Pre-Existing Conditions and Workers’ Compensation Claims - Front Range Injury Attorneys

Pre-Existing Conditions and Workers’ Compensation Claims

Pre-existing medical conditions or injuries are not uncommon among workers in Colorado who experience new workplace injuries. However, these pre-existing conditions can pose challenges when it comes to filing a workers’ compensation claim. Insurance companies may unfairly leverage these conditions as grounds for claim denial or to reduce the available financial benefits. To ensure you navigate these complexities successfully, it is crucial to consult with a skilled workers’ compensation attorney in Denver. An experienced work comp attorney can gather evidence and present a claim for benefits for injuries or illness caused by a workplace accident or condition, even if you have pre-existing medical conditions.

Explaining Pre-Existing Conditions

A pre-existing condition refers to any health or medical condition, illness, disease, or injury (including previously healed injuries) that an employee had before the workplace accident that is now the subject of the new insurance claim. Generally, a pre-existing condition becomes relevant during an insurance claim only if it affects the same part of the body as the new work injury. For example, if you sprain a muscle in your back where you already had a herniated disk. Common examples of pre-existing conditions include:

  • Healed broken bones
  • Muscle and ligament injuries
  • Back injuries
  • Herniated disks
  • Knee injuries
  • Elbow injuries
  • Repetitive motion injuries
  • Degenerative spine conditions
  • Sleep apnea
  • Lupus
  • Diabetes
  • Arthritis
  • Cancer
  • Pregnancy

Almost any injury or condition that existed before your most recent work accident can qualify as a pre-existing condition for insurance purposes. If you have a pre-existing injury that is relevant to your case, it is essential to disclose this information to the insurance company during your workers’ compensation claim. Failure to do so could potentially disqualify you from receiving benefits.

Does a Pre-Existing Injury Disqualify You from Workers’ Compensation?

No, a pre-existing condition does not disqualify you from receiving workers’ compensation benefits. Employers in Colorado must provide workers’ comp benefits to employees with pre-existing injuries if the work-related accident worsened, aggravated, or in any way affected the pre-existing condition. In other words, a pre-existing injury or condition does not bar a worker from utilizing workers’ comp insurance to cover medical expenses, lost wages, and other losses.

If an insurance company denies your workers’ compensation claim based on a pre-existing injury, you have the right to appeal the decision and request a reconsideration. Similarly, if the insurance company appears to have reduced the financial benefits due to a pre-existing condition, you can challenge their decision. By law, an insurer must provide full workers’ comp benefits, even if they exceed what they would have been without your pre-existing condition, unless they can prove that your work injury did not exacerbate your existing injury.

Managing a Claim Involving a Pre-Existing Condition

Insurance companies often seize any opportunity to devalue or deny your claim. However, there are steps you can take to protect your right to a fair financial recovery if you have a pre-existing condition. These steps include:

  1. Promptly filing your insurance claim.
  2. Informing your medical provider about your pre-existing condition.
  3. Obtaining medical documents that demonstrate how your new work injury is impacting your pre-existing condition.
  4. Adhering to your doctor’s treatment plan.
  5. Enlisting the services of an experienced attorney to advocate for you during the claims process.

While your right to receive workers’ compensation remains intact, having a pre-existing condition can make it more challenging to obtain fair financial benefits after a workplace accident in Colorado. If you face this obstacle, a workers’ compensation attorney in Denver can assist you in obtaining the necessary medical records for your insurance claim, as well as combating insurance bad faith tactics and handling claims paperwork on your behalf. An experienced attorney will go the extra mile to maximize your financial recovery following a workplace accident. Don’t hesitate to contact an attorney at Front Range Injury Attorneys today for a free consultation regarding your workers’ compensation case.

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