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Can a Pre-Existing Injury Impact My Workers’ Compensation Claim in Pennsylvania?

Posted on June 16, 2022

If you are hurt in an accident at work but already had a pre-existing injury or condition, your claim could be affected. However, you are likely still entitled to receive workers’ compensation benefits if your personal injury or condition was furthered or aggravated. 

When are Workers’ Compensation Benefits Awarded for a Pre-Existing Condition in Pennsylvania?

Under Pennsylvania law, the aggravation or exacerbation of a pre-existing condition is considered a new injury. Therefore, workers’ compensation benefits will be awarded as long as there is medical evidence that your pre-existing condition was made worse while you were working. That will involve establishing the difference in your condition’s severity after the accident compared to before. If you were already in treatment for your pre-existing condition, it could be particularly challenging since the insurance company is unlikely to reimburse the costs for the medical care you were already receiving. However, as long as you can prove an increase in symptoms, you are entitled to workers’ compensation benefits. 

Benefits are determined based on the severity and classification of your injury, wage loss from the injury, and medical expenses. For a total disability, injured workers receive approximately two-thirds of their salary until they either medically recover without restrictions, return to full, pre-injury employment, or are medically able to perform other employment available to them with no loss in earnings. Suppose you were already receiving workers’ compensation when you aggravated a pre-existing injury. In that case, your benefits might be reduced depending on how much you receive from your previous claim and the severity of your new injury. 

Are Employers Required to Pay For Workers’ Compensation?

As long as you are an employee and suffer an injury while working, your employer is required to pay for workers’ compensation benefits once they receive notice that your claim is approved. Their insurer must investigate and either approve or deny your claim within 21 days of your employer being informed of the injury. It does not matter whether your job was full-time, part-time, or seasonal. If your claim is denied or you do not agree with the amount of compensation, you can file a petition to have a workers’ compensation judge hear your case. 

To receive benefits from the date of the injury, injured workers must give notice of their injury to their employer within 21 days of the accident or incident which caused them harm or the date they discover their medical condition. In total, an injured worker has 120 days to report an injury to maintain their right to seek workers’ compensation benefits. If notice is given past 120 days, an employer may not be required to pay benefits at all. 

Common Types of Pre-Existing Conditions

Any injury or condition you suffered from before a workplace injury can be classified as a pre-existing condition. The types of pre-existing conditions most commonly reported include: 

  • Back injuries (e.g., herniated or slipped disc, sciatica, chronic pain, degenerative disc disease, etc.)
  • Neck or brain injuries
  • Past surgeries
  • Healed bone fractures
  • Arthritis
  • History of chiropractic care
  • Cancer
  • Diabetes
  • Chronic illness
  • Emotional or psychological conditions
  • Blood pressure problems
  • Heart problems
  • Respiratory conditions

If you have been injured on the job and are concerned about a pre-existing injury, speak to a Philadelphia work injury attorney. They can help you file your claim and ensure you receive the workers’ compensation benefits you are entitled to.