Can a Pre-existing Condition Affect a Workers Compensation Claim?

Can a Pre-existing Condition Affect a Workers Compensation Claim?

Thousands of Australians are affected by injury and chronic conditions, sustained on the sporting field, in a car accident or from birth. If you’re one of many working with a pre-existing condition, it is important to know how this will affect a workers compensation claim, should you need to make one.

What is a workers compensation claim?

A worker is eligible to make a compensation claim if they are injured or become sick as a result of their work. A claim will generally cover an injured worker’s lost wages while they are unable to work, plus any medical or rehabilitation costs associated with the injury or disease.

What happens if there is a pre-existing condition?

A worker is still entitled to make a workers compensation claim if they have a pre-existing condition. In these cases, a worker must show that the pre-existing condition has been aggravated, acceleration, exacerbated or deteriorated and that work was a ‘significant contributing factor’ to the aggravation, acceleration, exacerbation or deterioration of the pre-existing injury or disease.

It is this definition of ‘significant contributing factor’ that comes under fire when making a workers compensation claim if a pre-existing injury or disease exists. Workers Compensation insurers can be quick to dismiss a claim if there is a pre-existing injury, simply labelling the injury as ‘old’, ‘pre-existing’ or ‘degenerative’.

There are however a number of things you can do to ensure your workers compensation claim, should you need to make one is not adversely affected just because you have a pre-existing condition or disease.

Keep medical records

Medical records are essential to any successful claim, but particularly important when showing that a pre-existing condition has been aggravated or accelerated as a result of employment. Medical records should include reports and assessments from treating doctors. Make sure you explain to your doctors the way in which your work has impacted on your pre-existing condition or disease.

WorkCover Medical Certificates

Ensure that you are covered by up to date WorkCover medical certificates. These certificates last 28 days and are issued by your treating doctor.

In the certificate a doctor will identify:

  • any medical treatment you may need
  • your capacity to perform certain activities and how much
  • a referral to a workplace rehabilitation provider
  • any delays in your recovery

These certificates will be beneficial when making a workers compensation claim, particularly when a pre-existing condition exists.

Has a pre-existing condition affected your workers compensation claim?

If an insurer has knocked back your workers compensation claim due to a pre-existing condition or insufficient evidence, we may be able to help. We can investigate the circumstances surrounding your claim and advise you on potential outcomes.

We understand that a successful compensation claim can make a big difference in your life, so we work hard to file a winning claim.

All Workers Compensation Claims are conducted with a grant of funding from WIRO meaning there are NO legal costs for you to pay.

At Taylor & Scott, We Care For You.

How can we help?