In some cases, people can receive benefits for pre-existing conditions under workers’ compensation insurance. South Carolina law allows eligible workers to file a work injury claim if a job-related accident or exposure harms or worsens an existing condition. The person does not need to prove that their workplace is the sole reason their pre-existing condition has worsened. However, they should have evidence showing that it is a primary factor.
Williams & Roche, LLC, is a dedicated Columbia workers’ compensation law firm providing diligent legal services to employees throughout South Carolina. We can help you determine if you are eligible for work injury benefits because of a worsened pre-existing injury.
Does Workers’ Comp Cover Pre-Existing Conditions?
It depends. Under South Carolina’s regulations, workers may be eligible to request benefits if they are an employee and their pre-existing condition was aggravated by a qualifying work activity. They could show that the injury that happened now was aggravated or worsened by a prior condition. Eligible employees may include people with an employment relationship with the company instead of an independent contractor.
The worker would also have to prove that the condition they are currently requesting benefits for happened while they were acting within the scope of their job. For example, they may have come into contact with pollutants on a job site or tripped because of an old ankle injury.
What Is Considered a Pre-Existing Condition?
A pre-existing condition is something, such as an injury, diagnosis, or sensitivity, that existed before the person experienced the current incident. A pre-existing condition might also be a permanent disability or impairment that the person had when they were hired or acquired on the job.
For example, a worker might have diabetes, which causes them to have circulation issues and numbness in their feet. As a result, they may be more likely to slip, trip, and fall while at work.
The person may have asthma that worsens because of irritants, like chemicals or smoke, in the air on their job site.
Can You Still File a Claim if You Have a Pre-Existing Condition?
Yes, you may still get workers’ comp for a pre-existing condition. However, you need to be able to show that something happened on the job that aggravated or was caused by your existing injury. For example, you may have a bad knee from an accident that occurred years ago, but an incident at your current job caused it to flare up.
How Insurers Use Pre-Existing Conditions To Deny Claims
Unfortunately, insurers and employers may try to discredit a worker’s claim by saying the injury is not new and, therefore, not covered. For instance, they may say the worker’s condition they are claiming compensation for is only part of an old injury that happened before the current job.
Or they may try to reject the person’s claim by arguing that a non-work activity caused or aggravated it.
Because of this, workers must be prepared and develop a strong case in their favor. For example, they can gather records from their doctor showing that the injury existed before and worsened because of the person’s job conditions. They can also use the current law to prove they are entitled to benefits even though they have a pre-existing condition.
What Medical Evidence Can Help Your Pre-Existing Injury Case?
You will need to present legal arguments and evidence to prove that you qualify for benefits under your employer’s workers’ compensation insurance policy. Evidence that may be useful for you includes:
- X-rays or other imaging studies to show the old and new injuries
- Statements from medical experts or your treating physician
- Photographs, surveillance footage, and eyewitness testimony
- Pain logs that explain how the pre-existing condition and current injury have impacted you
- Reports from your doctors about your impairment level or disability rating
These records can help you prove the source of your condition and show you are entitled to benefits.
The more robust and supported your claim is, the more likely it is to be accepted.
Contact a Columbia Workers’ Compensation Lawyer at Williams & Roche, LLC
South Carolina law allows some employees to request a settlement if a work injury aggravated pre-existing conditions. Workers’ compensation may still be available to them if they can show they are covered under their employer’s insurance policy. Additionally, they would need to prove that a work-related activity caused or aggravated a pre-existing condition.
The team at Williams & Roche, LLC, is devoted to lifting up and fighting for workers who are injured at their jobs. Our founding attorneys are both former Workers’ Compensation Commissioners who understand how challenging it can be for people when an accident prevents them from earning a living.
We also have extensive knowledge of how to navigate South Carolina’s workers’ compensation system effectively. Get in touch with us today by calling 803.784.0503 to see how we can help you during this time.
