In Illinois, each year approximately 250,000 workers report being injured to their employer and 60,000 claims are submitted to the the Illinois Workers’ Compensation Commission (IWCC). With so many claims being filed, it is inevitable that a significant number of them will involve pre-existing conditions. Pre-existing conditions are addressed in the Illinois Workers’ Compensation Act and workers are still eligible to receive benefits so long as there is proof that their employment aggravated their pre-existing condition.
Dealing with pre-existing conditions, however, can be tricky and there are several nuances that must be taken into account. Not all pre-existing conditions are equal and some will affect the injured worker’s benefits more than others.
Here is what Chicago workers need to know about how pre-existing conditions may affect their workers’ compensation claim and benefits.
Types of Pre-Existing Conditions
The first step in understanding how pre-existing conditions affect workers’ compensation benefits is to first have clear definition of what a pre-existing condition is. For the purposes of workers’
compensation, a pre-existing condition can be any medical condition the worker already had before they filed a claim for a work injury or occupational disease. There are three main categories of pre-existing conditions.
Pre-Existing Conditions Tied to a Previous Workers’ Compensation Claim – This category encompasses all pre-existing conditions that involve the worsening of previous work injuries. For instance, consider a worker who filed a claim a year ago due to a herniated disc and after a full day of loading heavy boxes suddenly has a disc flare up again. In this case, the job duties performed aggravated an old injury. If the worker files a claim for this injury, the employer still must pay the medical bills involved. In addition, if the injured worker needs to miss days of work due to the injury, the employer will need to pay temporary disability benefits. The benefits the worker receives, however, will be slightly reduced to account for the benefits they collected previously. The determination as to whether the injury is truly related to an old injury, to what extent the pre-existing condition has been aggravated, or if it has been permanently worsened should be done by a doctor.
Pre-Existing Conditions from Injuries Not Sustained at Work – There are many instances when workers have been injured outside of work that have left them with pre-existing conditions with no prior workers’ compensation claim. For example, a worker who dislocated their shoulder in a car accident, and then later has the injury aggravated due to work activities, falls under this category. Although the injury is not related to any previous claims, the workers’ compensation benefits the worker could receive will only cover the aggravation of the condition. Again, having a doctor evaluate the extent to which the injury has been worsened is extremely important as they will be best prepared to accurately describe the condition as it relates to workers’ compensation.
Completely Unrelated Pre-Existing Conditions – If a worker simply has a pre-existing condition, either from a previous workplace injury or not, it may have little to no impact on filing a new claim. This would be the case for a worker who has osteoporosis and breaks a bone due to a fall at work. The employer is still required to compensate the injured worker for their medical expenses and missed time at work.
One of the major concerns with pre-existing conditions comes up when dealing with total permanent disabilities. Because of the complications that may arise in workers’ compensation claims involving pre-existing conditions, it is useful to speak to an attorney about the specifics of the individual case.