Anytime 24/7—Hablamos Español

Can You Get Workers’ Comp for a Preexisting Condition?

A lot of people assume that having a preexisting condition automatically disqualifies them from workers’ compensation benefits, but that’s not necessarily how it works in New York. In many cases, what matters isn’t whether a condition existed before the injury, but whether your job made it worse.

Read more about how these claims work and what to expect if you decide to file below.

What Is Considered a Preexisting Injury?

A preexisting injury or condition refers to a medical issue that existed before your workplace injury took place. It could be something you’ve dealt with for years, from arthritis to a previous back injury, asthma, or a chronic health condition. It can also include injuries from prior accidents that’ve never fully healed.

Common Examples of Preexisting Conditions

Many workers’ compensation claims involve conditions that were already present before a workplace injury or before job duties caused them to deteriorate. Some of the more common examples include:

Back and Neck Injuries: Herniated disks or previous neck injuries can worsen due to repeated lifting or other physically demanding tasks.
Arthritis and Joint Conditions: Repetitive motion or prolonged physical stress on the joints can result in increased pain and stiffness.
Respiratory Conditions: Asthma, chronic bronchitis, and related conditions can worsen with ongoing exposure to dust, fumes, chemicals, or other airborne irritants on the job.
Heart Conditions: Strenuous physical work or prolonged stress in the workplace can sometimes aggravate underlying cardiovascular problems.
Mental Health Conditions: Anxiety, depression, post-traumatic stress disorder (PTSD), and other mental health conditions can become harder to manage following a traumatic workplace event or ongoing job pressure.

Can You Get Workers’ Comp for a Preexisting Condition?

Yes, in many situations, New York workers’ compensation benefits may be available when a work-related activity aggravates or accelerates a preexisting condition. For example, someone with a history of back problems may still have a valid claim if repeatedly bending over at work makes their pain worse or leads to an additional injury.

With workers’ compensation, you don’t have to prove your employer did something wrong since it’s generally a no-fault system. What matters is whether your work contributed to the worsening of your preexisting condition.

How Does New York Workers’ Comp Handle Preexisting Conditions?

Simply put, New York’s workers’ compensation system recognizes that some employees already have prior injuries or health issues before starting a job. Because of that, as mentioned above, the existence of a preexisting condition doesn’t automatically disqualify someone from receiving benefits.

In these particular cases, insurance carriers will typically take a closer look at medical records to determine what symptoms existed before the injury and whether there’s evidence that shows that the work caused a meaningful change in the worker’s condition.

What Is Apportionment in Workers’ Compensation?

Apportionment comes up when there’s a dispute about how much of a worker’s disability is related to a preexisting condition and how much is related to the workplace injury. In other words, the insurance company may argue that some portion of the worker’s limitations existed before the work-related aggravation occurred.

What Evidence Is Needed to Prove That Work Aggravated a Preexisting Condition?

In most cases, the strongest claims are those supported by medical evidence that shows a clear change in the worker’s condition. Medical records are one of the best ways to establish a baseline because they document symptoms and physical limitations as they existed at the time before the workplace injury. Records created afterward can then reflect whether new symptoms developed or additional treatment became necessary.

Physician opinions also carry a lot of weight. A doctor who can draw a direct line between specific job duties and the worsening condition will generally make a more compelling case than one who simply notes that the condition deteriorated.

Diagnostic imaging, work restrictions, accident reports, and employment records can all help establish a connection between the worker’s job and the aggravated condition, depending on the circumstances.

Common Challenges When Filing a Workers’ Comp Claim with a Preexisting Condition

Claims involving preexisting conditions tend to receive more scrutiny because there’s already documented medical history for the insurance company to examine. One of the most common disputes involves causation. An insurance carrier may argue that the worker’s symptoms would have worsened regardless of their job duties because their underlying condition was already progressing.

Insurers also sometimes question whether the aggravation is actually connected to work if weeks or months pass before a worker reports that their condition has worsened.

What Should I Do If My Workers’ Compensation Claim Is Denied?

To start, it’s important to keep in mind that a denial doesn’t necessarily mean the end of your claim. Workers’ compensation claims involving preexisting conditions are denied relatively often, especially if there’s a disagreement about what caused the worker’s current symptoms.

If your claim is denied, your attorney will likely start by reviewing the explanation provided by the insurance carrier to determine what additional evidence may be needed to support your case. Most claims can be challenged through the New York workers’ compensation appeals process, particularly when additional medical evidence supports the worker’s position.

Key Takeaways

A preexisting condition doesn’t automatically disqualify you from New York’s workers’ compensation system.

Workers may qualify for benefits if their job duties or a workplace injury worsened or accelerated an existing condition.

Records that show a clear change in your condition before and after the workplace injury are what tend to make or break these claims.

Speak With an Experienced New York Workers’ Compensation Attorney Today!

If your job aggravated a pre-existing injury or medical condition, you may still have options under New York’s workers’ compensation law. At Field Law Group, we help injured workers understand their rights and pursue the benefits they be entitled to receive.

Whether you’re filing an initial claim or dealing with a denial, our team can help you evaluate your situation and determine the next steps. Call 212-739-7278 or contact us today to schedule a consultation and learn more about your legal options.

About the Firm: With over a decade of experience, Field Law Group has been helping personal injury victims across New York since 2013. We’re dedicated to protecting the rights of accident victims and fighting to get them the compensation they deserve.

MILLIONS RECOVERED FOR OUR CLIENTS!

No Fees Unless We Get You Compensation.

Don't Wait Another Minute

Understanding your rights and how you can recover compensation under the law is important. At Field Law Group, there is no downtime. We are here for our clients whenever they need us.

Schedule Your FREE Consultation Today!

17 State Street, Floor 40
New York, New York 10004

Free Consultation

212.739.7278
Anytime 24/7
Hablamos Español

Quick Links

Home About Us Practice Areas Areas Served Testimonials Contact Blog

This website contains attorney advertising. Prior results do not guarantee a similar outcome, see Disclaimer | Designed & Developed by PostcardMania