If you have a pre-existing medical condition, an on-the-job injury can be stressful. You may have heard that a prior injury or illness will disqualify you from workers’ compensation benefits, but this is a common misunderstanding in Illinois.
If a work accident or your job duties aggravated or accelerated a pre-existing condition, you can still be entitled to benefits. The law does not allow employers to deny you benefits just because a previous condition made you more susceptible to an injury. The key is proving a connection between your work and the worsening of your condition.
Defining Illinois’ “aggravation rule”
In Illinois, an injury is typically covered under the Workers’ Compensation Act if your work activity was a contributing factor. The work incident does not need to be the sole or primary cause. The aggravation rule covers a variety of situations, including:
- A prior back injury worsens after lifting heavy objects at work.
- Repetitive tasks like typing that cause an old carpal tunnel injury to flare up.
- Workplace exposure to chemicals that worsen a pre-existing respiratory condition.
- A fall at work that causes the effects of a prior concussion to re-emerge.
A work incident can inflame an existing health issue, thereby making you eligible for benefits.
The burden of proof and evidence
To receive benefits, you must prove your injury arose out of and in the course of your employment. This means showing your work aggravated your pre-existing condition. You need strong documentation.
Be honest with your doctor about the prior injury and how the work incident made it worse. Your medical records are the backbone of your case. They should clearly document the change in your condition after the work incident. Your doctor’s opinion is vital, especially if it connects your current condition to your work.
Challenging insurance company tactics
Your employer’s insurance company may argue your condition is from your pre-existing injury, not your job. Their goal is to minimize or deny your claim. They might delay your claim, ask for a recorded statement or suggest you return to a light-duty job before you are ready.
Here are some ways to fight these tactics:
- Report your injury immediately: Inform your employer in writing as soon as you can. You have 45 days in Illinois to report it.
- Be careful with what you say: Never give a recorded statement to the insurance company without first consulting an attorney.
- Follow your doctor’s orders: Adhere to all medical advice and keep your doctor appointments.
- Document everything: Keep copies of all medical records and paperwork related to your claim.
Even if the insurer denies your claim, it’s not necessarily the final word. Illinois has a multi-stage process to appeal rejected claims.
Don’t go it alone with your well-being on the line
Having a pre-existing condition does not automatically disqualify you from workers’ compensation benefits. While the law is on your side, the process can be complicated. A skilled workers’ compensation attorney can provide guidance, help you gather evidence and fight for the benefits you deserve.