If you have suffered an injury at work or on the job, you may be entitled to receive additional benefits through workers compensation. In North Carolina, this may include time lost from work, disability (full or partial), and medical bills.
If your on-the-job accident involves a body part which was previously injured or which has a pre-existing condition (such as arthritis in your knee or shoulder or a degenerative disc in your back or neck), can you still receive workers’ compensation? The short answer is “yes.” Under our workers’ comp law, so long as the on-the-job accident aggravates or accelerates the pre-existing condition, it will be found compensable. In other words, if the on-the-job injury makes a previous condition worse, it will be compensable, even if the previous condition was already somewhat symptomatic.
For example, assume an employee has arthritis in her knee, and that she has previously undergone knee surgery for torn cartilage years ago. Following the surgery, she was able to return to work and go about her daily job duties. One day at work, she trips over a box, falls on the knee with the pre-existing condition and the doctor determines that she now needs a knee replacement. In this example, you have a condition (arthritis in the knee) that existed prior to the on-the-job incident. Even though the arthritis was not caused directly by the fall, the employee will be entitled to workers’ comp benefits so long as the accident (tripping over the box and falling on the knee) aggravated or worsened the arthritis. In other words, if the fall made the arthritis more problematic or caused it to become more symptomatic than it was previously, the employee has a compensable workers’ compensation case. The on-the-job incident does not have to be the direct cause of the condition. In this example, so long as the on-the-job accident makes the arthritis worse, the employee has a good workers’ comp case.
The outcomes of workers’ compensation cases involving pre-existing conditions are determined largely by the medical testimony. If a doctor testifies that the on-the-job incident aggravated or accelerated the pre-existing condition, then it will most likely be found compensable by the Industrial Commission. In investigating claims, the insurance company will look closely through an injured worker’s prior medical records and history to see if he has pre-existing conditions in hopes that it might deny the claim. Thus, it’s imperative that an injured employee be very specific and give an accurate history to the doctor. Tell your medical examiner what the condition was like prior to the accident (especially if there was a period with no or little problems) and describe how the condition has changed since the incident. Describe any changes in the nature of the pain, including its intensity or duration. Describe how it affects activities that you were able to do before the accident. Be straight. Be accurate. And be honest. Keep in mind the insurance company will try to obtain your prior medical records, and trying to “hide” information from the insurance company could have significant legal consequences for you.
As with all workers’ compensation cases, after the individual has reported the injury to the employer, been examined by a doctor and filed a form with the North Carolina Industrial Commission, he or she will be contacted by an insurance company representative to take a recorded statement. Talking with a lawyer prior to speaking with the insurance company rep ensures you’ll have the legal guidance needed so that you don’t unknowingly make a statement that could negatively impact your workers’ comp case.
13.03.2011. 16:55
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"Thank you John, and all the staff at The Law Offices of John M. McCabe, P.A., for all your help over the years since my accident and for your friendship! I am truly grateful!"
At The Law Offices of John M. McCabe, P.A., we have extensive experience in representing injured workers. We will work hard to protect you from the insurance company's tricks and traps.
