Yes, you can get workers’ compensation benefits in Massachusetts for a pre-existing condition if a work-related activity makes it worse. Insurance companies often use pre-existing conditions as an excuse to deny claims, in violation of injured workers’ rights. Keep reading to learn how a pre-existing condition can affect your claim and what to do if the insurance company is using a pre-existing condition against you.
How Massachusetts Determines if a Pre-Existing Condition Affects a Claim
Under Massachusetts law, you can get workers’ compensation for a pre-existing condition that is aggravated or exacerbated by a work-related injury or illness. The aggravation rule says that workers’ compensation must cover the entire cost of treatment, even if the two injuries combined are worse than just the work injury. Massachusetts recognizes the aggravation rule, but only if the work injury is a “major cause” of the new disability or need for treatment. However, it does not have to be the predominant cause.
Medical opinions often differ on what constitutes a “major cause.” Since there is no precise definition, insurance companies define it however they want and frequently deny benefits unfairly. You must provide detailed medical records to show the difference in your condition and treatment plans before and after the injury was made worse.
If you aggravate a pre-existing injury previously covered by workers’ compensation, you must show that the aggravated injury is a new injury and not a flare-up of the old injury. If more than two months have passed since you returned to work, you can file a new claim and receive benefits at the current rate.
Pre-Existing Condition that May Get Worse at Work
Proving your work activities are a major cause of your new symptoms may require a detailed breakdown of your new and old injuries. You will also need evidence showing how your work activities aggravated the injuries. Our experienced workers’ compensation lawyers can help you obtain the correct testing and evidence to prove your claim.
Below are some of the most common pre-existing conditions we often see in workers’ compensation claims.
Back Injuries
Back strains and disc herniations can cause permanent tissue damage, making you more susceptible to injuries. Activities like heavy lifting, twisting, bending, and stretching can cause inflammation, swelling, tearing of scar tissue, herniated disc relapse, and debilitating pain.
Joint Issues
Pre-existing joint conditions like osteoarthritis weaken the joints and reduce the range of motion. Excessive stress on the joints can cause tearing, inflammation, and increased pain.
Repetitive Stress Injuries
Repetitive stress injuries like carpal tunnel syndrome and tennis elbow can be aggravated through repetitive tasks, such as typing, gripping objects, or twisting, particularly when the work environment lacks ergonomic support.
Heart Conditions
If you have heart disease, angina, heart failure, or another cardiac condition, your job could aggravate it by requiring you to do heavy lifting, work in hot or humid conditions, exert yourself, or otherwise strain the cardiovascular system.
Mental Health Conditions
Stressful work environments can aggravate pre-existing mental health conditions like post-traumatic stress disorder, depression, anxiety, and panic disorders. Such aggravations are especially common in professions that repeatedly expose workers to traumatic situations, such as law enforcement and social work. However, it can also occur due to unrealistic demands or an abusive supervisor.
Are There Any Instances When Aggravated Injuries Are Not Covered?
Aggravated injuries are not covered in the following circumstances:
- The worsening of the injury was not related to work.
- The work injury is not a major cause of the new symptoms.
- The aggravation of the injury occurred due to serious, willful misconduct.
- The aggravation occurred during voluntary employer-sponsored events.
- An emotional injury was aggravated by an official personnel action, such as demotion, transfer, or termination of employment.
What To Do if a Pre-Existing Condition Is Complicating Your Workers' Compensation Claim?
Insurance companies use pre-existing conditions to complicate claims, worsening an already stressful situation. An experienced Massachusetts workers’ compensation lawyer can help you get the benefits you deserve and avoid delays.
When you choose Rob Levine Law, you can rest and recover while we take care of all of your legal details, including the following:
- Gathering medical records and doctors’ statements
- Interviewing witnesses
- Obtaining your job descriptions
- Obtaining expert witness testimony
- Negotiating with the insurance company for full benefits or a lump sum
- Representing you at hearings before the Department of Industrial Accidents
- Filing your appeal if your benefits are denied or your award is less than fair
We have recovered over $2 billion in disability benefits and injury compensation and have helped over 50,000 people. With 25 years of experience handling workers’ compensation claims, we take an aggressive approach to getting our clients the compensation they deserve.
We are available 24/7, and our Fee Free Guarantee® means Win or No Fee™. Contact us online today or call (800) 742-3920 for a free consultation.
