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Getting the System

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

By June 11, 2010February 22nd, 2016No Comments

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.

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