One of the biggest reasons insurance companies deny Illinois workers’ compensation claims is by saying that your problem is “pre-existing.” If you hurt your back ten years ago and haven’t been to a doctor in five years, they’ll still say your back problems aren’t from lifting heavy boxes all day at work.
The bad news is that these arguments are used to delay work comp benefits. The good news is that they are easily defeated if you can show your job aggravated or accelerated your condition then you should win the case. This can even be true when you’ve had a chronic problem.
This was shown to be true in a recent case at the Illinois Workers’ Compensation Commission. A housekeeper at a State of Illinois facility was hanging curtains when she felt pain in her arm. An MRI revealed a large effusion in her shoulder joint. She reported to her doctors that she had a long history of MRSA which is a dangerous infection that is hard to rid the body of.
This worker had to have a shoulder surgery and after it was over she had a unique diagnosis. Her doctor said she had septic arthritis.
She filed a case and the insurance company of course denied her benefits. Fortunately she didn’t give up and hired a lawyer who took the case to trial. On appeal the Commission awarded her benefits even though she was working with the MRSA issue before all of this happened. Her doctor was found to credibly testify that the work injury caused a joint effusion that then got infected with the bacteria. His opinion was based on the fact that she was fine before the accident and had symptoms after.
Even though her prior problems made it likely this would have happened sooner or later, that doesn’t matter under Illinois law. What matters is that the accident caused the symptoms to appear and eventually need surgery.
We hear about this type of issue probably more than any other that causes cases to be denied. The reason insurance companies do it is because they are able to convince enough injured workers not to pursue a case at all.
Our advice is always to get medical treatment and then just ask an experienced attorney if you have a case. Don’t take the insurance company at their word. It’s always free to talk to us and you are welcome to contact us any time about any legal issue.
