Workers Compensation and Pre-existing Conditions in Massachusetts

Workers compensation isn’t always a straightforward process. In Massachusetts today, we’re seeing a lot of workers compensation claims that involve “pre-existing conditions.” In this blog, I try to address what you should know.

What is a Pre-Existing Condition?

Pre-existing conditions and workers compensation in MassachusettsA pre-existing condition is a medical condition or injury that a worker had prior to a work injury that starts the workers compensation claim process. The Massachusetts workers compensation law (MGL Ch. 152) treats pre-existing conditions in two different ways. First, if the pre-existing condition is the result of a prior injury that is compensable under the Massachusetts workers compensation law and the worker suffers an aggravation of the pre-existing work injury, then the worker will be entitled to workers compensation even if the new injury occurs at a different job. If the pre-existing condition was not compensable under the Massachusetts workers compensation law, then the injured worker will be eligible to receive workers compensation benefits only to the extent the subsequent work injury combines with the pre-existing non-compensable injury as long as the subsequent work injury remains a major but not necessarily predominant cause for the disability and need for medical treatment.

This causation standard can appear confusing and is the subject of many legal disputes involving workers compensation claims.

Common types of pre-existing conditions include:

  • Arthritis
  • Degenerative Disc Disease
  • Spondylosis
  • Depression and Anxiety

Pre-Existing Conditions and Workers Compensation

Why do pre-existing conditions matter when it comes to a compensation claim in Massachusetts? Well, insurance companies are trying to avoid or limit how much they have to pay in workers compensation claims. If an injured worker had a history of significant back pain form a non-work related car accident and, later, injures his/her back at work, the insurance company will try to blame any prolonged claim of back pain on the prior car accident and deny or terminate payment of workers compensation benefits. There are many examples and scenarios involving pre-existing conditions and workers compensation.

As a result, we see a lot of arguments over compensation that claim the worker was already injured and therefore didn’t have a serious accident at work, or that the worker’s pre-existing condition is the cause of any disability or need for medical treatment.

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That’s why it’s important to contact an experienced attorney like John J. Sheehan if you have any further questions about a particular injury or claim.