Your employer, and the insurance company that provides workers’ compensation coverage, will likely be reluctant to fully pay out your claim if you sustain a work-related injury. That is just a fact of life. The fewer claims they have to pay, the more money they save. For this reason, it can be an extremely tricky situation if you sustain an injury that it at all related to a pre-existing condition or if your work aggravates a previous injury. Importantly, a pre-existing condition does not disqualify you from workers’ compensation. Therefore, you should never hesitate to make a claim if you feel that your job has contributed in some way to your pain. However, because your claim is likely to be more complex and it may be harder to obtain your full benefits than it would be if no pre-existing condition existed, it will likely be in your best interests to speak with an experienced Newark, New Jersey work related injury attorney from Rispoli & Borneo P.C. as soon as you have been affected by an accident. That way, you will have access to legal support and guidance as you navigate the claims process as efficiently and effectively as possible.
Your employer is almost certainly responsible for compensating you for any injury that you sustain on the job. That includes aggravation of an existing injury. However, your employer does not have to reimburse you for any injuries that occurred outside of work. Therefore, it is necessary to determine to what extent your pain has been caused by the present work-related injury and how much of it is attributable to pre-existing conditions. Your employer and workers’ compensation insurer may attempt to establish that your previous condition is responsible for most, if not all, of your symptoms. An experienced Newark, NJ work related injury attorney can help to correct that presumption.
It often falls to a treating physician to determine to what extent symptoms are caused by a pre-existing condition versus a work-related injury. Unfortunately, however, these records are not always successful in clearing up the matter because medical terms can have different connotations to physicians and insurance adjusters.
For example, insurance adjusters draw a distinction between an “aggravation” and an “exacerbation” of a particular condition. An aggravation means that the condition is worse now than it was before, while an exacerbation is a flare-up of existing symptoms. The former is more likely to be compensable than the latter. Insurance adjusters will take pains to firmly establish which is which. That is where the legal experience and support of a Newark, NJ work related injury attorney may prove particularly useful. A lawyer can clear up confusion and keep the claims progress moving forward.
Workers’ compensation insurers are not allowed to deny a claim on the basis of a pre-existing condition. Unfortunately, some attempt to do so anyway. If your workers’ compensation claim is denied and you think this may be the reason, this is not the time to meekly accept the decision. Rather, this is the time to open negotiations with the insurance company with the assistance of an experienced Newark, NJ work related injury attorney.