When you’re injured on the job in Florida, you expect workers’ compensation benefits to cover your medical expenses and lost wages. But what happens if you have a pre-existing medical condition? Many workers worry that a past injury or chronic illness will prevent them from getting benefits if they’re hurt at work.
Having a pre-existing condition does not disqualify you from receiving workers’ compensation. However, it can complicate the process of filing and proving your claim.
Understanding how pre-existing conditions affect workers’ compensation in Florida is key to protecting your rights. This article explains Florida workers’ compensation with pre-existing injuries and how a skilled workers’ compensation lawyer can help if you’re facing challenges.
What Are Pre-Existing Conditions?
A pre-existing condition is any health issue, injury, or illness that existed before you suffered a workplace injury. These can include a wide range of physical and mental conditions. For example, if you have chronic back pain from a car accident that happened years ago, that is a pre-existing condition.
If you had surgery for a torn shoulder tendon five years ago and then re-injured that shoulder at work, that prior injury counts as a pre-existing condition. Other common examples include arthritis, heart disease, diabetes, degenerative disc disease, and past fractures.
Insurance companies often use pre-existing conditions to limit or deny benefits. They may argue that your current medical issues are related to your old condition, not your work injury.
Florida Workers’ Compensation With Pre-Existing Conditions
Florida workers’ compensation law recognizes that many employees may have pre-existing conditions. The key issue is whether the workplace accident or injury is the “major contributing cause” (MCC) of your current condition. Under Florida law, to qualify for workers’ compensation benefits, your work-related accident must be more than 50% responsible for your need for treatment compared to all other causes, including any pre-existing condition.
If your workplace injury made a pre-existing condition worse, you may still be entitled to benefits. For instance, if you had mild knee arthritis that never bothered you much, but after a fall at work, the pain becomes severe and requires surgery, that could qualify for workers’ comp. The fall would need to be shown as the major contributing cause of your need for surgery and treatment, even though arthritis was already present.
However, proving that you deserve workers’ compensation when you have a pre-existing condition can be challenging. A skilled workers’ comp attorney will use medical evidence to support your claim.
How Pre-Existing Conditions Impact Workers’ Comp Claims
Having a pre-existing condition doesn’t disqualify you from filing a workers’ comp claim, it makes the process more complex.
One of the main challenges is proving that your work injury—not your old condition—is primarily responsible for your current symptoms and need for medical care. Insurance companies often try to argue that your pain, disability, or need for surgery is something you would have dealt with anyway, even without the work injury.
Doctors selected by the insurance company (called “independent medical examiners” or IMEs) may review your medical history and argue that your symptoms are mostly due to your prior condition. These opinions can be used to dispute your right to benefits or to cut off your benefits prematurely.
Workers’ comp claims involving pre-existing conditions are often hotly contested. You may face delays, denials, and requests for additional medical exams. Having an experienced attorney can make a huge difference in overcoming these obstacles.
How a Workers’ Compensation Lawyer Can Help
A workers’ comp lawyer is essential if you have a pre-existing condition and are hurt at work. At Florida Lawyers 360, we understand the tactics insurance companies use to deny claims and how to fight back effectively.
Gathering Evidence
One of the first ways a lawyer can help is by gathering strong medical evidence to support your case. This includes collecting medical records, diagnostic tests, and doctors’ statements showing your work injury aggravated or worsened your pre-existing condition. Your attorney can also help secure opinions from treating doctors who understand your condition and can explain that the work injury is the major contributing cause of your current problems.
Filing Your Workers’ Comp Claim
Another crucial role a workers’ comp lawyer plays is in navigating the complex claims process. Filing a claim properly and on time is critical. Your attorney can ensure all paperwork is submitted correctly, deadlines are met, and your rights are protected from the beginning.
Maximizing Your Benefits
A lawyer can help you pursue the full range of workers’ comp benefits you deserve. They will ensure that any settlement accounts for ongoing medical care or possible future surgeries. Without a lawyer, workers often accept low settlements that don’t fully cover their needs.
Appealing a Denied Claim
If your claim is denied, a workers’ compensation lawyer can represent you in appeals and hearings. This includes arguing your case before a judge, cross-examining medical experts hired by the insurance company, and presenting evidence to prove that your work injury—not just your pre-existing condition—is to blame for your current disability.
Having a lawyer on your side gives you peace of mind. Workers’ compensation claims are stressful, especially when you’re dealing with pain, medical appointments, and the fear of lost income. An experienced lawyer can handle the legal battles so you can focus on healing.
Contact Us for a Free Consultation
Pre-existing conditions can make workers’ compensation claims in Florida more complicated, but they do not prevent you from receiving benefits if your work injury aggravated or worsened your condition. The key is proving that your job accident is the major contributing cause of your current medical issues and need for treatment. Unfortunately, insurance companies often try to use pre-existing conditions as an excuse to deny benefits, making it harder for injured workers to get the help they need.
At Florida Lawyers 360, we are dedicated to helping injured workers navigate these challenges. If you or a loved one has suffered a workplace injury and you’re worried about how a pre-existing condition will affect your case, contact us today for a free consultation. We’ll review your case, explain your rights, and fight to get you the benefits you deserve.
Don’t let an insurance company use your medical history against you—get the legal help you need to protect your future.
