The way that workers’ compensation treats pre-existing conditions reflects the difficulties that an employee might face when applying for benefits. Specifically, those benefits that are available for medical expenses and disabilities associated with a worsening of a pre-existing condition. However, a workers’ comp insurance carrier might deny coverage, for example, with an argument that the condition, and not the accident, caused the injury.

Employees in New York who have pre-existing medical conditions will have a better opportunity to receive benefits when they enlist the help of a New York City personal injury lawyer who understands this process. The attorneys at Friedman, Levy, Goldfarb & Green, P.C. have developed a deep understanding of this through more than 50 years of representing injured workers. We advocate for our clients so that they get the full amount they are entitled to receive. 

How Might an Employer and Workers’ Compensation Insurance Carrier Use a Pre-Existing Condition to Deny Benefits?

These claims are always a function of the facts of each specific situation. Employers and insurance companies might use facts in an employee’s personnel file in a variety of ways to deny or limit benefits. This is especially true if the employee has a pre-existing medical condition:

  • Employment records might show that the worker was already unable to perform certain tasks due to a pre-existing condition;
  • An insurer might argue that exacerbation of a pre-existing injury might have nothing to do with the specific accident that caused a different injury (e.g. a hand injury has no relation to the further deterioration of a previous leg injury);
  • Claims for compensation due to pain can be denied if the pain is related more to the pre-existing injury than the on-the-job accident;
  • An employee who goes to work before receiving medical clearance for a pre-existing condition might be challenged for not following a physician’s recommendations.

What Should a Worker with a Pre-Existing Condition Do When Seeking Workers’ Compensation Benefits?

An individual in New York State that who a pre-existing medical condition can take steps to improve their opportunity to receive benefits for a new injury. They can do this by paying very close attention to the procedures and details that are inherent in every claim. Specifically, the individual should promptly notify their employer of the accident and injuries.

Next, they should also file for workers’ compensation benefits as soon as is possible. Filing the claim quickly will prevent the employer and insurance carrier from arguing that delays in seeking treatment and benefits were the primary cause of the injuries or disability.

Further, the worker should always inform medical personnel that they will be filing a claim for workers’ compensation. They should also disclose pre-existing conditions to every physician who is consulted for treatment. Finally, they should strictly follow all instructions from a treating physician, including recommendations for therapy and follow-up appointments.

How Are Claims for Pre-existing Conditions and Workplace Injuries Apportioned in New York State?

Employees can be injured multiple times in separate workplace accidents, each of which might generate a legitimate claim. An individual, for example, might already be receiving benefits for a prior injury that would be categorized as a pre-existing condition. Then they suffer another injury in a subsequent accident. In New York State, the benefits must be allocated proportionately between the separate injuries. A knowledgeable New York City construction accident attorney who has experience in apportioning claims and benefits under these circumstances– is a worker’s best resource.

Contact Friedman, Levy, Goldfarb & Green, P.C. for Representation in Filing Workers’ Compensation Claims

The workers’ compensation lawyers at Friedman, Levy, Goldfarb & Green, P.C. utilize the firm’s 50 years of collective knowledge and experience for our clients. We assist and advocate for injured individuals to recover the largest benefits that they are entitled to receive. These would include benefits for injuries that occur when a worker is already suffering from a pre-existing medical condition. We represent individuals in Manhattan, the Bronx, Long Island, Brooklyn, and elsewhere in the New York City metropolitan area.

Please see our website or call us when you have questions about filing applications for workers’ compensation benefits when you have a pre-existing condition– regardless of whether your new injuries have made it worse. We will review your case to verify that your employer and its workers’ compensation insurer are not using your prior medical problems as an excuse to deny your benefits claims. Contact us today for a free case evaluation.

 Additional Resources:

  1. www.dol.gov: Workers’ Compensation. https://www.dol.gov/general/topic/workcomp
  2. www.ny.gov: Workers’ Compensation (On the Job Injury or Illness). http://www.wcb.ny.gov/content/main/onthejob/Discrimination.jsp
  3. www.ssa.gov: Disability Benefits. https://www.ssa.gov/benefits/disability/