Does my pre-existing condition disqualify me for workers’ comp?

On Behalf of | Mar 9, 2020 | Workers' Compensation

After high school, most of our bodies are going downhill. From backs to necks to joints, virtually everyone has some pre-existing condition or degenerative process occurring. A pre-existing condition, however, does NOT defeat a worker’s compensation automatically.

Additionally, have a prior injury (whether work-related or not) does not necessarily defeat a work comp claim. If your job requires you to lift heavy objects, packages, equipment, chances are you’ve received an injury from them in the past. Maybe this injury was minor, you received treatment for it, physical therapy through your company health insurance. If you were injured again, and this time it’s much worse, your company may use the presence of a pre-existing condition to try to deny your workers’ compensation claim. The law, however, protects injured workers.

Wisconsin’s definition of qualifying injuries

The important distinction is that your work caused your injury or severely aggravated an existing injury beyond normal progression. There are a number of types of injuries to pre-existing conditions covered by Wisconsin’s workers’ compensation laws:

  • If there is clear damage from a workplace injury: The law defines a clear ‘breakage’ as a bodily change that can be definitively identified. This damage could include such injuries as a broken bone, a herniated disc, a snapped tendon, or a ligament tear. It doesn’t matter if the worker had a pre-existing condition when the workplace injury represents definite structural damage.
  • If the injury damages a pre-existing condition beyond normal deterioration: If your workplace injury worsens a pre-existing condition beyond its normal degenerative progression, you may be able to receive workers’ compensation.

For example, if a worker had some pre-injury knee pain (that may have required surgery at some point in their life), but a work injury caused that worker to have a knee surgery sooner than they otherwise would have needed to, a work comp claim should be pursued. Another example would be someone with periodic pre-injury treatment for low back pain, but then a work injury causes a severe increase in low back pain, along with radiating pain down their leg. In such an instance, the injury likely aggravated, accelerated, and precipitated the worker’s pre-existing low back condition beyond normal progression—resulting in a viable work comp claim.

Protecting your future

You deserve compensation for an injury that you incurred at work, even if it is an aggravation of an already present condition. If your workers’ compensation claim was denied due to a pre-existing condition, you need a lawyer with deep experience in workers’ compensation cases to advocate for your treatment and wage-loss compensation until you can get back on your feet.



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