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How to File for Workers’ Comp When You Have a Pre-Existing Condition

Workers’ compensation in Florida provides a lifeline for workers hurt on the job or suffering from illnesses caused by working conditions. But the insurance companies who are supposed to pay benefits seem to deny every claim they receive. One of the most common reasons they refuse to pay is that they claim an injury or illness is not covered because it is a pre-existing condition.

If you have a pre-existing condition, claiming workers’ compensation is challenging, but not impossible. Our Fort Lauderdale workers’ compensation attorney offers some tips for filing a workers’ comp claim when you have a pre-existing condition.

What Exactly Constitutes a Pre-Existing Condition?

Essentially, a pre-existing condition is an impairment or illness that a patient had before the current injury. If a workplace accident or exposure to job conditions caused that condition to become much worse, then the employee could be entitled to workers’ compensation benefits.

However, if the pre-existing condition is a major contributing cause—responsible for 51% of the current disability—then that condition generally bars an employee from receiving workers’ compensation benefits for that disability.

So, how can a doctor tell the exact percentage of a condition that existed before the workplace conditions caused further injury? Doctors’ opinions must be based on sufficient data with the application of reliable principles and methods. An attorney can challenge the admissibility of a doctor’s testimony about the percentage of disability due to a pre-existing condition if that testimony does not meet applicable standards.

The Right Way to File a Claim When You Have a Pre-Existing Condition

There are several steps an injured employee can take to improve the ability to achieve success with a workers’ compensation claim involving a pre-existing injury:

  • Gather and maintain all medical records and any other evidence pertaining to the pre-existing injury. Anything that shows your level of impairment or recovery from the existing condition could be helpful.
  • Maintain all medical records pertaining to the current injury. Comparing the two sets of records should show how much of the condition can be attributed to the workplace accident.
  • File your claim promptly. Florida law gives you 30 days and after that time, your ability to claim benefits is lost.
  • Comply with the insurance company’s exam request. In most cases, workers’ comp insurers will request an independent medical examination (IME). If you fail to comply and provide records as requested, the insurer can deny your claim.
  • Consult an experienced Fort Lauderdale workers’ compensation attorney. A knowledgeable legal advisor can guide you through the process, help avoid damaging mistakes that could jeopardize your claim, and advocate on your behalf to fight for fair treatment.  

Insurance companies can be relentless when it comes to questioning. Frequently, they hope to get an employee to say something that gives the company grounds to deny the claim. This is one reason it is crucial to seek advice from an attorney before talking to the insurance company.

When a Workplace Injury Aggravates a Pre-Existing Condition, The Maus Law Firm Can Get the Benefits You Deserve

Just because you have a pre-existing injury or illness does not mean you are not entitled to workers’ compensation relief. However, you will have a difficult time pursuing your claim against an insurer that is looking for any justifiable reason to deny your claim. Having the Maus Law Firm on your side can make all the difference. To find out how we could help, contact us now for a free consultation. 



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