When filing for workers’ compensation in Ohio, understanding the impact of pre-existing conditions on any possible claims is key. It’s important to note that if your claim involves a pre-existing condition, you may receive different compensation than if you only had the new injury or illness, as the insurer may not cover all related costs.
Additionally, existing conditions can influence the time and money you are entitled to receive for lost wages and medical bills.
Understanding how pre-existing conditions work with Ohio Workers’ Compensation can be critical to ensuring that claimants get all of their money benefits and medical care they are entitled to under state law.
Our Columbus workers’ compensation lawyers are here to help you with your case.
What Qualifies as a Pre-Existing Condition Under Ohio Workers’ Compensation?
In workers’ compensation cases, a pre-existing condition is any medical condition for which medical treatment was received before the work-related injury or illness occurred. That means any health conditions you’ve previously been diagnosed or treated for—even if you don’t experience any symptoms—can be classified as pre-existing.
Common examples of pre-existing conditions include prior injuries, degenerative conditions, and chronic illnesses such as arthritis, heart disease, and diabetes. If a worker has a pre-existing condition that exacerbates an existing injury or illness caused by workplace activity, their claim could be denied or reduced due to prior treatment.
However, you can still qualify for workers’ compensation if your work-related injury or illness aggravates your pre-existing condition significantly more than expected, given your previous diagnosis and treatment. Whether your pre-existing condition prevents you from getting the full benefit of workers’ compensation in Ohio depends on the circumstances surrounding your particular case.
How Pre-Existing Conditions Impact Ohio Workers’ Compensation Claims
When you file a Workers’ Compensation claim in Ohio, the insurance company will consider any pre-existing conditions when evaluating your eligibility and what kind of compensation you can expect if your claim is approved.
That’s because pre-existing conditions can influence the type and benefits you receive. They can also determine how long you’ll stay out of work and how much disability income you’ll be eligible for.
Here are the two main ways a pre-existing condition can affect your Ohio Workers’ Compensation claim.
Depending on the circumstances, a pre-existing condition may make it more difficult to prove that your work directly caused the injury or illness you’re filing a claim. In some cases, it may even disqualify you from receiving any benefits.
Amount of Compensation
If it’s determined that your work did contribute to the injury or illness (in part or in full), then any disability payments you receive may be impacted by pre-existing conditions, as they limit the severity of impairment. This means that although you can still receive benefits, they might not be as generous as they would be without a pre-existing condition present.
So if you have a pre-existing condition and are considering filing an Ohio Workers’ Compensation claim, consult an experienced attorney who can advise on what to expect when applying for this type of benefit.
Exceptions to Pre-Existing Conditions in Ohio Workers’ Compensation
You might not know this, but even if you had a pre-existing condition before experiencing an occupational injury, that doesn’t always mean you won’t be eligible for workers’ compensation. In the state of Ohio, there are exceptions to the pre-existing conditions rule.
Aggravation Due to Job Duties
In some cases, even if the injured worker already had a pre-existing condition, they may still be eligible to receive workers’ compensation if they can prove that their injury or illness was aggravated or worsened by their job duties.
For example, if an employee has chronic neck pain due to a pre-existing neck injury and further injures it from lifting objects as part of their job responsibilities, they could qualify for workers’ compensation.
Doctor Diagnosis Required For Approval Of Claim
To be approved for workers’ compensation, you must get your condition diagnosed by an authorized doctor in Ohio and provide documentation proving that the injury or illness related to your job duties.
The doctor would need to determine what percentage (if any) of your injury was caused by a pre-existing condition versus an aggravated condition from performing your job duties to approve your claim.
Steps To Take When Dealing With Pre-Existing Conditions In An Ohio Workers’ Compensation Claim
Filing for Ohio Workers’ Compensation can be more complicated if you have a pre-existing medical condition. Here are the steps you should take to make sure your claim is handled properly:
Notify Your Employer
Let your employer know as soon as you’re injured, even if it’s related to an old injury. You should also complete an Employer’s First Report of Injury and Illness form so you make sure to receive the maximum compensation you are entitled to.
Receive Medical Treatment
It’s crucial that you get the proper medical treatment for your injury or illness as soon as possible so that any delays in receiving care don’t affect your Workers’ Comp claim.
File A Workers’ Compensation Claim
While filing this claim doesn’t mean you are admitting liability on behalf of your employer, it begins the appeals process and sets certain deadlines that must be met to receive benefits. Make sure to keep all documents related to your injury in case they need to be submitted with the claim.
You may need proof that ties your pre-existing condition to the workplace injury or illness for it to be accepted by an Ohio court or workers’ compensation board panel member. It’s a good idea to consult with an experienced attorney who can help guide you through each step of the process and advise on how best to present this evidence during hearings and depositions.
You should also keep track of any lost wages, medical treatment costs, or other expenses related to your injury. This information can be used to increase the compensation you are entitled to. It’s important to note that since Ohio’s Workers’ Compensation system is a no-fault system, you don’t have to prove that your employer was at fault to receive benefits.
If your claim is denied or you feel that you are not getting the full benefits you are entitled to, you can file an appeal with the Ohio Industrial Commission, which will review the decision.
An injured worker may sometimes pursue a civil lawsuit and appeal a Workers’ Compensation claim. However, it’s important to understand that the Workers’ Compensation system is designed to provide certain benefits to injured workers, so it’s best to exhaust those benefits before considering other legal options.
Contact Columbus Workers’ Compensation Lawyers
Now that you know more about the importance of understanding pre-existing conditions in Ohio Workers’ Compensation, you are better armed to protect your rights and ensure you get the compensation you deserve for your injuries. It is important to remember that if there’s anything unclear, then don’t hesitate to contact an experienced attorney.
Our Ohio Workers’ Compensation Lawyers are here to answer any questions and guide your situation. If a pre-existing condition affects your case, we’ll work with you to ensure the outcome is in your favor. Contact us today for a free consultation. We look forward to helping you out!