In Pennsylvania Workers Compensation, insurance carriers frequently deny claims based on X-Ray or MRI findings that may reveal a degenerative condition. The injured worker is usually puzzled because they never knew they had a degenerative condition. They never experienced any symptoms and never sought any medical treatment.
So what’s the deal?
We see workers compensation denials more frequently with back and shoulder injuries. Degenerative spine conditions are usually defined as changes in the spine that cause loss of normal structure and function. Typically, the degenerative condition is due to age, rather than an actual incident. This spine condition can be accelerated over time due to repeated strains, sprains, and overuse. A shoulder degenerative condition can be defined as a gradual wearing of the cartilage that leads to pain and stiffness. Many times this may include a rotator cuff tear. Often, the injured worker is stunned to find that they had a pre-existing rotator cuff tear. The injured worker never experienced any shoulder pain prior to the work injury. Tears in the shoulder are commonly asymptomatic until an event happens that causes symptoms to arise. Degenerative findings are usually seen on diagnostic testing, such as X-Rays and MRIs and may be confirmed with certain physical examination maneuvers.
Just because an employee has an underlying or pre-existing condition does not mean that the injured worker is barred from workers’ compensation benefits. These conditions are frequently aggravated or exacerbated by a work incident or work activity. It is also important to know that even if you displayed some symptoms, that does not mean you are barred from workers compensation benefits. Sadly, some local employers lead their injured workers to believe that they do not have a workers compensation claim because of their pre-existing degenerative condition. That simply is not true.
These type of work injuries can be quite complex and often revolve around medical evidence and testimony by your doctor. It is also involves complex analysis on the extent of the aggravation and when, or if, the aggravation has ceased and the condition has returned to ‘baseline’. Analysis and argument also occurs with reference to known pre-existing conditions, such as a prior work injury or car accident s that may have caused back, neck, shoulder, or knee pain in the past. Often time, employers and insurance carrier deny these claims, arguing that the injury is not work-related or that any aggravation was temporary, and therefore no longer disabling.
It is imperative that you seek an experienced workers compensation attorney to navigate your workers compensation denial. Mooney Law has the proven experience in pre-existing condition and aggravation cases. Mooney Law will always provide FREE workers compensation consultations. We have 16 office spread throughout Central Pennsylvania and Northern Maryland and we can meet you at the office most convenient for you. What’s your case worth? Find out. Call Mooney Law to schedule your free consultation at 833-MOONEYLAW or at 717-200-HELP.