Will a Pre-Existing Condition Prevent Me From Getting Workers’ Compensation in PA?

A common question we hear is, “Will a pre-existing condition prevent me from getting Workers’ Compensation benefits in Pennsylvania?”

In short, no! In fact, many injured workers have pre-existing conditions. Sometimes, the pre-existing conditions may be due to the years of physical labor the employee has done. Other times, the pre-existing condition has nothing to do with the job, but nevertheless has an impact on the subsequent work injury. Either way, a pre-existing condition does not prevent an injured worker from being entitled to workers’ compensation benefits in Pennsylvania if they suffer a work injury.

Pre-Existing Conditions

Many people have pre-existing conditions that they manage every day, such as diabetes or asthma. However, they are able to work despite these pre-existing conditions. The pre-existing condition, nevertheless, may have an impact on a work injury. For example, if an employee is working in a warehouse and lacerates his foot, that may be a relatively simple injury for some people. For a diabetic, though, it can complicate and can even prolong the healing time of wounds, and the injured worker may have to be out of work longer than if an employee without diabetes got cut. The fact that the injured worker has a pre-existing condition – diabetes in this case – does not prevent them from being able to collect workers’ compensation benefits for the time they missed from work and medical bills related to this wound. In other words, the employer cannot say the injured worker missed time from work because they are diabetic. The injured worker missed time from work because of the injury itself. The injured worker just so happens to also have diabetes, complicating the injury.

This is because of the legal concept of the eggshell plaintiff doctrine. An employer takes an employee as he/she comes. In the example above, the employee had been working without any problems with diabetes. Then, the employee was injured and unable to work for a prolonged period of time due to a pre-existing condition, diabetes. The fact that the employee has diabetes is not a defense or a valid reason to deny the injured worker workers’ compensation benefits.

What is an “aggravation” under the law? 

Under the Act, an aggravation of a pre-existing condition is also considered a work injury. A common example of this is a worker who has arthritis. For example, a carpenter may have had knee arthritis for years and even would periodically treat for the knee arthritis. There is no dispute that it existed before the work injury being claimed. However, let’s say the worker twists his knee one day while getting up, and the knee pain becomes unbearable, preventing him from being able to work. The MRI may even only show arthritis. The insurance company will likely try to deny the claim, indicating that you have had arthritis all along. This is obviously true. But, that should not prevent you from being able to recover workers’ compensation benefits. This is because the twist clearly aggravated and worsened the knee condition to the point where the injured worker could no longer work. The injured worker had been able to work with this pre-existing condition before the injury at work aggravated it to the point where he could no longer tolerate the work.