Having an ongoing, pre-existing condition can seriously affect not just your enjoyment of life but also your ability to make a living. Many workers believe that a pre-existing condition does not entitle them to workers compensation, however, depending on their situation and how their injury has changed over time, they may still be entitled to compensation from their employer’s insurer. In the sections below we outline how a pre-existing condition is defined, how it can affect a worker’s compensation claim and how to maximise the chances of a successful outcome.
What is a pre-existing condition?
A pre-existing condition is defined as any ailment, illness or injury where the signs and symptoms of the condition existed before the person made a workers compensation claim. However, knowing when you are insured and the fine print of policies make it all a little more complex than this broad definition, which is why seeking professional medical and legal help is always recommended in these cases. For example, a childhood injury or an injury that you have claimed workers’ compensation on before could be considered pre-existing conditions.
When could a pre-existing condition make you ineligible for a worker’s compensation claim?
There are many instances where you can claim worker’s compensation for a pre-existing condition. In saying this the main reason that you would be ineligible would be if the injury did not change or worsen during your employment. If the injury remained the same and nothing happened to deteriorate your condition then this would simply be a continuation of your existing injury.. Similarly, if the condition did worsen but the reason for the deterioration was unrelated to the workplace then you may also find it difficult to make a workers compensation claim.
When can you make a workers’ compensation claim with a pre-existing condition?
The main reason you would be able to make a claim on a pre-existing condition would be if something happened to make your injury reoccur, become aggravated, accelerated, exacerbated or deteriorate. Usually, this deterioration would have to be of a permanent nature in order to make a claim. In other words, if something happens at work to reignite or worsen your pre-existing condition then you may be eligible to make a worker’s compensation claim. It should also be noted that even if your original injury was not work related but it was made worse by something that happened at work then you may still be able to claim worker’s compensation benefits.
How can you maximise your chances of a successful claim?
There are a number of things you can do to maximise your chances of a successful claim. First and foremost you should ensure that your doctor is keeping medical records and up to date WorkCover medical certificates. This will help you make your case that your condition has changed or worsened in some way. The second thing you should do is reach out to a professional legal advisor to help you make your claim. Worker’s compensation can be complex, particularly if you are trying to claim on a pre-existing condition, which is why a lawyer can help advise you on the best way forward by reviewing medical records and obtaining expert medico-legal opinions to help make your claim.