Does New York workers’ comp cover pre-existing conditions?

On Behalf of | Sep 7, 2023 | Workers' Compensation |

Some medical conditions cause challenges years after someone’s initial injury. Pre-existing medical conditions often cause financial complications for individuals in need of medical treatment through their health insurance or other benefits. People often assume that they won’t qualify for benefits that they need when they have a pre-existing condition and may fail to assert themselves appropriately.

For example, someone who had a back injury from a car crash or carpal tunnel from a prior job might notice that their symptoms have started getting worse since moving to a new position with their current employer. That worker might believe that they are ineligible for workers’ compensation coverage because their underlying condition was not necessarily caused by work-related circumstances, but that isn’t always the truth.

Pre-existing conditions sometimes qualify

Every workers’ compensation claim requires evaluation on a case-by-case basis. Someone’s prior medical records, the job that they perform and multiple other factors can all play a role in whether or not someone qualifies for benefits in their current situation.

If someone has a pre-existing medical condition diagnosed long before they started their current job, basic treatment and care for that condition would likely not be available through workers’ compensation. However, if their job worsens their condition their causes their symptoms to flare up after remaining manageable or stable for years, then workers’ compensation coverage could be available.

The worker will typically need to demonstrate that the job they perform affects and worsens their condition. They may then qualify for benefits that will provide full medical coverage as they attempt to manage their symptoms. Workers can even qualify for disability benefits if they require a leave of absence from their job until their symptoms become more manageable.

Complicated claims can be a challenge to manage

Showing that a pre-existing condition has worsened or otherwise handling a complicated workers’ compensation claim can be very difficult for someone already coping with medical issues. Particularly when an employer does not seem supportive of a worker’s desire to seek treatment or request accommodations, they may need help navigating the claims process.

Understanding the basic rules that apply to workers’ compensation claims in New York may help those who are struggling with a medical condition aggravated by their employment to pursue the support they need (and deserve) to continue supporting themselves until they can return to their job.