A pre-existing condition is one of the top reasons that your workers' compensation claim might be denied. The presence of a condition does not automatically mean you will not receive benefits, but it can make getting approved by your employer's insurance company a bit more difficult. If you have a pre-existing condition and are applying for workers' compensation, here is what you need to know.
What Impact Does a Pre-Existing Condition Have on Your Claim?
In evaluating your workers' compensation claim, the insurance company needs to know which injuries occurred as a result of the accident you had at work. Depending on the pre-existing condition you have, fully assessing your injuries can be challenging.
If the insurance company cannot fully distinguish which symptoms are from the accident and which are a result of the pre-existing condition, the company could decide to deny your claim. Therefore, it is up to you and your workers compensation attorney to prove to the insurance company that your injuries deserve compensation.
What Can You Do to Prove Your Claim?
One of the most important steps you can take to prove that your injuries from the accident are separate from the symptoms of your pre-existing condition is to provide copies of your medical records that can show your health status prior to the accident.
You can also get an examination from your medical care provider. He or she can then write a statement detailing the differences in your condition since the accident occurred.
It is important to note that even if the accident only led to an exacerbation of your symptoms, you can still receive compensation. You just have to prove that your symptoms were made worse by the accident. You can still rely on your medical records and doctor's statement to help prove your claim.
What If Your Claim Is Denied?
In the event the insurance company denies your workers' compensation claim, you have the right to file an appeal. As part of the appeals process, you can ask for an examination from an independent medical examiner. During your examination, you need to stress to the doctor how the accident impacted your medical condition.
You need to put distance between your accident and your pre-existing condition. The greater the distance, the better your chances are of getting your workers' compensation claim approved. Work with your workers' compensation attorney to find other ways to build your case.