Law Office of Howard J. Stevens APC
Over 40 Years Of Experience In Workers’ Compensation

Does California workers’ comp cover pre-existing conditions?

On Behalf of | Jan 12, 2024 | Workers' Compensation

A worker injury can be stressful for an employee and potentially expensive for their employer. Most companies in California provide workers’ compensation coverage for workers if they develop a job-related health condition. The benefits available can pay for their treatment and replace lost wages. Unfortunately, many workers do not file claims when they might qualify for coverage. They may fail to understand the rules that apply to California workers’ compensation and end up using their own health insurance or paid leave benefits in place of workers’ compensation benefits.

For example, many workers mistakenly assume that their employers won’t help them if they have a job-related flare-up of a pre-existing condition. Yet, workers’ compensation can potentially help those with pre-existing medical challenges if certain circumstances apply.

Some pre-existing conditions may qualify for coverage

Any medical condition that directly relates to someone’s job could potentially be eligible for workers’ compensation coverage. A worker must establish a clear connection between their employment and their health challenges to successfully pursue a benefits claim.

If someone has a pre-existing condition, there are a couple of kinds of evidence that could help them obtain workers’ compensation coverage. The first involves documentation of their prior diagnosis and possibly records of the treatment they received. Proof that they had reduced or eliminated their symptoms could help them strengthen their claim that their current job worsened their pre-existing condition.

The second form of evidence the worker may require relates to their job responsibilities. Typically, there needs to be a clear connection between their work functions and their worsening condition. Someone with carpal tunnel syndrome who starts a job working in a warehouse, driving a commercial truck or working in an office might experience a flare-up of their symptoms that could affect their overall health and their job performance.

The more proof there is that their job functions relate to their symptoms, the easier it will be to establish a causative relationship. In some cases, workers may need to undergo a specialized medical evaluation to validate their claim that their job contributed to their worsening symptoms. Those who understand the rules for workers’ compensation may have an easier time recognizing when they have grounds to file a claim. They may also feel more confident when fighting back against an unfair benefits denial.

Connecting a worsening pre-existing condition to someone’s job activities, and seeking legal guidance accordingly, could help them obtain workers’ compensation coverage for future treatment and necessary leave from work.