How Workers Comp Works If You Have a Preexisting Condition
Updated: Jun 17, 2019
Many people wonder if they can still get workers compensation in Vermont if they have a preexisting condition. As a workers comp attorney, I am asked this question fairly regularly. The answer is - yes. (Usually.) The existence of a preexisting condition does not bar a workers compensation claim.
Aggravation, Flare Up or Continuation? Categorizing Your Injury...
When it comes to workers comp, the State of Vermont has three different ways to categorize an injury as it relates to a preexisting condition. Whether or not it is covered by workers comp will depend on which of the three categories your injury falls into. The categories are as follows:
An “aggravation” or “exacerbation” of a preexisting condition, which is defined as a worsening of the underlying condition, is covered by workers compensation as a new injury.
A temporary worsening of symptoms because of a work injury is called a “flare-up” and is covered by workers compensation, but only for the increase in symptoms.
A mere continuation of symptoms without change to the underlying condition will not be covered by workers compensation.
Let’s look at an example…
“Matt” works in construction and has a long-standing lower back condition. Most of the time Matt treats with his chiropractor once a month and lives with the discomfort. This would be considered his “baseline.”
If Matt injures his back at work and actually worsens the underlying condition (as opposed to simply worsening the symptoms), then this would be considered an “aggravation” under workers compensation law. This is considered a new injury and the insurance company is now completely responsible for this injury going forward.
If Matt had already received payment for permanent impairment for this injury, however, the insurance company may only have to pay for the increase in the permanent impairment.
If Matt’s injury at work causes an increase or worsening of his symptoms, this would be categorized as a “flare-up” under workers compensation law. The increase in symptoms would be considered a new injury and workers comp would have to pay for medical bills for the increased treatment and lost wages if Matt’s doctor tells him to take more than three days off because of the injury. Once Matt returns to baseline, workers compensation would no longer be responsible.
Sometimes it is not clear whether the work injury is a flare-up or an aggravation until sometime after the injury occurs.
If the prior non-work condition was a progressively degenerative disease, there is a slightly different analysis that will be addressed in my next blog - coming soon!
Stay tuned for more blogs explaining the purpose of workers compensation, how it works and who is eligible in Vermont.
Do you need workers comp legal advice? I can help! Contact me.