The Impact of Pre-Existing Conditions on Workers’ Compensation Claims: How to Navigate Potential Challenges

Workers whose pre-existing condition is worsened or aggravated by an on-the-job injury face additional hurdles in securing workers’ compensation benefits. In Pennsylvania, workers’ compensation provides financial support and medical benefits to workers who suffer work-related injuries or illnesses. However, when a worker has a pre-existing condition, it can complicate filing a workers’ compensation claim. 

An injured employee may believe they have no rights to compensation. That is not the case. An experienced workers’ comp lawyer can help an injured employee navigate the complex workers’ compensation law and receive compensation notwithstanding a pre-existing condition. The best advice is to follow the law and have a workers’ compensation attorney at your side to protect your rights.

Understanding Pre-Existing Conditions

A pre-existing condition refers to a medical condition or injury before the work-related incident. It can range from chronic illnesses to previous injuries or disabilities. In Pennsylvania, having a pre-existing condition does not automatically disqualify an employee from receiving workers’ compensation benefits. However, it can influence the eligibility criteria, benefit calculations, and burden of proof in a workers’ compensation claim.

Delicate Balancing Act: Effect on Eligibility and Benefits

Filing for workers’ compensation is challenging, especially when a pre-existing medical history is involved. The complexity stems from the need to discern whether the workplace exacerbates an ongoing ailment or if the problem is a separate issue. Employers and insurers often delve deep into such cases to minimize liability.

If a work-related incident worsens a pre-existing condition, the affected worker may qualify for workers’ compensation benefits. Pennsylvania law acknowledges “occupational disease” when a worker’s environment exacerbates a pre-existing condition. Clear evidence linking the work incident to the aggravated condition is vital for a successful claim.

Establishing Causation

One of the critical aspects in such cases is establishing causation—the direct link between the workplace incident and the aggravation of the pre-existing condition. This process requires thorough medical documentation and expert opinion to prove that the work-related event substantially worsened the existing condition. Workers must gather comprehensive evidence and consult with medical professionals who can clearly connect the two.

Burden of Proof 

In cases involving pre-existing conditions, the burden of proof often lies with the injured worker to demonstrate that the work-related incident substantially worsened their pre-existing condition. This requires gathering compelling medical evidence, expert opinions, and documentation of the pre-existing condition’s status before and after the work-related incident. Working with an experienced workers’ compensation lawyer can significantly strengthen your case and ensure that all necessary evidence is presented effectively.

Navigating the Legal Challenges 

Navigating the challenges associated with pre-existing conditions in workers’ compensation claims requires a strategic approach. Working closely with an attorney specializing in workers’ compensation law is essential to understand Pennsylvania’s specific requirements and legal strategies. They can help gather medical records, consult with medical experts, and build a compelling case that establishes the causal relationship between the work-related incident and the aggravation of the pre-existing condition.

Tips for Success: 

To increase the chances of a successful workers’ compensation claim involving a pre-existing condition, it is crucial to:

  • Report the work-related incident immediately to your employer and seek prompt medical attention.
  • Document any changes or worsening of your pre-existing condition after the work-related incident.
  • Keep detailed records of all medical treatments, prescriptions, and therapy related to the aggravated condition.
  • Consult with an experienced workers’ compensation attorney who can guide you through the process and protect your rights.
  • Follow all recommended medical treatments and attend scheduled medical appointments to demonstrate your commitment to recovery.

Don’t Give Up on Your Right to Workers’ Compensation

Although pre-existing conditions can complicate workers’ compensation claims, they shouldn’t discourage injured workers from seeking the benefits owed to them. Workers can tackle the challenges ahead and bolster their cases by working with a skilled attorney and gaining knowledge about how these conditions can affect claims in Pennsylvania. 

If you’ve sustained a work-related injury that has worsened a pre-existing condition, you may still be eligible for compensation and should explore your options with an experienced legal professional.

The experienced and knowledgeable workers’ compensation attorneys at Larry Pitt & Associates have decades of experience protecting the rights of injured workers and collecting the compensation they deserve for their on-the-job injuries.

If you need help with any aspect of your workers’ compensation claim, contact a knowledgeable Philadelphia workers’ compensation lawyer at Larry Pitt & Associates, P.C. We can help you navigate the workers’ compensation process and obtain all the benefits to which you are entitled. For a free consultation, call us at 888-PITT-LAW or complete our online contact form.



Larry Pitt

Larry Pitt

If you've been injured, Larry Pitt & Associates can provide you with the legal assistance and representation you need to ensure that justice is served. Get in touch today for a free consultation to discuss your case. Whether it’s a work injury, auto accident, medical malpractice, or any other injury-related matter, we are here to help make sure your rights and interests are respected. We understand the stress and frustration that can accompany an injury, and we are committed to providing thorough legal guidance and support throughout the entire process.