One of the biggest Illinois workers’ compensation myths is that a pre-existing condition can prevent you from having a case. Those prior problems can have an impact on your case and are often grounds for a bogus denial of benefits by the work comp insurance company. But unless you were under active care in the recent days or weeks prior to your work injury, those old problems are not usually held up as valid by Arbitrators who ultimately decide your case.
Take for example the recent case of an Illinois floor finisher. One day in March he fell down several steps while doing his job and hurt his low back. His injury was serious enough that it kept him from coming back to work. Like most people, including me, this wasn’t the first time he had back problems. That’s to be expected as you get older. Unlike most people though, this wasn’t a temporary aggravation even though that’s exactly what the hired gun doctor for the insurance company said.
In this case, he hurt himself in 2018. His prior back problems were from 2007 and he didn’t have any problems with his back after that time. In other words, he’d been treatment free and essentially pain free for over ten years. There was no testimony or medical records that said otherwise. He wasn’t limited in any way from doing his job duties prior to his work accident. After the accident he needed to seek ongoing medical care.
Calling this a temporary aggravation of an old problem, which is what the IME doctor said, is a farce. It drives me bonkers that insurance companies will be this extreme in trying to deny benefits, but they certainly are. In fact, this case is a great lesson for other claims. Even when they are paying for your care, they are looking for a way to cut you off. They’ll do it in what seems like the most painfully obvious ways. All they need to do to be successful, at least until you get in to court, is to get a hired gun doctor to say whatever they want to say.
And that’s the real problem. Finding a doctor who will say things that are completely counter intuitive and obviously wrong is not a problem. The only good news is that if you are cut off or denied for ridiculous reasons, winning at trial is usually not a problem if you have a lawyer who knows what they are doing. Sadly though, medical care can get delayed and health can be put at risk while this happens. It’s all the more reason to have a case officially on file so if a problem occurs you can get a hearing as soon as possible.
