Pennsylvania Workers’ Compensation and Pre-Existing Conditions
Each state has its own workers’ compensation statutes, therefore laws regarding pre-existing conditions vary. Employers often try to dissuade workers from filing a claim when there is a pre-existing injury. However, work-related aggravation of a pre-existing injury is generally covered under the Pennsylvania Workers’ Compensation Act (the Act).
Workers’ Compensation in Pennsylvania
Most employers in Pennsylvania are required to carry workers’ compensation insurance under the Act. As such, they must compensate employees for work-related injuries regardless of who was at fault for the accident. Workers’ compensation benefits in Pennsylvania include medical expenses, lost wages, specific loss, vocational rehabilitation, and death benefits.
To retain eligibility, employees generally must notify their employers of their injuries within 120 days of the workplace accident. It is advisable to provide the notice in writing with the date listed for proof of compliance. Employers may then accept or deny the worker’s claim for benefits.
Aggravation of a Pre-Existing Condition
Generally, injuries must be work-related to qualify for workers’ compensation. However, under the Act, a pre-existing condition may be compensable if it was aggravated by the injured employee’s work activities or environment. The condition does not need to be visible, nor is the employee required to have previous knowledge of it.
Some common types of pre-existing injuries include:
The pre-existing injury may have been caused by a car accident outside of work or a prior medical procedure. It may also be a medical condition such as asthma.
Pre-Existing Condition Claims Are Often Denied
Employers may choose to deny workers’ compensation claims for various reasons, including:
- The claim was not filed within the statutory time limit
- Vital information was missing or inaccurate
- The employer disputes that the injury took place at work or was work-related
Employers and their insurance companies often deny claims for pre-existing conditions by claiming that the injury was not work-related, but rather a result of the pre-existing injury’s natural progression. Employees with pre-existing injuries that were aggravated by their work activities or environment are eligible for workers’ compensation benefits. However pre-existing injury claims are typically more complex than the average workers’ compensation claim; therefore, workers are advised to seek qualified legal counsel for assistance. The workers’ compensation lawyers at Larry Pitt & Associates, P.C. know what it takes to file a successful claim, both initially and on appeal.
Appealing a Denied Workers’ Compensation Claim for a Pre-Existing Condition
Workers whose claims have been denied may still be able to obtain benefits. The original appeal, plus two copies, must be mailed to the Workers’ Compensation Appeal Board (WCAB) and postmarked within 120 calendar days of the Circulation Date listed on the initial decision. A statement of the grounds upon which the appeal is based must also be included, along with a copy of the initial decision and proof of service.
Workers and employers are both given an opportunity to appear before the WCAB, which will then issue a written decision. The WCAB decision may be further appealed within 30 days to the Pennsylvania Commonwealth Court, which will determine if an error was made, and issue a written decision.
A final appeal may be made to the Pennsylvania Supreme Court, which may decide whether to hear the case. If it decides to hear the case, their ruling is final and cannot be appealed.
Philadelphia Workers’ Compensation Attorneys at Larry Pitt & Associates, P.C. Help Workers Obtain Benefits for Pre-Existing Injuries
If your pre-existing injury was aggravated by your work duties or environment, contact a Philadelphia workers’ compensation attorney at Larry Pitt & Associates, P.C. Our experienced lawyers can help you navigate the workers’ compensation process in order to get the benefits you deserve. To discuss your case, call 888-PITT-LAW today to arrange a free consultation or contact us online.
We represent injured workers in Berks County, Bucks County, Chester County, Delaware County, Montgomery County, Philadelphia County and throughout Pennsylvania, including those in the communities of Abington, Ambler, Ardmore, Bala Cynwyd, Bensalem, Clifton Heights, Crum Lynne, Darby, Downingtown, Doylestown, Drexel Hill, Essington, Folcroft, Glenolden, Haverford, Havertown, Holmes, Kutztown, Lansdowne, Media, Merion Station, Morton, Narberth, Norristown, Norwood, Philadelphia, Prospect Park, Quakertown, Reading, Roxborough, Sharon Hill, Upper Darby, West Chester and Wynnewood.