Pre-existing condition? Don’t throw in the towel.
Unless you are an 18-year-old fitness instructor, you probably have some kind of pre-existing condition. Popping knees, achy elbow, sore back, bum shoulder? Such medical conditions are rampant among adults, and especially common in older workers and in workers whose jobs require repetitive or heavy lifting. Sometimes, North Carolina workers aggravate their condition at work but figure they cannot receive workers’ compensation benefits since they have been hurting for a long time. They drop the ball on reporting a workers’ compensation claim, giving up the fight before it even starts.
Do not fall into this trap! The North Carolina Workers’ Compensation Act allows workers to recover benefits for many types of aggravation. Here are some tips if you think you aggravated a pre-existing condition:
Seek New Treatment
When the insurance adjuster learns that you have a pre-existing condition, he or she will investigate whether the accident caused you to seek any new treatment. If you simply return to the same doctor you have been seeing for years and complain about the same kind of pain (or, worse, do not see a doctor at all), the insurer may deny the aggravation claim. See a medical provider right away if your symptoms change or worsen due to an accident. This one easy step may make the difference between a recovery or a denial.
Report Any Changes
The adjuster probably also will look for any evidence that your medical condition remained pretty much the same as it was before the accident. The evidence the adjuster will use? Your own description of pain to the doctors, as documented in your medical records. Too often, workers who aggravate pre-existing conditions fail to explain to their doctors how their pain has worsened or changed since the accident. They make the mistake of saying, “my back is still hurting” instead of “my back hurts even worse now, since the accident.” Little details, like the fact that you increased your dose of over-the-counter pain killers or that you cannot sleep due to pain can make or break the case. Even the precise area of pain is important. If your pain level is the same but you feel the pain in a slightly different spot, make sure to mention that change, as well.
Consult an Attorney
Under North Carolina law, if an injured worker requires new treatment following the accident, then the accident likely aggravated a pre-existing condition and could be found compensable. But it also could not be found compensable. Small nuances in the way you describe your condition to your employer, your doctor, your nurse, and the insurance adjuster can affect your outcome drastically. For example, the insurance adjuster may ask you leading questions, hoping for certain magic words that will allow her to deny your claim. Experienced workers’ compensation attorneys like those at Ricci Law Firm can make sure you get to tell your whole story, so that the insurance company sees the truth about your injury.
The attorneys at Ricci Law Firm regularly help workers’ compensation clients who have substantially aggravated or exacerbated a pre-existing condition. If your medical condition changed or worsened due to an accident at work, contact Ricci Law Firm.