Will my work injury be covered if I have had prior problems?

Group 152

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Injured workers often wonder whether an injury will be covered under workers’ compensation if they have experienced prior problems with the body part at issue. The answer is – it depends. Under Minnesota law, a work injury need not be the sole cause of a condition. It is not even required that the work injury be the biggest cause or main cause of the condition. However, the law does require that the work injury be a substantial contributing cause to the condition diagnosed and treated.

Minnesota Courts have defined substantial as synonymous with significant and appreciable. These words simply mean that the injury must be a big deal in causing the ongoing problem. Thus, the existence of a pre-existing condition does not necessarily mean that a work injury affecting the same body part will be denied coverage.

If someone has a pre-existing condition that is made worse by a work injury, the precise legal question is whether the work injury substantially aggravated, accelerated or worsened the pre-existing condition. Again, this can be boiled down to asking whether the injury plays a large role in making the pre-existing condition worse.

If a dispute arises as to whether the injury is a substantial cause to the condition involved, the injured worker will need the supporting opinion of a physician. It is not enough for the injured worker to indicate that in her opinion, the injury played a substantial role in the condition and disability that followed; rather, a medical provider must be able to indicate that the injury indeed constitutes a substantial contributing cause.

Unfortunately, insurers often deny cases where the injured worker had a prior injury to the same body part. Often, these denials are not appropriate. If you have experienced a denial of an injury because you had a pre-existing condition, then you should give some thought to consulting with an experienced workers’ compensation attorney.