How Worsening Pre-Existing Conditions Impact L&I Claim

Suffering an injury at work can happen as a result of an employer’s negligence and mistakes, and filing a workers’ compensation claim seems like a straightforward process. However, if you have pre-existing conditions, you may find it more challenging to obtain the compensation you believe you are owed.

It is critical to understand how the aggravation of a pre-existing condition for a workers’ compensation claim impacts your ability to file and recover your losses. For specific help with your case, turn to our workers’ compensation attorney for clarification on your rights after a work-related injury.

What Is Aggravation of a Pre-Existing Condition in L&I?

Under Washington state law, WAC 296-27-01103, an employee may file a claim for compensation for losses suffered in an aggravation of a pre-existing injury or illness that occurs while within the work environment. Generally speaking, a pre-existing condition has to have worsened as a result of the workplace incident in order to receive compensation for it.

Aggravation is not just a coincidence. To file a workers’ compensation claim, the injury or illness must have made the pre-existing condition worse to some degree beyond what is expected to be a natural progression of the illness or expected continued limitations from the initial injury.

This applies to any injury or illness that predates the workplace injury. In some situations, it may be an obvious injury, such as a broken bone or herniated disc. Other times, a pre-existing condition could be less obvious, such as carpal tunnel or post-traumatic stress disorder.

How Pre-Existing Conditions Affect the L&I Workers’ Compensation Amount

A pre-existing condition may impact the value of what you receive from a workers’ compensation claim. Typically, pre-existing conditions aggravated by a workplace injury will receive compensation related just to the worsening of the injury. However, there are limitations to this.

1. It is possible that L&I will deny workers’ compensation claims that involve a pre-existing condition if they assert the condition is purely degenerative or congenital.
2. In some situations, L&I that are degenerative can be worsened by work-related tasks. For example, some of the most common include the shoulders, spinal column, and knees. If you are able to work but the work activity leads to the development of arthritis or tears in shoulder tissues, workers’ comp may cover those losses.

Unlike in a new injury, where workers’ compensation insurance covers all of the medical care and lost time at work from that injury, the Department or Self-Insurer may attempt to not cover a previous injury that is worsening, as would be expected if the workplace accident was not the direct cause of that worsening.

What is a Good Way to Report How the Incident Affected the Pre-Existing Condition?

If you have a previous injury that was made worse by an accident at work, take every step required.

• Report the injury to your supervisor.
• Get medical care as soon as possible.
• Follow the doctor’s requirements.
• File a claim with the insurance company.

However, you also need to provide information about your previous injury, starting with your doctors. As an injured employee, your doctor needs to know your medical history to provide proper care to you and administer medical treatment associated with your health. If you were in a car accident a year ago and had back injuries, the exacerbation of those injuries in a new fall at work could mean advancing your care to surgery.

Before or shortly after you file your workers’ compensation claim, alert your attorney to your pre-existing condition. Be honest and do not hide this information. It will be found later in your medical records if you hide it. That will make L&I believe your claim could be false or misleading, leading to a denial. Instead, work with your law firm to be sure your condition is carefully understood and reported as a component of your workplace accident claim.

Why Clients Choose McPartland Law Offices

Our intricate knowledge of the workers’ compensation system enables McPartland Law Office to be the law firm you want on your side when pursuing workers’ comp benefits. We know how to protect your rights, protect your medical records, and can help you recover the medical expenses and other losses you have.

As experienced workers’ compensation attorneys, we also recognize the importance of providing you with confidence and peace of mind. Our recent $428,000 workers’ compensation claim awarded to an injured worker because they were sent back to work too soon is just one example of our experience. Before you file a claim, request a free case evaluation with us.

Testimonials

“I actually began my case with another law firm before my accountant referred me to McPartland Law Offices. I had been injured on the job, and my employer was making things very challenging for me, primarily by misrepresenting things to the Department of Labor & Industries. From the beginning, McPartland Law Offices aggressively pursued a fair time loss calculation from my employer and the Department of Labor & Industries. When my employer retaliated against me and fired me, Mr. McPartland brought a claim for discrimination and retaliation, which was ultimately resolved for a six figure settlement that was life-changing money for me and my family. I was impressed that every avenue was so thoroughly explored on my behalf, to ensure that I was treated and compensated fairly. I am very happy that I found McPartland Law Offices.” — AG.

Worried About Your Workers’ Compensation Claim? Contact Us.

You may have rights to workers’ compensation benefits from knee injuries to degenerative back injuries, even if you have a pre-existing condition if the current injury worsens your condition. These are complex cases. Let our team provide a free consultation to discuss your injuries and potential benefits from the work accident. Discuss your workers’ compensation case with McPartland Law Offices by calling 509-495-1247 or filing out our contact form now.