A Guide to Pre-Existing Injuries and Workers’ Compensation

The workers’ compensation system provides medical treatment and partial wage replacement should a worker suffer from an occupational injury within the course and scope of their employment.

The workers’ compensation scheme recognizes that jobs may cause injury or distress to workers. Indeed, even jobs considered less physical can cause some forms of injuries like back pains and carpal tunnel injuries. Therefore, every state must maintain a workers’ compensation program to cover employees with injuries.

Employees with Pre-Existing Conditions

Employees with pre-existing conditions may suffer an aggravation in the workplace, and it can be hard to determine compensation benefits resulting from such injuries. Employers and insurance carriers are often at loggerheads with workplace injury victims when determining benefits due for such injuries. 

Workers’ compensation benefits can vary widely depending on state jurisdictions and the rules and regulations imposed.

So, when a worker files for a workers’ compensation benefit, a medical professional must assess the injured worker to determine the extent and nature of injuries – and whether these injuries affect a pre-existing condition.

Every state uses different guidelines when determining workers’ compensation. These classifications must consider whether the injury is temporary, permanent, partial, or total. A permanent or total injury is the most severe form of work injury.

The Challenge of Pre-Existing Injuries and Workers Comp

According to the SC Workers’ Compensation Act, if an injured employee is completely unable to work because of an injury, the employer must pay two-thirds of the employee’s total weekly wages during this period of total disability. This compensation shall not be less than seventy-five dollars a week and should not exceed the injured worker’s total weekly wages.

So, suppose you suffer from some pre-existing condition like carpal tunnel syndrome before you’re employed and you work in manufacturing. If that condition is worsened because of your work activities, determining the medical and compensation benefits you’re entitled to becomes complex. That’s because you must prove with medical evidence that the condition was aggravated, which is sometimes not as simple as it might sound, and the law provides that the insurance company could  receive credit for any previous impairment that condition may have caused.  

What to Know About Workers’ Compensation for Pre-Existing Conditions?

A compensation insurance company will often deny any benefit payments to employees who suffer workplace injuries that aggravate a pre-existing condition. The insurance firm will often not voluntarily cover claims for pre-existing conditions. It is likely that an injured worker will have to collect and present medical evidence to the Workers’ Compensation Commission at a hearing in order to obtain such benefits.

So, a qualified medical professional must examine the injury and provide evidence on the nature and extent of workplace injury in case of a dispute regarding workers’ compensation benefits for a pre-existing condition. Specifically-worded medical opinions must be provided. In many cases, a lawyer with knowledge and experience in these matters will be necessary to obtain properly-worded opinions to present at a hearing and/or negotiate a reasonable settlement of the claim.

Workers’ compensation attorneys like ours at Williams & Kamb can be a big help in navigating the possibility of a claim. Contact Williams & Kamb, LLC to discuss a worker’s compensation claim involving a pre-existing condition.