It’s a scenario repeated frequently by callers to our office. First, the caller tells us he suffered a work-related accident and injury. Then, the caller tells us the workers’ compensation carrier has simply denied his claim on the basis he had a “pre-existing” injury or condition. Often, these denials involve some prior injury that occurred years ago or some prior condition that did not prevent the person from working his current job.
How does Alabama’s Workers’ Compensation Act treat the issue of “pre-existing” conditions? I learned long ago that every case presents unique facts and issues. But, here are two general principles in Alabama:
- A pre-existing condition that did NOT affect the employee’s work performance before the disabling injury is generally NOT considered a pre-existing condition under Alabama’s Workers’ Compensation Act.
- An employee is not prevented from collecting workers’ compensation benefits even though the worker has a pre-existing condition, if the current employment aggravates, accelerates, or combines with, a latent disease or infirmity to produce disability.
Alabama’s workers’ compensation laws are complex with different issues and standards for different types of injuries. The Act treats accidental injuries, repetitive trauma injuries, and occupational diseases, differently in many ways. Yet, the two principles I mentioned are important to keep in mind.
If the insurance carrier claims your condition is “pre-existing,” you have options. First, don’t simply accept a denial if you were previously able to work your job. Second, if your claim has progressed to a lawsuit, then your attorney can and should seek discovery on this issue. Your employer often possesses numerous documents that would support your case. These documents can include time sheets and work calendars which can be used to show you worked a full schedule before the accident. They can include performance reviews and production reports which can be used to show your work performance was excellent. Witnesses such as co-workers can also testify that you fully performed your job prior to the injury. In my practice, I aggressively pursue witnesses with information to help your case.
Alabama’s workers’ compensation laws are not intended to protect just those few who enjoyed perfect health prior to their work-related injury. Instead, our laws were intended to protect all workers by providing necessary medical care and a base level of benefits. As a result, if you were able to perform your job prior to suffering a work-related injury, don’t simply accept a blanket denial of your claim. Seek skilled legal advice. You are likely entitled to benefits under Alabama law.