Can You Get Workers’ Comp for a Pre-Existing Injury?

Accidents and injuries can happen in any line of work. And when they do, workers’ compensation insurance provides a possible lifeline for mitigating your financial losses and getting assistance with medical expenses. But it’s not always a seamless process, and things get a bit trickier when a pre-existing injury is involved. 

Here’s what to know on the topic of pre-existing injury workers’ compensation, including some quick tips to help you strengthen your claim. 

What is Workers’ Compensation?

Workers’ compensation, or workers’ comp, is an insurance program for employees who have been injured on the job or suffered an occupational disease. Under the program, harmed employees are provided with financial support for managing wage loss and/or medical bills related to their condition. In return, they waive their right to file a lawsuit against their employer. 

So, can you get workers’ comp for a pre-existing injury? Yes, but you will have to prove that the work-related incident significantly worsened your injury.

Insurance companies often look for any excuse to deny or diminish workers’ comp claims. A pre-existing injury is low-hanging fruit in these instances, and it puts the burden on you to prove without reasonable doubt that your accident was a major contributing cause of your current, worsened health status. 

Because of the complexities of proving a pre-existing condition workers comp injury, it’s highly recommended that you work with a qualified attorney who can help you navigate the process and fight for your rights and a fair settlement. 

What Florida Law Says About Pre-Existing Injury Workers’ Compensation

Workers’ compensation programs are managed by the state. Here in Florida, workers’ comp claims that contain a pre-existing injury are decided in large part based on Statute §440.09, which dictates that the work-related injury must account for at least 50% of an individual’s current condition. This is a principle known as major contributing cause (MCC), and it can be used both in defense of your claim and – on the part of the insurance company – as a reason to deny you any benefits. 

Successfully proving your claim requires evidence that your injury meets this 50% rule. This is done through a doctor’s confirmation, and ideally, it will be thoroughly supported with medical records from before the work accident occurred. 

How to Strengthen Your Claim

While the answer to “can you get workers’ comp for a pre-existing injury?” is yes, it’s not always easy to achieve. 

Here are four actions you should definitely take in order to increase your chances of a successful pre-existing condition workers comp injury claim:

• Seek medical attention right away – The sooner you can get a physical examination of your post-accident injury, the better. A physician will be able to assess your current condition and provide an authoritative opinion on whether (a) it is worse than before and (b) your accident was a major contributing cause. 
• Gather all relevant medical records – Medical documentation is key for proving your claim. Collect all documentation from previous years related to your pre-existing injury, and be sure to hold on to any records of your post-accident care as well. 
• Report your injury to your employer – You have thirty (30) days under Florida law to notify your employer of a work injury. Don’t miss this window, or you won’t be able to file a workers’ comp claim regardless of standing. 
• Comply with all insurance company requests – Even if you think you have a strong claim, it’s ultimately up to the insurance company to decide whether you qualify for workers’ comp with a pre-existing injury. Promptly follow all requests, including following through with an insurance-ordered medical examination separate from the one you did with your own doctor. 

If you are in search of legal assistance for your claim, contact a Gordon & Partners workers’ compensation attorney for a free case evaluation. 

Our Work Injury Lawyers May Be Able to Help

Gordon & Partners attorneys have more than 200 years of combined experience working with Florida insurance companies on workers’ compensation, and we may be able to help you with your pre-existing condition workers’ comp injury claim. 

Our services are offered on a contingency fee basis, which means that you only pay if your claim is successful. While each case is unique, services may include:

• Claim investigation and assessment
• Collection of relevant medical records
• Communication with the insurance company, including settlement negotiations
• Representation through the appeals process 

A pre-existing injury is an obstacle to a workers’ compensation claim, but it is by no means a guarantee that you will be denied. Contact us today for your free case evaluation and find out what your next steps should be.