February 25, 2021

Pre-Existing Conditions & Workers’ Compensation: An Overview

Pre-existing conditions have been widely discussed in national and regional media, particularly with the emergence of 2014's Patient Protection and Affordable Care Act. Colloquially referred to as "Obamacare," this federal healthcare policy mandated that health insurance open their enrollment to individuals with pre-existing medical conditions, such as asthma, cancer, and diabetes.

While the connection to healthcare providers is obvious, some readers may be wondering how this change in policy impacts workers' compensation eligibility?

Below we delve into this topic in greater detail along with some of the legal issues surrounding it.

clipboard with words "pre-existing conditions"

What Constitutes a Pre-Existing Condition?

In the context of workers' comp, pre-existing conditions refer to previous medical conditions or aggravation of pre-existing conditions that stem from a work-related injury. Unfortunately, some employers and their insurance companies will seek to deny claims from an injured worker who has a pre-existing condition, arguing that any aggravation is not directly tied to their work duties.

Example Conditions That May Lead to a Denied Claim

  • Old injuries stemming from a car accident or sporting activities
  • Arthritis
  • Degenerative disk disease related to aging

How Maryland Workers' Comp Law Handles Pre-Existing Conditions

To reiterate, pre-existing conditions are not a bar to workers' compensation benefits. Many injured workers, especially those with physical jobs, have prior injuries. The Maryland Workers' Compensation Commission will consider this at the end of a case.  The final award for permanent problems can apportion some of the disability to prior problems. For example, an injured worker can be awarded 15% disability to the back, with 5% pre-existing and 10% to this accidental injury.

For subsequent intervening accidents, whether it is the same accident or not, they are typically handled as new cases and would supersede the prior injury.

Regardless, individuals should make sure to tell their treating physician about their pre-existing condition and how, if it all, it is different now.

How We Can Help

If you are attempting to file a workers' compensation claim and have a pre-existing medical condition, you will want an experienced Maryland workers' comp attorney on your side. Not only will they assist with the management of your case and fight for the best possible outcome, but they will also ensure your questions and concerns are addressed throughout the process.

Get started by contacting Shultz Legal either by phone or using our contact form.