Does a Pre-Existing Condition or Injury Affect a Claim for Workers Compensation?

There is a significant number of people in Australia who suffer from a chronic illness or have experienced a prior injury, which can leave them with ongoing symptoms.  These illnesses or injuries are referred to as ‘pre-existing conditions’ and it is important that you declare these conditions if you are asked about your health or medical background by an employer, or a prospective employer.

If you have a pre-existing condition, and then sustain a subsequent injury in the workplace, it is important to understand how it might affect a workers’ compensation claim if you need to make one.

Making a claim if you have a pre-existing condition

You are entitled to make a claim for workers' compensation if you sustain an injury at work, even if you have a pre-existing condition that affects the same body parts involved in the work accident.

In most cases, you will also need to show that your pre-existing condition has been:

1. aggravated, accelerated, exacerbated, or deteriorated by your work; AND

2. that work was a “significant contributing factor” to the aggravation, acceleration, exacerbation or deterioration of the pre-existing injury or disease.

Your medical records, from both before and after the injury, will be highly relevant when showing that a pre-existing condition or injury has been aggravated, accelerated, exacerbated, or deteriorated due to the nature of your work or an accident at work.

To make a claim you must obtain a WorkCover Certificate from your treating doctor which identifies your injuries and how they affect your capacity to work. This must be provided to an Insurer at the time of making a workers' compensation claim.

What if my pre-existing condition or injury affects my claim?

If you make a workers’ compensation claim because a pre-existing condition or injury has been aggravated, accelerated, exacerbated, or deteriorated due to your work and the insurer disputes that claim, it is important that you seek legal advice as to whether the decision of the insurer can be overturned. 

The experienced Personal Injury team at Lamrocks can investigate your individual circumstances and provide expert advice on the potential outcome of your claim.  Our lawyers are approved by the government’s Independent Legal Assistance and Review Service  (ILARS) to provide access to free, independent legal advice for injured workers which means that you will not be responsible for any costs involved with our team investigating and assisting with your claim.

If your workers’ compensation claim has been disputed by an Insurer, or you would like assistance with making a claim, contact the Personal Injury Team at Lamrocks on (02) 4731 5688 for advice.