Monday Workers’ Compensation Q&A: Preexisting Injury

QUESTION: I HAVE A PREEXISTING INJURY TO THE SAME BODY PART I HURT AT WORK. DOES THIS MEAN I CANNOT CLAIM WORKERS COMPENSATION BENEFITS?

ANSWER: A PREEXISTING INJURY DOES NOT STOP A CLAIM.  FILE THAT CLAIM!    

Joe Worker was a high school quarterback.  Until that knee injury sidelined his dreams of playing for the NFL.  So he became one of the best construction workers New York City could ask for.  Until one day, on the job, Joe tripped over stuff somebody should have put away, and landed on that bad knee. Now, if his knee hadn’t been so screwed up in the first place, Joe would have been fine.  He would have dusted himself off and gone on with the day.  But the old injury flared up and Joe was sidelined again.  Joe didn’t know what to do.  It was, after all, his bad knee that made things worse, not a minor trip and fall on the job.  So he hesitated filing a new claim.  What should he do?

It is very common for people to injure themselves during the course of their lives.  An employer takes you as you are, so if you have had a prior injury and the accident at work disables you or worsens your condition it is a compensable injury!  That’s why it’s important to file!

The Workers’ Compensation Law does not penalize a worker because of prior non-work related injury. So even if Joe had injured his knee in high school before injuring it again on the job, he has the right to file a claim.  Perhaps Joe’s compensation carrier might seek to use that prior injury to limit their liability on his new case but there are laws to help Joe and other injured workers who were previously hurt.

In fact, Joe’s compensation carrier does not get an automatic deduction because of prior injury. Compensation carriers have the burden to show that the prior non-work related injury disabled Joe at the time of the accident. So, if at the time of his fall at work Joe was employed at full capacity with out any limitations, it will be tough for his compensation carrier to use that prior accident to limit their responsibility to Joe.

If you or your workers have a prior injury to a body part injured at work, be open and honest about the prior injury from Day One. In this case, as in most cases, Honesty Is The Best Policy.  In order for Joe’s claim to be processed successfully, he must let his doctors and the carrier’s consultants know about his previous injury.  There are some workers who think that by keeping their mouth shut, nobody will know about the prior injury. This is not true. The compensation carriers will find out. They have special people who investigate just those situations.  And to make matters worse, if the injured worker hides a prior condition he or she can possibly be found in violation of the fraud sections of the law and lose their rights to benefits.

So, tell the truth and file that claim!

Matthew Funk, a partner at Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP, has been practicing Workers’ Compensation Law for over a decade.  He is a member of the Workers’ Compensation Bar Association, Injured Workers’ Bar Association and the New York Coalition for Occupational Safety and Health (NYCOSH). He has written for the New York State Trial Lawyers’ Workers’ Compensation Decisions program and has lectured on numerous occasions focusing on Workers’ Compensation Law.

Prior results do not guarantee outcomes.
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