Injured on the Job, Pre-Existing Conditions, and Workers’ Compensation in Arizona

A pre-existing condition does not prevent a worker from getting coverage for a worker related injury in Arizona. The condition could be from a prior accident, a birth defect, or other health problem that occurred before you were hurt on the job (i.e. a prior back injury that was has not completely healed).

Generally, an injured worker is only entitled to benefits for the workplace injury, not for the underlying pre-existing condition. For example, if you were born with scoliosis and later suffer a herniated disc at work, your employer’s insurance company may be responsible for costs to treat the herniated disc (the injury that happened on the job), but not the scoliosis. Likewise, if you already had a torn meniscus in your knee and you suffer further deterioration of the knee cartilage at work, you may be entitled to compensation for the percentage of knee damage that occurred while on the job, but denied compensation for the pre-existing impairment of the meniscus. However, Arizona courts have provided workers’ compensation benefits when an industrial injury aggravates a pre-existing condition.

Of course, there are many variations to the situations mentioned above.  Courts handle these issues on a case-by-case basis. Defining Arizona workers’ compensation benefits based on aggravation of an existing injury can be complicated. Most of the time, there isn’t a clear line between an old injury and a new one. This leaves room for interpretation from you and your employer’s insurance company.

If you are already receiving treatment for the pre-existing condition, your on-the-job injury should not interfere with your rights to continued coverage of the pre-existing condition under your health insurance. Your employer’s workers’ compensation insurance is responsible for coverage of the work-related part of your condition. The dual coverage, however, may require you to see two or more doctors. Although this may be inconvenient, it may allow you to receive more comprehensive health coverage with minimal out-of-pocket expenses.

It is important to note that it’s wise to disclose a pre-existing condition to your attorney and to your doctor. A prompt disclosure can ensure that your attorney has all the important information he may need to properly structure your workers’ compensation claim. It will also help your doctor to provide the best possible care and to be prepared to discuss your condition if your case ever goes to court.

Weston Montrose, Esq.

Attorneys at Taylor and Associates, PLLC are happy to answer any questions you may have regarding your Arizona workers’ compensation claim and pre-existing conditions. Our lawyers will help protect you from the common tactic used by insurance companies that claim your work injury was pre-existing and therefore not covered by workers’ compensation.

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