The pre-existing injury defense is used way too commonly by insurance companies to deny legitimate workers’ compensation claims. A pre-existing injury defense can be defeated by showing that the prior injuries had nothing to do with the current injury claim. Additionally, if the pre-existing injury has been aggravated or exacerbated by the accident at work then the claim would still be compensable. All of these opinions must be supported by the treating physician.
Pre-existing condition in its simplest terms just means that the injured worker, before they had an accident or became symptomatic with injuries or conditions from a workplace situation, that they had some type of medical situation, medical care, surgery, physical therapy, whatever it may be before coming into the workplace or coming into or having that accident that led to the injuries that are now at issue.
Very commonly the pre-existing defense or this issue deals with prior knee injuries, prior back injuries, shoulders et cetera. For example if someone had a back injury in a Work Comp claim and it came out either through the discovery either through medical records or testimony, whatever it may be that the person had had prior back surgeries in the past.
And what we look at and the way the law treats this is whether or not the person for our analysis purposes, is whether or not the person had any restrictions, limitations or under doctor’s care before, just before this event, this accident or whatever it may have been that caused the injury that’s now at issue.
If doesn’t matter if there were prior back injuries, prior back surgeries et cetera. If the person could do all of what was expected of them at work and they had no limitations at the time they got re-injured or injured again in the workplace then the pre-existing injury defense should fail, meaning it should be a compensable claim.
Typically we have to take the doctor’s deposition or get a written opinion from the doctor to figure out whether or not the pre-existing injuries themselves caused or contributed to the current injuries that are going on. Whether or not the symptoms, the injury itself that’s being complained of in the current Workers Comp case, whether or not any of that has any contribution from what happened at work.
It could be a brand new injury even if it is the same body part, the same level on the back. Additionally even if you have a pre-existing medical condition and that condition at the time of the accident that caused the current issues that are going on in the claim, if the accident itself aggravated or exacerbated a pre-existing condition then that too could be a compensable claim.
And again a lot of these terms, exacerbated, aggravated et cetera, they’re not common terms that everyone uses. It’s very specific to Workers Comp cases. If you have questions or concerns about whether or not your pre-existing medical conditions are the cause or maybe the reason for denial of a Workers Comp claim please give us a call.
Nomberg Law Firm. Birmingham, Alabama. 205-930-6900. NombergLaw.com is our website. We also can be found at Facebook and Twitter. Thank you.
If you have any questions or concerns about this issue or other issues on the law, please contact the Nomberg Law Firm at 205-769-4824.