Plenty of people who get hurt at work already had a bad back, a worn knee, or an old shoulder injury. A pre-existing condition does not bar a Virginia workers’ comp claim. But it changes what the fight is about.
Can You Get Workers’ Comp for a Pre-Existing Condition?
Yes, in the right case. Workers’ comp can cover a pre-existing condition that a work accident made materially worse, but the medical records have to show what the accident changed.
There has to be an accident. Your injury must arise out of and in the course of your employment, and an identifiable incident at a reasonably definite time must cause a sudden mechanical or structural change to your body. A condition that simply wore down over time, even when work makes it hurt more, is generally not covered by itself. More on how to qualify for workers’ comp in Virginia.
Where the Insurance Company Looks
The insurance company will look for the old condition in your records and argue that your problems today come from it, not from the accident. As Bryn Swartz puts it about back claims:
“In back cases, the fight is rarely over whether someone is hurt. It’s over the first medical record. If it says your back has been bothering you for a while, and not the box you lifted on Tuesday, the insurance company builds its whole defense on that one line.” (Bryn Swartz)
Expect the same argument with an old knee, shoulder, or neck injury. What matters most:
- What you tell the first doctor. Say what happened at work, when, and what changed afterward: pain you didn’t have before, a limp, a job you could do last week and can’t do now.
- Being honest about the old condition. The insurance company will find your earlier records. A history that leaves them out gives it a reason to doubt everything else you said.
- The difference before and after. Old records showing you were working full duty, without treatment, before the accident can help show what the accident changed.
What Benefits Can Be Covered?
If the claim is accepted, workers’ comp pays for specific things: medical care, part of your lost wages, and permanent loss of use of certain body parts. It does not pay for pain and suffering. Here’s whether workers’ comp pays for lost wages and how impairment ratings work.
If you hurt another body part by favoring the work injury, that can be covered too. Here’s when an injury from favoring your work injury is covered.
What If the Claim Is Denied?
If you have received a denial of your workers’ comp claim, you have the right to dispute that decision and take your claim to a hearing before the Virginia Workers’ Compensation Commission. At the hearing, a deputy commissioner hears the evidence and decides whether benefits are due. Read about what happens if your claim is denied.
Hurt at Work With an Old Injury?
Pathfinder Injury Law handles only Virginia workers’ compensation claims. Call 804-505-0633 or use our online contact form.