“You Already Had a Bad Back”
You have dealt with some back stiffness for years. It never kept you from working. Then you lifted a heavy box at your job in Bensalem, felt something give, and now you cannot get out of bed without pain. When you file a claim, the insurer’s answer is short: “This is a pre-existing condition. Not our problem.”
That answer is often wrong. Here is how pre-existing condition workers comp PA rules protect workers in Bucks, Montgomery, and Delaware counties, including Levittown, Norristown, and Philadelphia.
Work Aggravation Is a Work Injury
In Pennsylvania, if your job aggravated, accelerated, or worsened a condition you already had, that aggravation can be a compensable work injury. The law generally takes workers as they are. You do not need a perfectly healthy body to be covered. You can find general information about the system from the Pennsylvania Bureau of Workers’ Compensation.
This comes up constantly. According to the U.S. Bureau of Labor Statistics, sprains, strains, and tears are among the most common workplace injuries that lead to time off work, and many of them happen to backs, shoulders, and knees that already had some wear and tear.
Common Pre-Existing Condition Scenarios
| Before Work Injury | After Work Injury | Possibly Compensable? |
|---|---|---|
| Mild arthritis, no treatment | New disc herniation after lifting | Yes, as a new injury or aggravation |
| Old knee surgery, fully working | Fall at work tears the knee again | Yes, as an aggravation |
| Occasional back pain | Pain becomes constant, needs surgery | Likely, with medical support |
| Already out of work for the same condition | No real change after the work event | Harder to prove |
How the Insurer Will Fight It
Expect the insurer to dig into your past medical records. Common tactics include:
- Saying your symptoms are “just” the old condition
- Describing your injury narrowly on the Notice of Compensation Payable, such as “lumbar strain” only
- Sending you to an Independent Medical Exam and later arguing you have returned to your “baseline”
- Filing a petition to end your benefits once the aggravation supposedly resolves
How to Protect Your Claim
- Be honest with your doctors about your prior history. Hiding it hurts your credibility.
- Ask your doctor to explain clearly what changed after the work incident.
- Gather proof that you were working full duty before the injury.
- Check how your injury is described on the NCP. If it leaves out conditions, the description can be challenged and expanded.
- Keep a simple log of what you could do before and what you cannot do now.
The most important evidence is usually a medical opinion that connects the work incident to the worsening of your condition.
When to Speak with a Pennsylvania Workers’ Comp Lawyer
Pre-existing condition claims often turn into a battle between doctors. A lawyer can help make sure the right medical evidence is in place and that your injury is described fully. Learn more about the firm’s workers’ compensation services here, or see answers to more common questions on our FAQ page.
Your History Does Not Erase Your Rights
Plenty of hardworking people carry old injuries and still do their jobs every day. If work made your condition worse, Pennsylvania law can still protect you. If your claim has already been turned down, see our guide on fighting a denied workers’ comp claim in PA.
If your claim was denied because of a pre-existing condition, The Law Office of Kaitlin Files LLC can help you fight back. Contact Files Injury Lawyers today by visiting filesinjurylawyers.com or call us at 215-987-6452.
FAQs
Can I get workers’ comp if I had a pre-existing condition?
Yes. If your work aggravated, accelerated, or worsened the condition, it may be a compensable injury in Pennsylvania.
Should I tell my doctor about old injuries?
Yes. Being honest protects your credibility and helps your doctor explain what changed.
Will the insurer look at my old medical records?
Usually, yes. Insurers often review prior records to argue your symptoms are not work-related.
What if my injury description is too narrow?
The description on your Notice of Compensation Payable can be challenged and expanded to include related conditions.
Can my benefits stop if I return to “baseline”?
The insurer may try to end benefits by arguing the aggravation has resolved. You can challenge that with your own medical evidence.
This article is general information about Pennsylvania workers’ compensation and is not legal advice. Every case is different. For advice about your situation, speak with a licensed Pennsylvania attorney.
