One of the most misunderstood but often used defenses in Illinois workers comp law is to say a worker had a pre-existing condition.
Sometimes the insurance company defense is just dumb. They’ll claim that an injury you had as a teenager is the reason you are having problems in your 40’s even though you had a work related accident. Those are “Hail Mary” type defenses where an insurance company will say that your case is denied and hope that you go away. They don’t sincerely believe that you didn’t have a work injury that is causing your problems. They are just playing games.
Other denials of “pre-existing” problems are more sincere. Take for example a recent call we had from an injured worker with a back injury. She was frustrated because her doctor had put her on light duty six months ago due to back problems she’s had for five years. Her employer refused to accommodate her, so she continued to work the full duty job which requires a lot of lifting. Her back has broken down, and now she can’t go into work at all.
In this case, her doctor ordered a MRI of her back and compared it to one from 18 months ago. The new MRI shows herniated discs at multiple levels, and it’s a significant change from the old MRI.
In other words, she has diagnostic evidence that proves her condition has gotten worse, and it seems clear that the job has been the reason the condition has been aggravated. And while her own testimony about how her back feels different is relevant, having her doctor in her corner and his opinion supported by the MRI changes is what will likely win the case.
Of course the injury could have been to the arm, the knee or any other body part. It just happens to be the back where we see the most pre-existing conditions used as a possible defense by an insurance company. I’m here to tell you that your prior problems are not the end of any case. Whether or not you will get Illinois workers comp benefits is dependent on the facts. If you haven’t treated for years and it’s clear that your repetitive job duties have made your problem worse, you win. If you have a specific work accident that makes your problems worse, you win.
And even if you’ve been treating with a doctor, if you can prove that your condition has gotten worse due to the job, you should win. What you should never do is take the word of the insurance company that you don’t have a case. Talk to an experienced lawyer and get their opinion. If you would like to talk to us for free with no commitment at all, please call us any time.