Workers' compensation claims are very important and are affected by various conditions. If there are any pre-existing conditions, then they might affect the claims significantly, so we must understand these factors clearly. Understanding how pre-existing conditions affect workplace compensation is important for both the employees and the employers.
 
Therefore, in this article, we will discuss the nuances of pre-existing conditions and their impacts on workers compensation claims. Let’s begin our discussion to get a comprehensive idea about what to expect and how to navigate the issues of compensation if there are any pre-existing injuries.

 

Understanding Pre-Existing Conditions

 
A pre-existing condition is a health issue or a medical condition that existed before a workplace injury occurred. So, this might be the condition due to chronic illness such as diabetes or any other issues. However, not every pre-existing condition may affect your injury claims, but most of the conditions will do so. Therefore, you must have an idea about how to deal with such issues while filing a worker's compensation claim.
 

What is the Concept of Aggravation and New Injury?

 
If a worker has a pre-existing condition, the main concern is whether the workplace incident aggravated it or caused a new injury. Aggravation refers to a situation when the pre-existing condition is worsened due to a workplace incident. For instance, if a worker has a back issue and flares up by lifting a heavy material, then it is considered an aggravating condition.
On the other hand, a new injury is an entirely separate injury that occurs regardless of any pre-existing conditions. It is important to determine whether a case is based on aggravation or a new injury, and this is done through a medical evaluation and expert opinions.
 

What is the Legal Framework for Pre-Existing Conditions?

 
In Vermont’s worker’s compensation laws, there is a special provision for pre-existing conditions. It provides benefits for employees who suffer work-related injuries and new injuries, as well as for people with pre-existing conditions. The presence of a pre-existing condition does not automatically disqualify an employee from receiving benefits.
 
If the workplace accident aggravates or exacerbates the pre-existing condition, then it will be considered a new injury, and workers' compensation will be awarded in this case. However, the worker has to prove the injury with medical evidence and all other proof in their compensation claims.

 

What is the Role of Medical Evidence in Pre-Existing Conditions?

 
Medical evidence plays a significant role in worker’s compensation claims, especially when it involves pre-existing conditions. If accurate and thorough documentation of the employee’s medical history is available, it will be easier to file compensation claims. This documentation should include medical records, diagnostic tests, expert testimony, and other reports from medical professionals.
 
The medical history will clearly connect the workplace incident to the aggravated injury. So, employers and insurance companies will scrutinize the claims and check the pre-existing medical records to fix a compensation amount.

 

What are the Challenges for Employees with Pre-Existing Conditions?

 
If an employee is facing a pre-existing condition, then they might face several challenges while filing the worker’s compensation. We must understand some of the common challenges, which are as follows:
 
  • Employers and insurance companies will be more scrutinized of the employee’s conditions and rigorously examine them. They might argue that the injury is unrelated to the work and thus affect the compensation claims.
  • The burden of proof is on the employee to prove that the workplace incident aggravated their injury. It can be a complex and lengthy process for the employee and requires substantial medical evidence.
  • It is also possible that due to pre-existing conditions, claims procedures will be delayed, and there is a high potential for them to be denied.

 

What Strategies Can Employees Adopt to Deal with Pre-Existing Medical Conditions in Workers' Compensation?

 
  • Report the injury on time. Delaying reporting an injury can raise questions about the validity of the claims.
  • It would help if you documented everything about the injury so that you have a record of every event.
  • You must seek medical attention, which will ensure that you have a document to showcase your injury and will also be good for your health.
  • The last and most crucial strategy is to consult an experienced attorney who can legally solve your problems and guide you through the legal journey of workers' compensation.
 
Pre-existing conditions can add a layer of complexity to your case, but it is solvable with the help of a well-planned strategy and an experienced lawyer. So, if you are in such a situation, you must consult an experienced attorney and claim your compensation.