The Impact of Preexisting Conditions on Workers’ Comp Claims | RGMR

The Impact of Pre-existing Conditions on Workers' Comp Claims over seated concerned man

Understanding your rights as an injured worker is essential to getting the financial compensation you deserve. Workers’ compensation law is notoriously complex, and going through the claims process can be frustrating even in the most straightforward cases. Unfortunately, insurance companies like SAIF may try to discredit workers’ claims using unfair tactics, such as exploiting a pre-existing condition.

When it comes to workers’ comp, pre-existing conditions can make proving your case more difficult, especially when an insurance company is looking for any reason to deny you benefits.

But you don’t have to accept defeat. At RGMR, we pride ourselves on giving a voice to injured workers from all walks of life. If you have a pre-existing condition and you’re concerned about its impact on your case, don’t give up. Our workers’ comp attorneys are ready to offer the expert representation and counsel you need to win your case.

 

Understanding Pre-existing Conditions

Doctor Speaking With Patient

In the context of workers’ compensation law, the term “pre-existing condition” refers to any previous or worsening medical condition that predates the illness or injury for which a worker is filing a claim. Pre-existing conditions may be obvious physical injuries, general or medical health conditions, or mental health disorders.

Examples of common pre-existing conditions include:

  • Broken bones
  • Herniated discs
  • Spine degeneration
  • Carpal tunnel
  • Torn ligaments
  • Sprains
  • Post-traumatic stress disorder
  • Depression or anxiety
  • Neck, back, and knee injuries
  • Arthritis

How Pre-existing Conditions Interact With Workers’ Comp Claims

One of the most common tactics SAIF and other insurance companies use to deny workers’ comp claims in Oregon is to argue that an employee’s work injury has combined with a pre-existing condition. But everyone has a medical history, and just because you have a pre-existing injury or illness, that doesn’t justify a claim denial.

If your claim has been unfairly denied, you have the right to request a hearing to dispute the denial. In order to win their case, the insurance company must prove:

  1. That there was a pre-existing condition, and
  2. That the pre-existing condition was the primary cause of the injury or disability.

For example, if you injured your knee lifting a heavy object and filed an injury claim, the insurer would have to prove that a previous knee injury was the major cause of your work injury. Similarly, if you developed carpal tunnel due to repetitive tasks at work and filed an occupational disease claim, the insurer would need to prove that your work was not the primary cause.

At RGMR, we fight for the rights of workers whose claims have been unfairly denied. We’ll help you through the process of requesting a hearing and arguing your case so you get the benefits you need and deserve.

 

Strategies to Strengthen Your Pre-Existing Injury Claim in Oregon

Judge Signing Papers

The relationship between your workplace injury and your pre-existing condition can complicate an investigation and make your case more difficult to prove. Fortunately, there are many ways to build an effective case and increase your chances of winning.

Hiring a Workers’ Comp Attorney

Working with an experienced lawyer will significantly increase your chances of winning your case and maximizing your benefits. As experts in workers’ comp law in Oregon, the attorneys at RGMR know the process inside and out and can provide you with the knowledge and guidance you need to build the strongest case possible.

Filing Your Claim as Soon as Possible

You should file your claim as soon as you become aware of your injury. This allows you to gather abundant and accurate evidence, including crucial details about your symptoms, witness testimonies, and official documentation. Waiting too long to notify your employer and start the process can make it more difficult to get a clear picture of the situation, increasing your chance of being denied.

Seeking a Medical Examination

As an injured worker, you have the right to receive medical care from your attending physician. If you have a doctor that has experience or expertise regarding your specific pre-existing condition, they will be able to provide a thorough evaluation of your injury and how it does or does not interact with your condition. This expert evaluation can be key to proving that your symptoms were caused primarily by the workplace accident.

Keep in mind that insurance companies can also request that you undergo an independent medical examination (IME) with a different doctor. While they’re supposed to act as a neutral third party, many doctors who perform IMEs are biased toward the insurance company. That’s why it’s essential that you’re fully prepared for an IME and know how to effectively advocate yourself.

Gathering Your Medical Records

Obtaining all your medical records, including any documentation regarding the history of your pre-existing condition is essential to proving your claim. This information can help provide the necessary context to prove that your injury was caused by the accident rather than pre-existing injuries.

Being Transparent

It’s always vital that you remain honest and completely transparent throughout the claims process. Exaggerating your symptoms or omitting important information will ultimately harm your credibility and destroy your case.

Your Resource for Workers’ Comp Claims

At RGMR, we care deeply about the rights of injured workers in Oregon. We know how frustrating and complex the legal process can be. We’re here to listen to your story, help you navigate the claims and appeals process, and argue your case on your behalf to ensure you get the best possible outcome.

Our website is your one-stop-shop for information about workers’ compensation in Oregon. Here are a few resources to get started:

 

Were You Injured at Work? RGMR Is Here To Help!

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Workplace injuries can be devastating both financially and emotionally. You should never be denied the compensation you deserve because of a pre-existing condition.

At Ransom, Gilbertson, Martin, & Ratliff, LLP, we’re keenly aware of the unfair tactics used by insurance companies to deny you benefits. As expert attorneys with over 70 years of combined experience fighting for the rights of injured workers in Oregon, we can help you navigate this process, offer thorough and tenacious representation in court, and fight for your interests every step of the way.

Contact us today and tell us about your case. We offer completely free consultations and we never charge you a single fee unless we win your case.

Adian Martin

Adian Martin (JD) is an accomplished attorney with over 25 years of experience. His goal is to use his legal expertise and passion for problem-solving to help people get the benefits and proper compensation they deserve after an injury. He received his law degree from Northwestern School of Law of Lewis & Clark College and is currently a partner at Ransom Gilbertson Martin & Ratliff. In his spare time, Adian enjoys exploring the outdoors with his dog and bicycling.

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