Will a Pre-Existing Condition Prevent Me From Getting Workers’ Compensation in PA?
No. A pre-existing condition does not automatically prevent you from receiving workers’ compensation benefits in Pennsylvania. If a work injury causes a pre-existing condition to worsen or aggravates an existing medical issue, you may still be entitled to benefits. The key question is whether your work injury contributed to your disability, need for treatment, or inability to work.
Workers’ Compensation and Pre-Existing Conditions
A common question we hear is:
“Will a pre-existing condition prevent me from getting workers’ compensation benefits in Pennsylvania?”
In short, no.
Many injured workers have pre-existing medical conditions. Sometimes those conditions are related to years of physical labor. Other times, they are completely unrelated to work but still affect the recovery process after a workplace injury.
Either way, a pre-existing condition does not automatically prevent an injured worker from receiving Pennsylvania workers’ compensation benefits after a work injury.
How Pre-Existing Conditions Affect Workers’ Compensation Claims
Many people manage pre-existing conditions every day while continuing to work. Common examples include:
- Diabetes
- Arthritis
- Asthma
- Degenerative disc disease
- Prior back injuries
- Previous knee or shoulder problems
A pre-existing condition may affect how an injured worker heals after a workplace accident, but that does not mean the workers’ compensation claim should be denied.
For example, imagine an employee working in a warehouse who suffers a laceration to their foot. For some workers, the injury may heal relatively quickly. For a worker with diabetes, however, the healing process may be slower and more complicated.
The fact that the worker has diabetes does not prevent them from receiving workers’ compensation benefits. The employee missed work because of the work injury. The pre-existing condition simply made the recovery process more difficult.
The Eggshell Plaintiff Rule in Pennsylvania Workers’ Compensation Cases
Pennsylvania workers’ compensation law generally follows the principle that an employer takes an employee as they find them.
This concept is often referred to as the “eggshell plaintiff” doctrine.
Using the example above, the employee was successfully performing their job despite having diabetes. After suffering a workplace injury, the worker required additional treatment and missed more time from work because the diabetes complicated the recovery.
The employer cannot avoid responsibility simply because the injured worker had a pre-existing medical condition.
If the work injury caused disability, medical treatment, or lost time from work, workers’ compensation benefits may still be available.
Aggravation of a Pre-Existing Condition
Under Pennsylvania workers’ compensation law, an aggravation of a pre-existing condition may itself be considered a compensable work injury.
A common example involves arthritis.
Imagine a carpenter who has experienced knee arthritis for years and occasionally receives treatment for the condition. Despite the arthritis, the worker continues to perform their job without restrictions.
One day, the worker twists their knee while working, causing severe pain that prevents them from continuing to work.
An MRI may reveal arthritis that existed before the incident. Because of this, the insurance company may argue that the worker’s condition was pre-existing.
However, the important issue is whether the workplace incident aggravated or worsened the condition.
If the worker was able to perform their job before the injury but can no longer do so afterward, the aggravation of the pre-existing condition may qualify for Pennsylvania workers’ compensation benefits.
Proving a Work Injury Aggravated a Pre-Existing Condition
Insurance companies frequently challenge claims involving pre-existing conditions.
For that reason, medical evidence is often critical.
Medical records, diagnostic testing, and physician opinions can help establish that:
- The pre-existing condition existed before the injury
- The work injury aggravated or worsened the condition
- Additional treatment became necessary
- The worker became disabled as a result of the aggravation
Even when a condition existed before the work injury, benefits may still be available if the workplace incident contributed to the disability or need for treatment.
Talk to a Pennsylvania Workers’ Compensation Lawyer
If you or a loved one has been injured at work, Stern & Cohen can help.
Our Pennsylvania workers’ compensation attorneys regularly represent injured workers whose claims involve pre-existing conditions, aggravation injuries, and disputes with insurance companies.
Contact Stern & Cohen today for a free consultation.
FAQs
Can I get workers' compensation if I already had a bad back?
Yes. A pre-existing back condition does not automatically prevent you from receiving workers’ compensation benefits if a workplace injury aggravated or worsened the condition.
Can arthritis qualify for workers' compensation in Pennsylvania?
Potentially. If a work injury aggravates pre-existing arthritis and causes disability, lost wages, or the need for additional treatment, workers’ compensation benefits may be available.
What if the insurance company says my injury was pre-existing?
Insurance companies often raise this argument. However, a claim may still be successful if medical evidence shows that a workplace injury aggravated, accelerated, or worsened the pre-existing condition.
Can I receive workers' compensation for a pre-existing knee injury?
Yes. Workers may be entitled to benefits if a workplace accident aggravates a pre-existing knee condition and results in disability or additional medical treatment.