HOW A PREVIOUS INJURY COULD AFFECT A WORKERS' COMPENSATION CLAIM

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HOW A PREVIOUS INJURY COULD AFFECT A WORKERS' COMPENSATION CLAIM

Admin • Apr 09, 2019

Person Typing on a Laptop — San Fransisco, CA — The Law Offices of Jeffrey M. Greenberg

Workers' compensation cases do not always progress as easily as the injured employee would prefer. The case can become even more complicated if an earlier incident injured the same body part. Injured workers with prior claims need to understand the complications that could affect their new claim.

SETTLEMENT REDUCTION

An employer will still need to cover all new medical bills and any loss of pay due to an inability to work, even if the same injury took place in the past. However, your new claim will be reduced because you had a previous claim - essentially, your employer will only pay for the increase in disability.

The second settlement could be higher than the first one if the disability is more profound, but complications can arise. In instances like this, it is necessary to have legal representation to ensure a fair decision.

The State of California uses its own guide to determine disability. The Schedule for Rating Permanent Disabilities lists specific body parts and what the percentage of total disability it causes to the body. The percentage is used to calculate the amount of income loss the victim suffered due to their disability.

A shoulder injury, for example, has three possible disability percentages based on how the injury affected movement. The minor muscle groups cause 30 percent disability, major muscle groups are 35 percent, and both major and minor together are 80 percent.

If the first accident prevented movement of the minor muscles in the shoulder and the second accident affected the major muscle groups, the insurance company may claim that the employee only deserves a 35 percent disability rating for the new injury. The employee may need legal help to argue for 80 percent since both muscle groups are now affected.

INCIDENT CAUSE

Claim denials also occur if the employee ignored the orders of their doctor. Employees sometimes perform tasks they are told to avoid or go back to work earlier than a doctor recommends. Workers' compensation boards will deny a claim if the employee causes their own injury in this manner.

Some exceptions can alter the decision. An employer that threatens to fire the employee because of their limited abilities after an accident could be breaking the law, however, employees do need some proof of the threats.

Employers must try to make accommodations for injured or disabled workers or retrain them for more suitable work.

WORSENING CONDITION

A physical exam could reveal that the discomfort is not an injury but the worsening of the first injury rather than a new injury. The development of arthritis is a frequent problem after a trauma, and it may begin in people much younger than the typical arthritis patient. Arthritis causes pain and higher medical costs and can become severe enough to be disabling.

It is possible to reopen a settled workers' compensation case to request more compensation to cover new costs if a work injury leads to the development of arthritis. In California, employees have up to five years to reopen an earlier workers' compensation claim.

The problems associated with post-traumatic arthritis may not appear in time to reopen a case, but there is still the possibility of it being accepted as a workers' compensation claim. Arthritis that becomes accelerated because of the manner of work performed is a work-related illness. A new claim for the condition could prove successful.

The added complications of earlier injuries can make the already confusing process of workers' compensation claims even more frustrating. At The Law Offices of Jeffrey M. Greenberg, we can help to simplify the situation and assist you with your claim. Let out team help you to receive a fair result. Contact us today to schedule a consultation.

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