Contrary to what some employers and insurers want their employees to believe, pre-existing injuries do not bar workers’ compensation coverage. If you were told otherwise, then you should get in touch with a North Carolina workers’ compensation lawyer. North Carolina law allows employees with pre-existing injuries to receive benefits when new injuries aggravate their condition. It all starts from the premise that employers accept their employees as they are, with their health conditions. If the employees’ preexisting injuries allow them to work, they should not prevent them from obtaining workers’ compensation benefits.
This principle applies even to latent pre-existing conditions, like cancer or back injuries. In order to obtain the benefits, the employee has to prove that their pre-existing injury or disease aggravated due to workplace-related factors. Of course, this is easier said than done, so it is better to benefit from the advice of an experienced workers’ comp attorney.
Proving Workplace-Related Contributing Factors
As mentioned above, the most challenging part of obtaining compensation for pre-existing injuries is proving that they aggravated due to work-related conditions. No employer or insurer will pay you compensation for injuries that aggravated due to factors unrelated to your work.
The work-related conditions could mean anything from a work accident to workplace environmental factors and tasks. For example, let’s say you had pre-existing back problems. With time, your back problems aggravated to the point where you can no longer work.
In order to obtain workers’ compensation benefits, you would have to prove that:
1) A workplace accident caused complications to your pre-existing back problems (you fell and hit your back, you were hit by a hard object or forced to lift a very heavy weight); and/or
2) Your work duties (heavy lifting, prolonged standing or repeated bending) aggravated your back problems to the point where you can no longer work.
Of course, your employer or their insurer would probably deny your claim. To force them to accept it, you would have to prove that your back problems would not have aggravated, had it not been for the workplace accident and/or duties.
How to Avoid or Manage a Workers’ Compensation Claim Denial
Most employees have no idea how to prove the work-related factors contributing to their injury or condition. They simply submit their medical records to their claim. The insurers reject their claims arguing that their inability to work was caused by pre-existing injuries or conditions.
Few claimants know that it is considered bad faith for an insurance company to automatically deny claims on these grounds alone. Even fewer take advantage of their right to appeal the insurer’s decision. The easiest way to prevent a claim denial or appeal it, should the need arise, is to work with a North Carolina workers’ compensation attorney.
Contacted from the beginning, the latter will review your medical records and make sure they reflect the work-related contributing factors. If they do not, they will help you obtain more. This could involve changing doctors, undergoing further medical exams, and/or documenting the history of your pre-existing condition.
In case of a claim denial, they will file an appeal with the insurance company and, if necessary, file form 33 with the North Carolina Industrial Commission. Another option is to sue the insurer or your employer in court. In all scenarios, working with a workers’ comp lawyer will save you valuable time and effort and increase your chances of obtaining the due compensation.
Your North Carolina workers’ compensation attorney will fill in all the paperwork, follow all the necessary procedures, and deal with the employer and insurer on your behalf. They will gather evidence, represent you during negotiations or in court, and not rest until they get you the benefits you deserve.
Get Help with Your Pre-Existing Injury Claim from the North Carolina Workers Comp Lawyers at Ted A. Greve & Associates
Our North Carolina workers’ compensation lawyers at Ted A. Greve & Associates have handled and won numerous cases involving pre-existing injuries. They know how insurers act and how to get them to pay. Since our team includes medical professionals as well, we know all about proving contributing factors to pre-existing injuries. Whether you are preparing to file your claim or you have already received the denial letter, we can help. To find out how, call our office now and schedule a free consultation with one of our NC workers’ comp attorneys!