Not every Washington state employee is in perfect health. Whether it is a bad back, old sports injury, or a chronic condition, you may have been working through or around symptoms for years before your work injury happened. But how will those pre-existing conditions affect your L&I claim? Can you get compensation if your working environment makes your pre-existing condition worse?

What are Pre-Existing Conditions?

A pre-existing condition is an injury or chronic health issue that you had before your workplace injury or occupational disease occurred. The term includes physical injuries, illnesses, and mental health conditions. They can be the result of congenital defects (that you have had since birth), prior accidents or injuries, or even the natural aging process. Basically, any ongoing diagnosis you receive from a doctor could be a pre-existing condition. Common examples include:

• Degenerative diseases (such as degenerative disc disease)
• Genetic disorders
• Arthritis
• Carpal tunnel syndrome
• Congenital conditions
• Neurological issues
• Chronic mental health issues
• Orthopedic conditions
• Past accident injuries

Does Washington’s Workers’ Compensation Cover Pre-Existing Conditions?

Having a pre-existing condition will not keep you from receiving L&I benefits for a workplace injury or occupational disease. You can’t get L&I claim benefits simply because you have a pre-existing condition and are employed in the state. Remember that, for L&I benefits, your injury or condition must be directly connected to your work. The fact that you have an unrelated diagnosis should not affect your L&I claim. But under Washington Law, you can still receive Workers’ Compensation benefits on claims filed with the Department of Labor & Industries (L&I Claims) even if you have a pre-existing condition related to the injury or illness in question.

For example, if you suffer from Major Depressive Disorder (MDD), you may have periods when you cannot work due to a dysregulated emotional state. The simple fact that you are unable to work will not create an L&I claim, but if a specific event in your workplace triggers a depressive episode, that could be the basis for an L&I claim.

What Happens if a Work Injury Aggravates a Pre-Existing Condition?

To receive L&I benefits for a pre-existing condition, you need to demonstrate that your workplace injury impacted your pre-existing condition, increasing the number, frequency, or severity of symptoms you experience compared to before the event. If your condition was already symptomatic (meaning you had specific symptoms you experienced prior to the injury), then you will need to demonstrate that those symptoms would not have gotten worse had the accident not occurred. If you had a latent or asymptomatic condition, a workplace injury could “light up” that condition, triggering symptoms you were not experiencing before. This same standard applies to old injuries, chronic conditions, and degenerative conditions.

For example, as many people age they begin to experience arthritis in their joints. This is a degenerative condition that tends to get worse over time. However, if you suffer from arthritis and then participate in a job that involves repetitive use injury from bending or lifting heavy weights, the increased pain, stiffness, and inflammation that results could be an aggravation of your pre-existing condition and qualify you for L&I benefits.

Pre-Existing Conditions in L&I Claims

It is not uncommon for employers and their insurance companies to challenge L&I claims on the basis of a pre-existing condition. You could face an argument that your pain, suffering, and disability are not connected to your work because you already had the condition prior to the accident. Even if your injury is not directly connected to an earlier diagnosed condition, your employer’s insurance company may scour your medical records to identify pre-existing conditions they can connect the injury to, rather than your work. When that happens, your L&I claims manager may request additional information, send you for an independent medical exam, or even deny your claim.

Distinguishing between an old condition and a new workplace injury can be difficult, especially if the cause is repetitive use or aggravation of a pre-existing condition. If your workplace injury or occupational disease is related to a pre-existing condition, you and your medical provider need to be prepared to draw a line directly from your work activities to specific exacerbated symptoms or functional impairment.

Your L&I claim attorney can help you do that, using medical records to document your earlier injury, recovery, treatment, and new increase in symptoms or severity. Through thorough documentation and advocacy, your attorney can show your L&I claims manager the connection between your workplace and your increased symptoms, reducing the chance that your claim is denied, or guiding you through the L&I claim appeals process.

Summary

Receiving L&I claim benefits for aggravation of a pre-existing condition can be complicated. You could face more resistance from your employer than in a straightforward workplace injury case. But you are entitled to benefits. You should work with an experienced L&I attorney to demonstrate the connection between your new or increased symptoms and your workplace injury, and defend against arguments by your employer that your injury is not related to your work. If your claim is dismissed, your L&I attorney can help you protest the decision or file an appeal.

At Reck Law, PLLC, we know it can be frustrating to get the help you need. We are here to help you get the benefits you need when a workplace injury aggravates a pre-existing condition. To learn more about our individualized approach to workers’ compensation claims in Washington State, contact Reck Law to schedule a free consultation.