What are my Rights Regarding Pre-Existing Conditions and Missouri Workers’ Comp?
If you’ve been injured at work in Missouri, you might be expecting workers’ compensation to cover your medical bills and lost wages without any trouble. But what if you already had a pre-existing condition? This can complicate things, especially when employers or insurance companies argue that your injury isn’t connected to the job. This is where having a Workers’ Comp Lawyer St. Peters MO by your side becomes essential to protect your rights and help you get the compensation you deserve.
Missouri workers’ compensation laws do account for pre-existing conditions, but the process can still be tricky. The key is proving that your work injury either worsened your pre-existing condition or directly caused it. With proper legal support, your chances of success increase significantly. Understanding how the system works and getting the help of an experienced lawyer is essential to fight for your benefits.
Quick Summary:
- Having a pre-existing condition doesn’t mean you’re automatically disqualified from receiving workers’ compensation benefits in Missouri. If a workplace injury worsens a prior condition, you may still be eligible for compensation, but insurance companies often try to deny these claims.
- To receive benefits, your workplace injury must be the primary cause of your need for medical treatment or work limitations. If the injury only mildly affects your pre-existing condition, your claim could be denied, making strong medical evidence essential.
- Missouri’s Second Injury Fund provides financial assistance to workers whose prior medical conditions worsen due to a work-related injury. This fund helps cover additional costs, such as medical expenses and lost wages, that traditional workers’ compensation may not fully cover.
- A workers’ comp lawyer can fight insurance company denials, gather necessary medical evidence, and ensure you get the full benefits you deserve. With legal guidance, you stand a much better chance of proving your injury was work-related and securing compensation for your aggravated condition.
What Qualifies as a Pre-Existing Condition?
A pre-existing condition refers to any health issue someone had before getting injured at work. This could include conditions like arthritis, previous back injuries, or past surgeries. Having a pre-existing condition doesn’t automatically disqualify you from receiving benefits under Missouri workers’ compensation laws. The important factor is whether your job-related injury made the condition worse.
Workers’ comp for pre-existing conditions in Missouri focuses on proving that your workplace injury was the main cause of the need for medical treatment. If your job aggravated the condition to the point that you require additional care or can no longer work, you may still qualify for benefits.
Aggravation vs. Exacerbation: What’s the Difference?
When a workplace injury affects a pre-existing condition, it can either aggravate or exacerbate it. Understanding the difference is key to your workers’ comp claim.
Aggravation
When a work injury makes a pre-existing condition worse in a permanent way, it’s called an aggravation. In Missouri, this is usually covered under workers’ compensation, meaning you can still get benefits even if you had a prior health issue.
Exacerbation
If a work-related incident briefly worsens an existing condition but doesn’t cause long-term damage, it might not be covered under workers’ comp. This means the symptoms may go away after a short period without requiring extensive treatment or permanent changes to your health.
For example, if a worker with mild arthritis in their knee falls at work and now requires surgery due to the impact, the fall may be considered the prevailing factor in the injury. However, if the worker simply experiences temporary soreness that resolves on its own, their claim may be denied.
What is Missouri’s “Prevailing Factor” Standard?
Missouri follows the prevailing factor rule when deciding if an injury qualifies for workers’ compensation. This means that your work injury must be the main reason for a new medical condition or for making an old condition worse. If the workplace accident only caused mild symptoms without really making the pre-existing condition worse, your claim might be denied.
According to the Missouri Department of Labor, the injury must be more than just a small contributing factor—it has to be the main reason you need medical care or can’t work.
The Role of Missouri’s Second Injury Fund
Missouri has a Second Injury Fund (SIF) designed to help workers who already have a disability or medical condition that gets worse due to a workplace injury. The SIF provides financial assistance in cases where a combination of a prior condition and a new work injury leads to greater disability than either injury would have caused alone. This is especially useful for employees who may struggle to prove that their workplace injury significantly aggravated their existing condition.
The fund helps cover medical expenses, lost wages, and other benefits that might not be fully provided by traditional workers’ compensation. If you have a pre-existing condition and are injured at work, you should explore whether the SIF can help support your claim.
Steps to Take if Your Claim Involves a Pre-Existing Condition
If you have a pre-existing condition and suffer a workplace injury, taking the right steps can improve your chances of getting workers’ compensation benefits. Here’s what you should do:
- Report the Injury Immediately: Tell your employer about your injury as soon as it happens. Waiting too long to report it can make it harder to get workers’ comp benefits because the insurance company may argue that the injury didn’t happen at work. The sooner you report it, the better your chances of getting the medical care and financial help you need.
- Seek Medical Treatment: A doctor’s evaluation is important in determining whether the workplace incident aggravated a pre-existing condition. Medical records and professional opinions can provide the necessary proof that your injury is work-related. Delaying medical care could weaken your claim, so it’s important to get checked out as soon as possible.
- Document Everything: Keep detailed records of all medical visits, treatments, and any symptoms you experience after your injury. Also, save any emails, messages, or letters from your employer or their insurance company. These documents can help prove your case if there is a dispute about your claim or the severity of your condition.
- Consult a Workers’ Compensation Attorney: If your claim is denied or disputed, having a lawyer on your side can make all the difference. An attorney knows the legal system, understands how to handle insurance companies, and can gather the right evidence to prove that your injury is work-related.
Without legal help, you might struggle to get the benefits you deserve, but with a lawyer, you have a much better chance of a successful claim.
Contact Our Workers’ Comp Lawyer in St. Peters MO Now
Missouri workers’ compensation law does not automatically disqualify injured workers with pre-existing conditions. If a work injury significantly worsens a prior condition, benefits may still be available. However, handling these claims can be difficult due to strict legal standards and insurance company tactics. Working with a Workers’ Comp Lawyer St. Peters MO can help you understand your rights, gather strong medical evidence, and improve your chances of receiving the compensation you deserve.
For legal guidance, consider reaching out to Adams Law Group for tips on Workers’ Compensation. Our St. Peters MO attorneys understand the complexities of Missouri workers’ comp laws and can help ensure you receive the benefits you deserve.
Don’t let a past injury stand in the way of your recovery—get the legal support you need today. Schedule a free consultation now.
