Pre-Existing Conditions And Workers’ Compensation Insurance: What To Know

Once a worker is injured at work or begins to experience the symptoms of an occupational condition, a claim must be filed to obtain coverage. Unfortunately, some workers are turned down for coverage based on pre-existing conditions. To find out more about this very common workers' comp issue, read below.

Filing the Claim

Workers who successfully file a claim and are approved for benefits can expect to be paid for their medical expenses as well as a partial disability salary if they are out of work. Usually, the insurer will ask about the details of the condition and if you have already been treated for the same or similar condition before. Almost any part of the claim form can trip workers up, but it's the last issue that often brings claims to a full stop.

Dealing With Denied Claims

You might assume that your injury or illness is covered under the plan only to be told that it's not because of a pre-existing condition. It's vital that you not give up in your efforts to obtain benefits regardless of the reason for the denial. Many workers get denied and must take extra steps to be paid the benefits that are rightfully theirs. Workers' comp insurers will pounce on anything that appears to be grounds for denial to avoid paying workers what they should. If you are denied workers' comp benefits for having a pre-existing condition, speak to a workers' compensation lawyer about your case. This type of lawyer is familiar with the tricks insurers pull on hurt workers and knows how to get your case resolved.

Conditions Made Worse

The key to obtaining workers' comp benefits is to understand that the insurer will only cover injuries or illnesses made worse by working conditions. If you have been previously treated for a condition, you must be able to show that even though you are suffering from a past condition, it has now become more serious and is preventing you from working. For example, you may have been treated for a back condition or suffered from a back injury in a car accident. However, your job required you to constantly bend and twist and now your back is so badly damaged that surgery may be needed.

This type of workers' comp case is not easily resolved. You may need to appeal the rulings and take things to the highest level before you obtain benefits. It's worth pursuing, however, because your injury could continue to affect you for the rest of your working days. Speak to a workers' comp lawyer and get help with your claim.