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One tactic Illinois work comp insurance companies try to use to fight legitimate cases is to ask for your medical records related to all the treatment you’ve received at any time in your life. They will try to use evidence of prior problems as justification for saying that you weren’t really hurt at work.
I’m not saying this strategy never works, but a pre-existing condition does not mean that your job didn’t aggravate or accelerate a problem you had. If you can prove that, you are entitled to work comp benefits. But there might be a fight.
So how do you prove it?
1. Your credible testimony as to what your job duties are, how the condition of your back has changed as far as what you notice, and testimony as to what happened.
2. A credible written opinion from a doctor (usually an orthopedic one) that will testify that you didn’t suffer a temporary aggravation, but instead the job made things worse.
In a recent case, a cargo worker for Southwest Airlines alleged that he hurt his back while bending over and pulling on an object. He had a medical history of spinal stenosis along with two prior car accidents. Southwest used this information as the basis to deny his benefits.
He won at trial because a closer look showed a chain of events that displayed the injury was work-related. Prior to the accident date, he was working without problem. After it happened, he had an MRI that showed multi-level degenerative disc disease and a herniated disc. He eventually underwent a spinal fusion.
While he did have two car accidents, one was in the 1970’s (I told you they’ll look into anything) and the other was almost a year prior and involved no medical care. Both his doctor and the company-hired doctor agreed that the herniated disc was acute (meaning recently developed). The treating doctor credibly testified that the work accident aggravated the pre-existing degenerative back condition. This is an important point. You can have a bad back that becomes much worse from a job accident. You might be hanging on by a thread, but if a work injury is the last straw then you should get benefits.
In this case, his accident caused a massive herniation that required serious medical care. The car accident claims were a bogus distraction and the reality is that this guy was working a hard job and was healthy doing it until his back gave out. Fortunately in the end justice prevailed and he got a lot of benefits, all of which were clearly deserved from the get-go.
By Mike Helfand
Courtesy of Illinois Workers' Compensation Law Blog
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