When you have been hurt on the job, managing the legal aspects of a case involving a pre-existing medical condition can complicate your workers’ compensation claim. However, a tenacious workers’ compensation attorney is skilled in handling the nuances of pre-existing conditions for workers in Fresno and could help you understand your available options. In some cases they can give rise to a Subsequent Injury Benefit Trust Fund (SIBTF) claim that can result in more benefits to an injured worker.
Our practiced legal team at Silberman & Lam could be an asset to your case. We could help navigate potential challenges from your employer or their claim adjuster during this difficult time.
Pre-existing conditions are medical injuries or illnesses that a person had before their workplace incident that created a potential claim for workers’ compensation benefits. In other words, it is a condition that results solely from non-work-related events.
A pre-existing condition can be compensable as a workplace injury if there is evidence showing that the incident caused a significant aggravation of the condition. Regulation Section 14300.5(b)(4) identifies several situations where a workplace injury is a significant aggravation of a pre-existing condition because the workplace event results in any of the following:
While California workers’ compensation regulations extend coverage to aggravated pre-existing conditions, a Fresno worker must show the aggravation only happened because of the workplace event. Aggravated injuries that would have happened on their own are not generally compensable.
Two major challenges can exist in obtaining workers’ compensation benefits for an aggravated pre-existing injury in Fresno. Employers or their claim adjuster may be quick to raise these challenges depending on the facts of the case and the potential liability from the injury.
Without irrefutable evidence of a workplace incident that caused the injury, an employer may question if the pre-existing condition became aggravated outside the scope of work. This may involve a close look into personal events that happened outside of work and related medical records, evidencing an alternative story of causation. Immediately reporting a workplace incident aggravating an injury can be important for refuting potential speculation about alternative causes of the aggravation.
The available medical documentation about the status of the pre-existing condition before and after the workplace incident is essential in these cases where significant aggravation occurred. Ideally, the medical evidence will show a clear shift in the condition, either through the onset of new symptoms or an obvious worsening of ongoing symptoms.
Pre-existing conditions can lead to additional challenges for injured workers when seeking workers’ compensation benefits. The experience of a well-versed attorney could be useful in these cases by helping people overcome the necessary evidentiary hurdles in their claims. Employers may quickly deny claims involving pre-existing conditions without diligent representation or pay for any temporary disability claims at a lesser rate.
A knowledgeable lawyer can also help navigate other essential steps of the claim process that could be especially important for pre-existing conditions for workers in Fresno, such as managing reports and statements from a qualified medical examiner that do not fairly reflect your injury. Our legal team is here to advocate for you. Call today for a consultation meeting.
