A work injury can turn your life upside down, but what happens if you already had a pre-existing condition? In Arizona, you can still qualify for workers’ compensation benefits if your job aggravated or worsened your condition. However, proving this can be tricky, as insurance companies often try to deny these claims. Understanding how pre-existing conditions impact your case is essential to securing the benefits you deserve.
How Arizona Law Treats Pre-Existing Conditions
The “Aggravation” Rule
Arizona workers’ compensation law follows the “aggravation” rule, meaning that if your work-related injury worsens a pre-existing condition, you are still eligible for benefits. The key factor is proving that your job made your condition worse beyond its natural progression.
What Insurers Look For
Insurance companies will scrutinize your medical history to argue that your symptoms are due to the pre-existing condition rather than a work-related injury. They will look for:
- Past medical records showing prior treatment
- Evidence of ongoing symptoms before the work accident
- Whether the work incident significantly changed your condition
Proving That Work Made the Condition Worse
Medical Evidence is Key
Strong medical documentation is the foundation of a successful claim. A doctor must confirm that your job aggravated your condition and provide clear evidence of the change. Diagnostic tests, medical reports, and comparative assessments before and after the injury can strengthen your case.
Employer and Coworker Testimony
Witnesses can provide valuable evidence if they noticed your condition worsening due to job-related tasks. For example, if coworkers saw you struggling to lift objects before the injury but noticed a significant decline after an accident, their statements could support your claim.
Prior Medical Records
While past medical records might seem like a disadvantage, they can actually help if they show a clear difference in your condition before and after the workplace injury. These records establish a baseline and highlight the worsening effects caused by work-related activities.
Common Pre-Existing Conditions That Affect Claims
Back Injuries
Many workers have a history of back pain or prior spinal injuries. If a work accident or repetitive strain worsens an existing back problem, you may be eligible for compensation.
Arthritis
Arthritis is common, especially among older workers. If your job activities accelerate joint damage or cause increased pain, your condition may be considered aggravated by work-related factors.
Repetitive Stress Injuries
Conditions like carpal tunnel syndrome or tendonitis often develop over time. If your job exacerbates an existing repetitive stress injury, you may qualify for benefits.
Challenges Claimants Face
Insurance Company Denials
Insurers frequently argue that your condition existed before the injury and that work did not significantly impact it. They may use independent medical exams (IMEs) to downplay your claim.
Delayed Claims Processing
Pre-existing condition cases often face longer processing times because insurers demand extensive medical records and second opinions before approving benefits.
How a Lawyer Can Help
Gathering Strong Medical Evidence
An experienced attorney can help you obtain the right medical documentation and expert testimony to prove that your job worsened your condition.
Negotiating With Insurers
Lawyers understand how to counter insurance company tactics and fight for the benefits you deserve, whether through negotiations or formal appeals.
Get in Contact with Arizona’s Top Worker’s Comp Lawyers
Having a pre-existing condition does not mean you are automatically disqualified from receiving workers’ compensation in Arizona. However, proving that your work aggravated your condition requires strong medical evidence and legal expertise. Our workers’ compensation attorneys at Snow, Carpio & Weekley, PLC can help you navigate the process and ensure that you get the benefits you need.
Workers Comp FAQs
1. Can I still receive workers’ compensation if I had a prior injury?
Yes, as long as your job worsened or aggravated your condition beyond its natural progression.
2. What if my claim is denied due to my pre-existing condition?
You can appeal the decision and provide additional medical evidence showing how your job contributed to the worsening of your condition.
3. How do I prove that work made my condition worse?
Medical records, doctor testimony, witness statements, and diagnostic tests can help establish that your job aggravated your condition.
4. Will an independent medical exam (IME) affect my case?
IME doctors are often hired by insurance companies to challenge claims. A workers’ compensation lawyer can help you counter any biased reports.
5. Should I hire a lawyer for my workers’ compensation claim?
Yes, especially if you have a pre-existing condition. An attorney can strengthen your case, negotiate with insurers, and represent you in appeals if necessary.
