Posted by Larry Pitt & Associates, P.C. on 08/15/2017

How Do Pre-existing Conditions Affect a Pennsylvania Work Injury Claim?

How Do Pre-existing Conditions Affect a Pennsylvania Work Injury Claim?

Employers and their insurance companies will often try to show that your injuries didn’t happen because of a work injury – but rather because of a pre-existing condition. Employees should understand that there are perfectly legitimate ways to challenge the employer’s claim that you should be denied workers’ compensation benefits because of a pre-existing condition.

Common defenses to a pre-existing condition assertion

Employees can raise the following points:

  • The prior injury had healed. For example, you may have broken your arm when you were young. If properly treated, most breaks should heal within a year. If 10 or 20 years later, you break your arm in the same place again due to a slip and fall at work, the prior break should not affect your right to benefits. If your doctors can verify that the first break had healed and that it is the second break preventing you from working, then you claim 2/3 of your average weekly wages for the time you can’t work, plus any medical bills to repair the break to your arm.
  • The prior injury was to a different part of the anatomy. Sometimes, the employer just doesn’t have the facts correct. If you can show that the pre-existing condition is different than your current injury, then you can claim all the workers’ compensation you are allowed for medical bills and lost wages.
  • The current workplace accident worsened your condition. If a recent workplace accident worsened your medical status, then you have the right to seek and be compensated for medical treatment. You also have the right to some wage loss benefits. Those benefits will be reduced to reflect how much of the injury is due to the work accident and how much was due to the prior injury. For example, if you only had 80% range of motion in your knee before the accident and the workplace accident reduced that range of motion to 40%, then you should be paid a portion of your average weekly wage (times the 2/3 amount) for the period of time that you can’t work.

Additional considerations

Sometimes, the prior-existing condition was due to a previous workplace accident. If you tried to go back to work and reinjured the same part of your body, then you should claim full benefits. The prior injury may affect the ability to have your new injury classified as a permanent injury instead of a temporary injury. A permanent injury classification usually means that you get paid for a set number of weeks while a temporary injury means you get paid for the time you can’t work.

A prior personal injury award or SSDI award should not affect your ability to claim new benefits, but the evidence from those awards can be used to show you had a pre-existing condition. Pre-existing conditions are complicated cases that usually require that we work with your current and, if possible, your past medical doctors to determine which injuries are new and which are old.

At Larry Pitt & Associates, we have extensive experience working with doctors and physicians to determine which injuries were caused by your workplace accident and what your prognosis is. To discuss your case with a skilled Philadelphia workers’ compensation lawyer, please call us at 888.PITT.LAW or complete our contact form. We see employees who were injured in Philadelphia, Berks, Bucks, Chester, Delaware, and Montgomery Counties.

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