You are entitled to workers compensation benefits if you have an accident on the job and you injure a part of your body where you suffered a previous injury. The law allows you to collect workers compensation benefits only to the extent that the current accident is more than 50% responsible for the need for treatment. For example, 5 years ago you hurt your back in an auto accident and this year you have an accident on the job and re-injure your back. Workers compensation will cover your medical bills and lost wages for the back as long as a physician authorized by the workers’ compensation insurance carrier says that the work accident is 50% or more responsible for the need for back treatment and not the pre-existing condition.
A special situation arises when you are being treated for a work injury but a pre-existing condition interferes with such treatment. For example, you have a serious back injury which requires surgery, but you have a prior heart condition which must be taken care of before you can undergo back surgery. Prior to October 2003, the law was clear that the insurance carrier was responsible for treating the heart condition in order to treat the work related back condition. However, post October 2003, the law is not so clear. Florida Statutes Section 440.15(5)(b) seems to suggest that the insurance carrier can apportion out the pre-existing condition (i.e. the heart condition) and pay medical benefits only for the back condition. However, I have not seen any judicial interpretation of this issue and I take the position that the insurance company remains responsible for the heart condition as well as the back.
As you can see, the issue of prior injuries can complicate your workers compensation benefits. You should contact an experienced practitioner to discuss all your options and the best course of action based on your situation.
If you have a question about a pre-existing injury or pre-existing medical condition and how it relates to your Workers' Compensation claim, please feel free to contact us at (954)577-5763 for your free no obligation consultation.
Christine Nixon-Calamari, Esquire
