One of the biggest reasons an Illinois workers’ compensation case gets denied by an insurance company is because the injury is to a part of someone’s body where they have a preexisting condition.
Sounds scary and like a tough defense to overcome, but it’s not once you have context.
Having a previous problem IS NOT A BAR TO RECEIVING BENEFITS. I’m not the all caps yelling type, but it’s important that the point be made. If your job duties cause a problem you win your case. If they aggravate or accelerate a preexisting problem, you also win your case.
I’ll use myself as an example. I have a torn rotator cuff and have had back pain in the past. I haven’t needed needed to see a doctor for either problem in the past five years though and can live a normal life that includes working out almost daily. So if I had a job that required me to do a lot of overhead lifting and it made my rotator cuff problem worse, I’d win the case. I have no need for surgery or physical therapy now, but if the job was the reason I had to do that, I’d win. Every time.
This happened in a recent Appellate Court case with a taxi driver who had a back injury. He was driving when his car was rear-ended by another vehicle. In this case the driver had been experiencing back pain even before the accident happened. The Court said that a worker doesn’t have to show that they were completely pain free or that the job is the sole or even main factor in needing treatment.
To win your case you have to be able to do what this driver did. Show that the job was a causative factor.
In this case it was indisputable that he had a car accident on the clock. His doctors hadn’t taken him off work for any reason before the accident, but did so after the accident. When a chain events related to work shows a need for medical treatment you have met your burden of proving that at a minimum the job aggravated your condition. That is enough to win no matter what an insurance company tries to tell you.
This is a great and sensible decision by the Court.
Bottom line is that you should never, ever let an insurance adjuster tell you that you don’t have a case and take it as gospel. They might be right, but often they are just trying to deter you from going after benefits and other times they just don’t know any better.
A pre-existing problem is not by itself a bar to getting benefits. You have to look at the facts of your situation. If you weren’t missing time before, but now have to it’s a good sign the job made things worse.
As always call us at (312) 346-5578 or fill out the form to the right if you have any questions. Our state wide network of lawyers handles work comp cases in every county in Illinois.
