According to the Department of Labor, there were 496 workers’ compensation claims as of September 2023. Some of these claims did involve pre-existing conditions. When it comes to workers’ compensation claims, understanding the role of pre-existing health conditions is essential.
Pre-existing health conditions can influence workers’ compensation claims, but it is not a cause for complete denial.
Aggravation of pre-existing conditions
One of the most common ways pre-existing health conditions impact workers’ compensation claims is through the aggravation of these conditions due to a workplace injury. Employers and insurance companies may argue that the new injury is not solely responsible for the worker’s pain and disability.
In this case, a physician must verify that the aggravation is due to the worker’s employment activities and not just a worsening of the condition over time.
Causation and the major contributing cause standard
In Minnesota, there has to be a work-related major contributing cause to determine compensability. This means that for a claim to be successful, the workplace injury must be the primary cause of the disability or need for medical treatment. Pre-existing health conditions can make it challenging to establish causation, as it becomes a matter of proving that the workplace injury was the major contributing cause.
Defending against claim denials
Employers and insurance companies sometimes use pre-existing health conditions to argue against workers’ compensation claims. When this happens, injured workers must show proof from doctors and other documents during the appeal process. They have to make it clear that their current condition is part of the injury that happened at work.
Injured workers should know about these challenges and do everything possible to protect their rights. If they know the procedures and take action, they can increase their chances of getting workers’ compensation, even if they have a pre-existing health condition.