A pre-existing condition is a current injury or illness that developed prior to employment. In the event that work conditions or activities aggravate or worsen a pre-existing condition, employees may be eligible for worker’s compensation. In order to be eligible for benefits, however, Pennsylvania workers’ compensation law dictates that an injury must be directly related to a specific workplace accident or activity.

These guidelines create unique questions and challenges for Pennsylvania pre-existing injury workers’ compensation claimants concerned about their eligibility.

Average Workers’ Comp Benefits For A Pre-Existing Injury

The value of workers’ compensation varies from case to case depending on the body part affected, the severity of the injury, and the cost of medical care needed. Below is a table of estimated workers’ comp settlement amounts based on the NSC claim cost average for  injuries for each body part.

Body Part Affected Average Settlement
Head/Neck $92,439/$61,510
Back $36,882
Arms/Shoulders $46,205
Legs $57,476
Foot $27,628
Hand $24,627

Disclaimer: Every workers’ compensation case is different and these settlement values are not guaranteed. Final settlement depends on the severity of the injury, the body part affected, wage loss from the injury, and medical expenses incurred from the injury.

Pre-Existing Conditions

Pre-existing injuries include any condition a worker developed prior to employment. Some common conditions include:

  • Asthma
  • Sleep apnea
  • Cancer
  • Back injuries and other back problems
  • Knee injuries
  • Herniated discs
  • Carpal tunnel syndrome

Aggravation Of A Pre-Existing Condition

In the evaluation of workers’ comp claims, Pennsylvania law considers the aggravation of a prior injury to be an entirely new injury, mandating that liability be assumed by the employer for whom the claimant was working when the aggravation occurred.

While employers or insurance companies may attempt to deny a workers’ compensation claim by arguing they were not aware of an employee’s previous injury, the Pennsylvania Workers’ Compensation Act requires employers to provide benefits regardless of the visibility or awareness of a pre-existing condition.

Proving Your Worsening Condition Is Work Related

Pre-existing injuries can be job injuries from previous employment as well as personal injuries acquired outside the workplace. In order to be compensated under Pennsylvania law, an injured worker is only responsible for demonstrating that workplace conditions or activities resulted in an increase in symptoms.

How Are Workers’ Comp Benefits Decided?

Workers’ compensation protections, provided under the Pennsylvania Workers’ Compensation Law, afford workers financial protection and security in the form of full medical treatment coverage, disability benefits, ongoing physical therapy, and replacement of lost wages for a work-related injury

Especially in the event of an occupational injury, CT scans, x-rays, and even physical therapy can be necessary- and expensive. In Pennsylvania, weekly compensation loss benefits are generally provided at between 66.6% and 90% of average weekly wage (AWW) and capped at $1,081.00 per week.

Workers’ compensation benefits are determined based on:

  • Severity and classification of the injury
  • Wage loss from the injury
  • Medical expenses

Pennsylvania requires employers to purchase workers’ compensation insurance, and it is the employer’s insurance company that will provide coverage for the cost of medical care associated with the injured employee’s work injuries.

Compensation and coverage for medical bills afforded under the law are typically determined by the severity and type of the workplace injury an employee suffers, as well as the amount of lost wages and period the employee is unable to work.

Reduced Benefits and Previous Workers’ Compensation Claims

Claimants receiving workers’ compensation benefits due to a previous workplace injury, their benefits may be reduced to account for the prior worker’s compensation claim.

The amount of the reduced benefit is  dependent upon the amount of compensation the claimant receives from the previous claim, as well as the nature of the new injury. Claimants should expect to receive a reduction in both wage loss benefits and permanent disability benefits.

Get Your Workers’ Compensation Case Started Today

For help getting started your injury claim, it is a good idea to consult an experienced workers’ comp lawyer for best results.

The workers’ compensation lawyers at our law firm Krasno, Krasno, & Onwudinjo have significant experience helping clients with pre-existing medical conditions navigate the Pennsylvania’s workers’ compensation system.

Contact us today at (844) 243-4932 for a free consultation.

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