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 “preexisting conditions.” But, will a preexisting condition bar you from recovering workers’ compensation for an injury you sustained while on the job?  In this blog, Boston workers’ compensation lawyer John J. Sheehan addresses what you should know.

Even if you have a preexisting condition, you will more than likely be able to claim workers’ compensation for an injury or illness that you sustained as a result of your job.  The most common exception to this is where a preexisting condition was exacerbated by causes that were not associated with your work or workplace. According to our Lynn workers’ compensation lawyer, while insurers or employers may try to assert certain defenses, such as the “combination injury defense,” you should be able to recover what you deserve for your workplace injuries or illnesses with the help of a dedicated Massachusetts workers’ compensation attorney. Contact our Salem workers’ compensation lawyer for more information. 

The Law Office of John J. Sheehan has earned a reputation as a law firm for the working person, who won’t back down to the insurance companies no matter what.  at the Law Office of John J. Sheehan, our Massachusetts workers’ compensation lawyers can present you with your options and advocate for you to the insurance companies and employers that owe you for your workplace injuries.  For a free consultation, call us at (617) 925-6407.

Will Your Preexisting Condition Prevent You from Recovering Workers’ Compensation?

The bottom line is this: in most situations, you will be able to recover workers’ compensation payments even if you have a preexisting condition.  This is especially true if your preexisting condition has nothing to do with your present injuries or if your preexisting condition originated as an injury that qualified for workers’ compensation itself.  For instance, if you were at another job and developed chronic pain in your back, and this injury was covered by workers’ compensation insurance, you will be able to recover again if your time at a new job caused the aggravation of that same injury.

However, there are exceptions, and if you are concerned about whether your specific preexisting condition will bar you from recovery for a workplace injury, you should continue reading for the full picture of your options or speak to one of our Waltham, MA workers’ compensation lawyer about your particular circumstances.

What Qualifies as a Preexisting Condition?

A preexisting 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 preexisting conditions in two different ways. First, if the preexisting 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 preexisting work injury, then the worker will be entitled to workers’ compensation even if the new injury occurs at a different job.

If the preexisting condition was non-compensable (or not eligible for coverage) under the Massachusetts workers’ compensation law, then the injured worker will only be eligible to receive limited workers’ compensation benefits.

The benefits available in such a situation are limited to the extent that the subsequent work injury combines with the preexisting 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.  In other words, the relief available will be parsed proportionally to reflect the relative seriousness of the preexisting condition in comparison to the new condition.

This causation standard can appear confusing and is the subject of many legal disputes involving workers’ compensation claims. Common types of preexisting conditions for workers’ compensation in Boston include:

Preexisting Conditions and Workers’ Compensation in Massachusetts

Why do preexisting 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, suffers a back injury 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 preexisting conditions and workers’ compensation.

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

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

Process of Claiming Workers’ Compensation with a Preexisting Condition in Massachusetts

In order to properly claim workers’ compensation in Massachusetts, a person will have to subject themselves to medical examination.  The purpose of the medical analysis is to determine the extent of the disabilities caused by the injury or illness.  However, the medical analysis will also check for preexisting conditions that may have been a root cause of the currently claimed condition.

An employer or insurer who wants to fight payment of workers’ compensation benefits over a preexisting condition will likely attempt to introduce what is referred to as a “combination injury defense.”  This defense is essentially an argument that the present condition is merely a manifestation of the preexisting condition.  The argument hinges on the employer or insurer being able to prove that the present condition is not related to work or work-related activity and therefore shouldn’t be subject to workers’ compensation.

If you can demonstrate that your work was a significant cause of your injury, even if it is merely an exacerbation of a preexisting condition, you will likely be able to defeat a combination injury defense.  Speak to one of our experienced Cambridge workers’ compensation attorneys about the merits of your workers’ compensation claim today.

We Can Help You Get Workers’ Comp with a Preexisting Condition Today

Our greater Quincy workers’ compensation lawyers are dedicated to ensuring that our clients are taken care of by their employers and insurance providers, no matter what it takes.  Set up a free initial consultation about your potential workers’ compensation claim by calling the Law Office of John J. Sheehan at (617) 925-6407.