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Whether your old injury will be eligible for workers’ compensation and how much you can receive in benefits depends on a few factors, such as:
- If the original injury resulted because of a workplace issue
- If the new injury resulted because of your job
- If you have received benefits and treatment for the injury in the past
.These are just a few subjects to consider when determining your eligibility for workers’ compensation. Keep in mind that even these factors just serve as a guide for you, your attorney, and your employer’s insurance company. When an old injury acts up, there is no truly simple answer as to whether it qualifies for workers’ compensation. However, having an attorney on your side can help you decide.
Can You File a New Workers’ Compensation Claim for an Old Injury?
You can file a new claim for an old injury. However, whether the claim will be approved depends on several issues. You must prove that your new injury happened because of your job. If you cannot, you will likely be denied workers’ compensation benefits.
When it comes to workers’ compensation for an old injury, filing a claim is not the tricky part. Filing it in a way that will give you the best chance to recover full benefits is where it starts to get a bit more difficult.
Does the Initial Injury Have to Be Work-Related?
No. The initial injury you suffered does not have to be work-related. For instance, if you have a history of herniated discs and you suffer one because of a work incident, your company’s workers’ compensation program should cover you. Pre-existing conditions do not prevent you from recovering workers’ compensation if you can prove your job is the reason for your current ailment.It is very important that you tell the truth about your pre-existing conditions should you face a denial from your employer. When meeting with neutral third-party judges, agreed medical evaluators (AMEs), or qualified medical evaluators (QMEs), answer all their questions honestly and provide them with the necessary details.You may be tempted, but do not omit facts about your past medical health because you think they will prevent you from acquiring benefits. If you do not act honestly, you could risk losing benefits.
What If You Have Already Received Treatment and Benefits?
In the event that you suffer the same injury at work as you have in the past, you can still file another workers’ compensation claim and receive the same benefits as the last time, as long as you recovered from your injury. If you are still receiving treatment for an old injury, your employer may be able to apportion your benefits.
Apportionment
Per the California Department of Industrial Relations (DIR), workers’ compensation benefits can be apportioned. Whether apportionment will take place varies on a case-by-case basis. A physician will determine if apportionment is appropriate depending on how much of the injury was directly caused by your task.Suppose you have a temporary injury that you are receiving care for and reaggravate that injury. In that case, it will be up to a physician to determine what percentage of your new injury was actually caused by work and has not already been covered by your previous workers’ compensation claim. Whatever percentage they determine will then need to be covered by your employer’s insurance, while you will be responsible for the rest.
Apportionment for Permanent Disability
According to California Labor Code § 4663, in the case of a permanent disability, the physician must establish how much of the permanent disability resulted from your job. If you have an old athletic injury that is reaggravated at work and you cannot ever perform the same work again, the physician may determine that your employer’s insurance should pay for some of your benefits.
They may then hold you responsible for the remainder because the entire injury was not your current employer’s fault.
What If Your New Injury Is Not Work-Related?
If your new injury is not work-related, you will not be able to acquire workers’ compensation. This does mean that if your new injury was not work-related but is the same as a previous work-related injury, you will not be eligible for workers’ compensation benefits.Let’s say you injure your back at work, file a workers’ compensation claim, receive benefits, and a medical professional clears you as not permanently disabled and deems you healthy enough to return to work. Here, your employer’s insurance company has satisfied the demands of your initial injury.If you suffer the same injury is suffered at a later date but somewhere outside of work, you may not qualify for workers’ compensation benefits.
How a Workers’ Compensation Attorney Can Help You
Navigating the workers’ compensation system, especially with a unique case, can be difficult. You may benefit from having an attorney go over your options and take on your entire case. The services they may provide include:
- Collecting the incident report
- Gathering different types of evidence
- Communicating with involved parties
- Determining which laws apply to you
- Filing your claim or appeal
- Representing you during legal proceedings, if necessary
They can offer their help at no upfront cost.
KJT Law Group Can Determine Your Eligibility for Workers’ Compensation
Workers’ compensation law is complicated, especially if you re-injure the same body part from a previous claim. In these cases, you will likely have questions about how to recover compensation, if you are even able to recover it, and the best way to go about it. At KJT Law Group, we can help you decipher workers’ rights laws so that you receive appropriate compensation for your injuries. If necessary, we can help you prove that your injury took place at work and that your old injury was aggravated by an action that directly resulted from your job. To work with our workers’ compensation attorney, who can help you with an old injury, contact us at (818) 507-8525.
