One of the great parts about Illinois workers’ compensation law is the fact that having a pre-existing condition does NOT bar you from bringing a claim if your job aggravates or accelerates your condition.
Every injury has to be looked at on a case by case basis. If you’ve been treating for back problems for years and are currently undergoing physical therapy, it will be hard to state that lifting a box at work was anything more than a temporary aggravation if you notice pain while doing that activity. The exception would be if you can prove that your back got much worse which would happen through doctor’s statements and usually a new MRI report that shows big changes from an older MRI.
Some insurance companies though try to be sneaky and say that any pre-existing condition bars a new claim and that is simply not true. Recently I spoke with a really nice flight attendant who had injured her neck five years ago at home, received treatment for about six months and has been fine since. Earlier this year she was on a plane that had bad turbulence and kind of threw her a bit. She felt a pain in her neck and then woke up the next day with it feeling worse. She went to a doctor and is started on physical therapy. We’ll see where it goes from there.
Clearly this is a case where even if she had a pre-existing condition, it was recovered and she had been doing fine until the turbulence issue. She reported it to work and then got a call from an insurance company rep who heard her story and said that they were denying the claim because “it could have happened anywhere.”
In other words, they are trying to say that her neck was so brittle from the old injury that it was just a ticking time bomb waiting to go off. The problem with that statement is:
1. They are not doctors and are making medical conclusions.
2. Common sense tells you that what they are saying isn’t true as she’s been working without problems for four years.
3. It didn’t happen “anywhere” it happened while she was doing her job.
So too bad for them. To me this is a clearly compensable claim.
I told my caller that it’s just common insurance company strategy to try and frustrate an injured worker and make them go away. They might even believe their own b.s., but while they do hold the checkbook, they are not the Judge and don’t have final say over any of this.
So don’t be frustrated or take their word for it. It’s sad, especially because this is your life on the line when you are injured, but to a lot of insurance companies this whole process is just a game. You have to play the game, but you don’t have to follow their rules.