Aggravation Injury and Workers’ Comp

How Does an Aggravation Injury Affect Workers’ Comp?

Have you sustained an injury at work? Are you worried about paying medical bills or other expenses? You also may have aggravated a pre-existing injury or illness. If so, you need to understand the intersection between your aggravation injury and workers comp.

Like most of your friends, relatives and neighbors, you must work to support yourself and your family. Whether you work in an office, warehouse, factory, field or somewhere else, you may sustain an injury on the job. This injury may make it virtually impossible for you to perform your job duties.

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Pre-Existing Conditions

Pre-existing conditions are already-diagnosed injuries or illnesses you have when you go to work. A workplace accident or even your normal job duties may make your pre-existing conditions worse.

If you have arthritis, for example, the repetitive motions necessary to fill orders on an assembly line may worsen your joint pain. The arthritis may have been manageable before except for your job duties. Your flare-up may qualify you for workers’ compensation benefits.

While workplace injuries are often physical, most states offer benefits to individuals who sustain injuries to their mental health. If your existing anxiety order worsens because of your job duties, you may be eligible for workers’ compensation benefits.

The Workers’ Compensation Process

Workers’ compensation is an insurance program that provides injured workers with funds to pay for medical expenses, lost wages and other injury-related expenses. This type of insurance usually falls within the purview of state law.

If you have sustained a new injury, developed a new illness or aggravated an existing injury or illness at work, you must understand the workers’ compensation laws in your state. While the workers’ compensation process may vary from place to place, it is likely to have the following steps:

• Notification
• Medical treatment
• Attorney consultation
• Insurer investigation
• Approval or denial
• Appeal

Notification

Immediately after sustaining an on-the-job injury or aggravating a pre-existing one, you must notify your employer. When you inform your employer of the injury, someone at the company may ask you to complete a report form.

Your employer may use this form to notify its insurer of the injury, but completing paperwork may not be necessary everywhere. Your company’s human resources representative or your manager should advise you on how to report your injury correctly.

You do not usually want to delay reporting an injury or illness. If you believe your pre-existing condition is worse because of your job duties, it may be a good idea to inform your employer. After all, if you fail to do so, your employer may argue that you aggravated your pre-existing condition somewhere other than at work.

Medical Treatment

Delaying medical treatment may be problematic for a couple of reasons. First, your pre-existing condition may continue to deteriorate. Even worse, doctors may have limited options for treating your injury or illness. Either way, you need to obtain medical care as quickly as possible after sustaining your injury and notifying your employer.

In some states, your employer may choose which doctor you see. If you work in one of those states, your employer may give you a list of acceptable physicians. Otherwise, you may be able to see your primary care physician for your job-related aggravated injury.

When you see a doctor, you must explain how you aggravated your pre-existing condition. You should also tell the doctor about your medical history and any work or lifestyle limitations you have experienced because of your injury.

Your doctor may refer you to a specialist, therapist or other medical professionals. It is important to follow through with ongoing medical care. Your workers’ compensation doctor typically cannot share confidential information with your employer or its insurer.

Attorney Consultation

Following any on-the-job injury, it may make sense to talk to a workers’ compensation attorney. Your attorney may help you complete necessary paperwork, negotiate with your employer’s insurance company or otherwise assert your legal rights.

Consulting with an attorney early in the workers’ compensation process may also help you avoid making critical and unnecessary mistakes.

Insurer Investigation

After your employer submits a workers’ compensation claim to its insurer, the insurance provider may investigate. Often, these investigations attempt to discern whether an aggravated injury actually occurred at work.

During the insurance provider’s investigation, you may have to submit additional documentation or visit different doctors. If you learn of an investigation, your workers’ compensation attorney should know about it.

Approval or Denial

Whether your employer’s insurance provider chooses to investigate, you are likely to receive either an approval or a denial. If the insurer approves your claim, you may receive financial compensation for your medical bills, lost wages and ongoing care costs.

Your employer’s workers’ compensation insurer may also deny your claim in whole or in part. Here are some common reasons an insurer may deny your claim:

• You did not report your injury in time
• You did not obtain medical treatment
• Your injury did not appear to relate to your job
• You filed your claim too late

If you receive a denial, it is important to read the denial carefully and to deliver it to your attorney.

Appeal

If you receive a denial, you likely have a short time to appeal the decision. Before doing that, though, your attorney should review the denial to see if there is an easy way to correct the problem. If there is not, your appeal may require a hearing before an administrative law judge or a workers’ compensation board.

Work With an Experienced Local Lawyer

The workers’ compensation system is incredibly complex with many potential pitfalls for injured workers. An experienced local lawyer understands the law where you live.

If you hire an attorney for your workers’ compensation case, he or she may investigate your injury and build a comprehensive case. Your employer may also help you access support services, negotiate with your employer’s insurer or file an appeal of a denial.

Rather than hoping for the best, submit a request online or call us today at (866) 345-6784 to get in touch with an experienced lawyer in your area!