-existing conditions do not disqualify workers from benefits when a work-related injury worsens the condition. However, a worker seeking benefits for a reinjured or aggravated pre-existing injury must establish a causal relationship between their worsened condition and their work.
In many cases, workers applying for benefits for a reinjured or aggravated pre-existing condition must present expert medical testimony to explain how a work accident or exposure reinjured or aggravated the condition and explain how the worker’s condition worsened. When applying for workers’ comp benefits for an aggravated pre-existing condition or prior injury, employees should disclose the condition while emphasizing that a workplace accident has made the condition worse.
What Is Significant Aggravation of a Pre-Existing Condition?
A significant aggravation of a pre-existing condition may occur when a workplace accident or exposure substantially worsens a previously existing injury or medical condition, causing a worker to experience a noticeably greater level of pain or increased impairment or to require more prolonged or more intensive treatment than they would have needed without the significant aggravation.
A worker may experience a significant aggravation of a pre-existing condition or previous injury when a work accident or occupational exposure causes:
- Increased pain or disability
- Substantial deterioration of overall health due to the pre-existing condition
- A need for new or changed medical treatment, including a longer course of treatment or more intensive types of treatment (for example, surgery instead of physical therapy)
What Should I Do if I Aggravate a Pre-Existing Condition at Work
First and foremost, you should report the injury in writing to your supervisor and request that they direct you for medical attention. Be specific about what happened: “I tripped and fell to the ground and landed on my left shoulder.” “I was lifting heavy boxes and felt a pop in my back.”
When you go to the doctor and if you are asked if you have any prior injuries, be honest. It is okay if you have a pre-existing injury. You should tell the Dr. that you did have a prior injury, you recovered and now, after this incident, you are feeling new pain. If you get work restrictions, give them to your employer.
DO NOT give a recorded statement to the insurance adjuster. If an adjuster calls and wants to take your statement, politely decline and contact an experienced workers’ compensation attorney to learn about your rights and what benefits you may be entitled to receive.
How Workers’ Comp Insurance Companies Handle Pre-Existing Conditions
Workers’ compensation insurers often use pre-existing conditions or injuries as a basis to deny an employee’s workers’ comp claim. In cases like this, insurance adjusters will like to take a recorded statement and get information that they can use to deny your claim.
Once again, DO NOT agree to giving any kind of statement to the insurance company before consulting with an experienced workers compensation attorney.
Insurers may deny that a workplace accident or exposure reinjured or aggravated a pre-existing condition. Alternatively, an insurer may argue that specific medical treatments or rehabilitation do not treat the “work portion” of an injury but instead treat the pre-existing condition.
As a result, injured workers who reinjure or aggravate pre-existing conditions at work need experienced legal counsel to help them stand up to the employer’s insurance company and demand the benefits they need and deserve.
Contact Kornbluth Ginsberg today or call 24/7 at 919-980-9895 for a free consultation with a skilled workers’ compensation attorney to discuss your specific situation. Our office is conveniently located at 3400 Croasdaile Drive, Suite 300. Durham, NC. We are ready to help you understand your legal options.
