Has your Illinois workers’ compensation case been denied due to a pre-existing injury? Are you worried it will be? We can likely help. Call us at 312-346-5578 to have a free, confidential, consultation with an attorney.
A big misconception is that if you have a prior injury, you can’t bring a workers’ compensation claim for a new injury to that same body part. Insurance companies regularly (and often wrongly) will deny benefits to someone who had a prior injury. In other words, if you hurt your back a year ago at home, if you say you injured it at work today, they will likely fight you.
While it’s annoying for an insurance company to turn down your claim, you have to remember that they don’t have the final say. Under Illinois workers’ compensation law, an aggravation or acceleration of a prior injury is covered by the Work Comp Act. So if your job makes your injury worse, you win. If your prior injury was really old and hasn’t required medical care for a long time, you should win.
It’s still up to you to prove your case and we do that through credible medical testimony. That is usually from an orthopedic doctor or other treating physician depending on what is wrong with you. But there’s one simple way to blow the pre-existing injury defense out of the water. A recent Illinois Workers Compensation Commission case demonstrates how.
In that case, a forklift driver for a food company had a prior history of shoulder problems. One day he was driving when the steering wheel quickly turned. This caused him severe shoulder pain. He reported the incident to his boss and doctor. He was diagnosed with left shoulder biceps tendinitis and adhesive capsulitis. This happened in the spring of 2018.
What one him the case was the fact that in April of 2017 he had a left shoulder MRI. He was able to work up until the work injury in May of 2018. He then had another MRI in July of 2018. That one showed that the biceps injury was not present on the earlier MRI. In other words, it was a new problem and the work accident had accelerated or aggravated the prior problem significantly.
Also working in his favor was the post-accident treatment in 2018 was much more intense and significant compared to what was needed in 2017. Specifically, surgery wasn’t recommended until after the work accident. So while the MRI was the nail in the coffin to help him win in my opinion, the fact that the injury was much worse didn’t hurt either. In fact, even if the MRI was the same both times, I think he still would have won because the problem got so much worse.
Now not everyone has two MRIs to compare. If you don’t, don’t stress. The fact that an MRI wasn’t needed previously and was after you got hurt at work is another way to show that your injury became greatly aggravated due to the job.
The bottom line is that insurance companies fight these cases and often they have to go to trial. But they are winnable and with some simple facts, we often can convince the insurance company that they made the wrong decision without having to go to trial.