Due to precautions related to COVID-19, we have expanded our options for remote consultations. Please contact our office to discuss whether a full phone consultation or video conference is appropriate for your situation.

Can workers’ compensation help with pre-existing conditions?

On Behalf of | Mar 26, 2024 | Workers' Compensation

Most employees working on a direct-hire basis have certain forms of workplace protection. One of the most important is Kentucky workers’ compensation coverage. If something happens at work that puts someone in the hospital or leaves them unable to perform their job, workers’ compensation coverage is available.

The benefits provided include disability pay while someone cannot work and medical coverage that pays for all treatment expenses. A worker suddenly hurt due to an incident on the job can apply for workers’ compensation benefits. Someone diagnosed with a job-acquired condition, like carpal tunnel syndrome, could also file a claim for benefits.

Other people may feel less certain about their rights. For example, those with an old condition that has become worse due to employment may not know if they are eligible to file a claim. Can someone request workers’ compensation benefits if they have a pre-existing medical condition?

Some pre-existing conditions qualify

The main consideration when evaluating a worker’s eligibility for workers’ compensation is whether their condition is the result of their employment. An individual with a pre-existing condition who has had the same symptoms for years likely cannot ask workers’ compensation to cover their treatment costs because the condition is not a result of their employment.

However, if someone had their symptoms under control but their job has worsened their condition, then they may qualify. A dormant condition that suddenly re-emerges due to employment tasks may be eligible for workers’ compensation coverage. A pre-existing condition that had consistent symptoms before and during someone’s employment likely is not eligible for benefits.

There have been major cases in Kentucky related to pre-existing conditions that have helped establish the standard for coverage. Typically, there needs to be medical evidence establishing that someone’s employment caused or worsened their symptoms for them to qualify for coverage. The more medical documentation someone has exploring the symptoms they have experienced and how those symptoms have changed, the better their chances of successfully pursuing workers’ compensation benefits.

Employees in more complicated situations often need more assistance when pursuing workers’ compensation benefits. Employers or insurance providers may challenge claims based on pre-existing conditions or other unusual circumstances. Understanding the basic rules of how Kentucky workers’ compensation functions, and seeking personalized legal guidance, may help employees access the support they require. Those who know their rights may feel more confident filing a claim for disability pay or health coverage accordingly.