Pre-Existing Conditions and Workers’ Compensation in Florida

Florida workers’ compensation laws protect employees who suffer work-related injuries. However, getting workers’ comp benefits can be more complicated for individuals with pre-existing conditions. Workers’ compensation insurers may use pre-existing conditions as a reason to reduce or deny claims.

If you or a loved one has a pre-existing condition and were injured on the job, hiring an attorney to protect your rights is crucial. Our Fort Lauderdale workers’ compensation lawyers are dedicated to helping injured employees across Florida. Call today for a free case review.

What Is a Pre-Existing Condition?

A pre-existing condition refers to any injury or illness that predates your current workers’ compensation claim. These conditions may include a wide range of physical or medical issues, such as:

• Chronic illnesses (e.g., asthma, arthritis, diabetes)
• Old injuries (e.g., car accident injuries, sports injuries, bone fractures, torn ligaments)
• Degenerative conditions (e.g., herniated discs, spinal degeneration)
• Work-related conditions (e.g., carpal tunnel syndrome, repetitive motion injuries)

Can I Get Workers’ Comp If I Have a Pre-Existing Condition?

Florida workers’ compensation laws do not automatically disqualify you from receiving benefits if you have a pre-existing condition. However, the key factor is whether your workplace injury significantly aggravated the pre-existing condition or caused a new injury altogether.

Florida Statutes § 440.09(1)(b) states that if a workplace injury exacerbates a pre-existing injury or illness, the work injury must be more than 50% responsible for the combined condition for you to receive compensation.

It’s crucial to support your case with thorough medical records.

How Can Pre-Existing Conditions Affect Workers’ Comp Claims in Florida?

When you file a workers’ compensation claim in Florida, insurance companies will investigate your medical history. Their goal is often to minimize the amount they have to pay, and one common tactic is to argue that your disability or injury is primarily due to a pre-existing condition rather than a workplace injury.

According to Florida law, you can still receive benefits if your work-related injury worsens or aggravates a pre-existing condition. The burden of proof, however, falls on the injured worker. You must demonstrate that the new injury is at least 51% responsible for your current disability.

Insurance companies often use pre-existing conditions as a reason to reject workers’ compensation claims. For instance, they may argue that your current condition is simply an aggravation of an old injury rather than a new injury caused by your work. They may also claim that your current injury did not significantly worsen your prior condition.

To counter these tactics, you need to provide detailed medical documentation that demonstrates how your workplace injury has worsened your pre-existing condition. The better your documentation, the more difficult it will be for the insurance company to deny your claim.

Deadline to Report a Work Injury in Florida

One of the most critical aspects of filing a workers’ compensation claim in Florida is adhering to the strict reporting deadlines. Under Florida law, you must report your workplace injury to your employer within 30 days. If you fail to meet this deadline, your claim may be denied, even if your injury is legitimate.

For individuals with pre-existing conditions, this deadline can be tricky, especially for repetitive motion injuries that worsen over time. In these cases, the clock starts ticking once your doctor determines that your injury is work-related. This is why it’s important to seek medical attention as soon as you experience pain or discomfort. Prompt reporting is essential for protecting your rights.

Additionally, Florida Statutes § 440.19 limits the amount of time you have to file a claim for workers’ compensation benefits. Generally, you have two years from the time you became aware that your work duties exacerbated your pre-existing condition. However, delays can lead to disputes with the employer and insurer over whether your symptoms were caused by your job. Working with an experienced workers’ compensation attorney can help you navigate these complications.

Medical Documentation and Independent Medical Examinations

In any workers’ compensation claim involving a pre-existing condition, medical evidence plays a crucial role. You will need to provide all medical records related to your pre-existing condition as well as documentation of the current workplace injury. Insurance companies will likely request an independent medical examination (IME), where a physician will review your case and provide their assessment.

The independent medical examination is a critical part of the workers’ compensation process, and it’s important to comply with the request. However, the results of the IME may not always be in your favor, as the physician works for the insurance company. This is why it’s vital to have a skilled workers’ compensation attorney by your side who can challenge any biased conclusions.

Workers’ Compensation with Pre-Existing Conditions

Cases involving pre-existing conditions can be complicated, but that doesn’t mean you should be denied the compensation you deserve. Florida law clearly states that workers are entitled to benefits if their work-related injury aggravates a pre-existing condition. However, the burden of proof often lies with the injured worker, making it essential to gather as much evidence as possible.

Here are some steps you can take to protect your claim:

• Report your injury promptly: File your workers’ compensation claim within 30 days of the injury. Timely reporting is crucial in any case but especially important when pre-existing conditions are involved.
• Maintain comprehensive medical records: Document everything, from previous injuries to your current condition. This will help show that your workplace injury made your pre-existing condition worse.
• Hire a workers’ compensation attorney: An experienced workers’ compensation lawyer can help you navigate the complexities of your case, especially if the insurance company is attempting to deny your claim.
• Comply with requests for an independent medical examination (IME): Although the IME may not always be in your favor, failure to comply could result in your claim being denied. Your attorney can challenge any unfavorable findings during this process.
• Follow your doctor’s treatment plan: Failing to follow your medical provider’s recommendations could result in your benefits being reduced or denied.

Why Hire a Florida Workers’ Compensation Attorney?

Workers’ compensation cases involving pre-existing conditions are among the most challenging to navigate. Insurance companies will use any excuse to deny or reduce your benefits, and pre-existing conditions are a common reason. By working with an experienced workers’ compensation attorney, you can protect your rights.

A skilled attorney will help you gather the necessary evidence, file your claim on time, and fight back if the insurance company denies your workers’ comp claim. They will work tirelessly to ensure you get the benefits you need to recover from your workplace injury.

Let Us Help You Get Workers’ Compensation Benefits

If you have a pre-existing condition and were injured on the job in Florida, you don’t have to face the complexities of the workers’ compensation system alone. The Workers’ Compensation Lawyers Coalition serves injured workers in Fort Lauderdale, Miami, and throughout Florida, helping them navigate the difficult waters of workers’ compensation claims.

Whether your injury is directly related to your pre-existing condition or simply made it worse, you may still be entitled to compensation. Don’t allow the insurance company to use your medical history against you. By working with a knowledgeable attorney, you can build a strong case and receive the benefits you deserve.

Contact us today at (786) 686-2857 for a free consultation. We are here to help you every step of the way.