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An injury at work is stressful enough without the added worry of your medical history. Many people assume that a pre-existing condition will automatically disqualify them from receiving benefits after a work injury. As former Workers’ Compensation Commissioners, we at Mickle & Bass Law Firm know this is a common misconception. The truth is, having a prior medical condition does not bar you from filing a workers’ compensation claim. We work to ensure the focus remains on how the job incident aggravated your condition, not on your past medical history.
The workers’ compensation system operates under a legal principle that we must “take the worker as we find them.” This means an employer accepts an employee with all their current health issues, known or unknown. If a work injury aggravates or worsens a pre-existing condition, the employer and their insurer are generally responsible for the treatment and disability related to that specific aggravation. Our job is to prove this causal link clearly.
A key factor in securing a successful workers’ compensation claim is proving the work incident caused a substantial change to your pre-existing condition. This is a common defense insurers use to try and deny claims or limit benefits. We focus on objective medical evidence, like new diagnostic test results and physician testimony, to show your condition is now measurably worse due to the work injury. Simply having a prior issue is never a basis for outright denial.
Insurance companies frequently attempt to attribute your current disability entirely to your pre-existing condition to avoid paying benefits. They may argue your injury was merely an “exacerbation”—a temporary flare-up—rather than an “aggravation”—a permanent worsening. The attorneys at Mickle & Bass Law Firm anticipate these tactics. We counter their arguments by gathering robust evidence and leverage our experience as former Commissioners to protect your right to full and fair compensation.
Thorough medical documentation is essential in any workers’ compensation claim, but it is especially critical when a pre-existing condition is involved. We strongly advise full transparency about your medical history from the start. We work closely with your treating doctors to ensure they accurately document how the new work injury changed your baseline health, providing the clear, objective evidence needed to defeat the insurer’s attempts at denial or benefit reduction.
In many workers’ compensation systems, if a work injury aggravates a prior condition, the resulting permanent disability benefits may be subject to apportionment. This means that a portion of the disability is assigned to the pre-existing condition, and the employer is only liable for the percentage caused by the work injury. We challenge unfair apportionment decisions by focusing on objective medical evidence that isolates the disability percentage directly attributable to the job incident.
A significant legal distinction often arises between a sudden, accidental work injury (like a fall) and the slow progression of an occupational disease or degenerative pre-existing condition (like arthritis). While workers’ compensation generally covers the aggravation of both, the burden of proof differs. For degenerative conditions, we must show that specific work activities or the workplace environment substantially accelerated the condition beyond its natural progression.
Some injured workers worry that disclosing a prior injury will hurt their current case, leading them to conceal information. However, concealing a pre-existing condition can severely damage your credibility and provide the insurer with grounds to dispute your entire claim, regardless of merit. We recommend full disclosure, allowing us to proactively address the history and use it to better structure your workers’ compensation claim.
Workers’ compensation law is highly specialized, and claims involving a pre-existing condition are the most complex. Insurance companies have legal teams dedicated to minimizing their payout. Our team at Mickle & Bass Law Firm includes former Workers’ Compensation Commissioners who possess unparalleled knowledge of the system’s inner workings, rules, and common pitfalls, giving you a powerful strategic advantage.
Navigating a workers’ compensation claim with a pre-existing condition can feel like an overwhelming challenge, but you do not have to face the insurance companies alone. At Mickle & Bass Law Firm, we use our decades of focused experience to ensure your rights are upheld and you receive the full compensation you are due. We believe every injured worker deserves an advocate. Contact us today for a free, confidential consultation to discuss your specific situation, or visit our website to learn more about our commitment to injured workers.