Aggravation of Pre-Existing Condition Attorneys
In Los Angeles, the laws governing worker’s compensation and the aggravation of pre-existing conditions are regulated by the state of California. California has specific guidelines and provisions that address pre-existing conditions in the context of worker’s compensation claims.
If a work-related incident or activity worsens or exacerbates a pre-existing condition, you may be eligible for worker’s compensation benefits. The aggravation of a pre-existing condition is generally considered a compensable injury under worker’s compensation laws.
California follows a principle known as “apportionment” when it comes to pre-existing conditions. This means that if a pre-existing condition contributes to your disability or need for medical treatment, the worker’s compensation benefits may be reduced by the percentage of disability or impairment caused by the pre-existing condition. The employer is responsible for the portion of disability or medical treatment that is directly attributable to the work-related aggravation.
As worker’s compensation laws can be complex, consulting with an experienced attorney who specializes in worker’s compensation in Los Angeles or California is highly recommended. They can provide personalized advice based on the specifics of your case and help guide you through the process of filing a claim for the aggravation of your pre-existing condition.
What Qualifies as A Pre-Exisiting Condition?
A pre-existing condition refers to a medical condition or injury that existed prior to the work-related incident. To qualify for worker’s compensation benefits for the aggravation of a pre-existing condition, certain criteria need to be met. Here are some key factors that are typically considered:
- Prior Diagnosis: The pre-existing condition should have been diagnosed and documented before the work-related incident. Medical records or reports from healthcare providers can serve as evidence of the pre-existing condition.
- Active Treatment: The pre-existing condition should have been actively treated or managed before the work-related incident. This can include medical treatment, therapy, medication, or other interventions aimed at addressing the condition.
- Change in Condition: The work-related incident must result in a change or worsening of the pre-existing condition. There should be a direct causal relationship between the work-related incident and the aggravation of the pre-existing condition. This can be demonstrated through medical records, diagnostic tests, and expert medical opinions.
- Work-Related Connection: It must be established that the aggravation of the pre-existing condition is a result of the work-related incident or activity. This typically requires medical evidence and expert testimony to demonstrate that the work-related factors were a substantial contributing cause to the aggravation.
It’s important to note that the determination of a pre-existing condition and its aggravation for worker’s compensation purposes can be complex. Each case is unique and is evaluated on its individual merits, taking into account the specific medical evidence and legal standards.
Worker’s Compensation Law In LA
Workers’ compensation laws in Los Angeles, California, are governed by the state’s comprehensive workers’ compensation system. Here are some key points regarding workers’ compensation laws in Los Angeles:
- Coverage: Workers’ compensation provides benefits to employees who suffer work-related injuries or illnesses. It is a no-fault system, meaning that employees are generally entitled to benefits regardless of who was at fault for the incident.
- Employer Obligations: In Los Angeles, employers are legally required to carry workers’ compensation insurance or be self-insured. This coverage ensures that employees have access to benefits if they are injured or become ill due to their work.
- Benefits: Workers’ compensation benefits typically include medical treatment, temporary disability benefits (to replace a portion of lost wages during recovery), permanent disability benefits (if the injury or illness results in permanent impairment), vocational rehabilitation, and death benefits for eligible dependents in the case of fatal work-related incidents.
- Filing a Claim: To initiate a workers’ compensation claim, employees should report the injury or illness to their employer as soon as possible. The employer is then responsible for providing the necessary claim forms and information. It is important to adhere to the specific timelines and requirements outlined by the California Division of Workers’ Compensation.
- Dispute Resolution: In the event of a dispute regarding a workers’ compensation claim, the injured worker may pursue resolution through various channels, including negotiation, mediation, or the workers’ compensation appeals process. The California Workers’ Compensation Appeals Board oversees the resolution of disputes.
- Pre-Existing Conditions: Pre-existing conditions can be considered in workers’ compensation claims if they are aggravated or worsened by work-related activities. If a pre-existing condition is significantly aggravated by work, the worker may be eligible for benefits that cover the worsened condition.
Which Conditions Are Excluded From Aggravation of Pre-Existing Condition?
Under California workers’ compensation law, there are certain categories of injuries that are excluded from coverage. These include injuries that occur outside of work, intentionally self-inflicted injuries, and injuries that happen while the employee is intoxicated. Additionally, injuries sustained in a physical fight initiated by the worker or during the commission of a crime are not covered. Voluntary off-duty activities, even if they take place at the workplace, are also not covered.
However, pre-existing conditions are not automatically excluded from workers’ compensation coverage. If a pre-existing condition is aggravated by work-related activities, the resulting injury may be eligible for compensation. It’s important to note that an injury can occur due to a combination of covered and non-covered activities.
The legal effects of such a cumulative injury are addressed in the context of workers’ compensation. In these cases, the specific circumstances and evidence surrounding the injury, including the contribution of work-related factors to the aggravation of the pre-existing condition, will be evaluated to determine the extent of compensation.
How Do Pre-Existing Conditions Affect The Coverage?
Pre-existing conditions can affect the coverage amount in workers’ compensation cases through a process called “apportionment.” Apportionment refers to the division or allocation of responsibility for a worker’s disability or needs for medical treatment between a pre-existing condition and the work-related aggravation or injury.
In California, when a pre-existing condition is present, the workers’ compensation benefits may be apportioned, meaning that the employer is responsible only for the portion of disability or medical treatment directly related to the work-related aggravation. The benefits are reduced based on the percentage of disability or impairment that is attributed to the pre-existing condition.
To determine apportionment, medical evidence and expert opinions play a crucial role. Medical professionals will evaluate the extent of the pre-existing condition, the change or worsening caused by the work-related incident, and the overall impact on the worker’s disability or need for treatment.
If your pre-existing condition worsens to the point where you are unable to continue working, you may be eligible for permanent disability benefits. However, in cases involving pre-existing conditions and permanent disability claims, the coverage you receive is influenced by the apportionment of fault between the new injury and the pre-existing condition.
During the claims process, adjusters will carefully consider the percentage of the illness or condition that existed prior to the workplace injury. For instance, let’s consider a scenario where a worker files a claim for severe neck pain, but it is discovered that the worker had previously been in a car accident. Upon examination by a physician, it is determined that 30% of neck problems can be attributed to a prior car crash rather than workplace activity.
Consequently, the worker would be entitled to 70% of the compensation they would have otherwise received under their workers’ compensation coverage for their neck.
The objective of apportionment is to ensure that the compensation awarded aligns with the specific portion of the disability that directly resulted from the work-related aggravation, rather than attributing the entire disability solely to the workplace incident.
How Can the Pacific Attorney Group Help with Compensation For Aggravation of Pre-Existing Condition?
The Pacific Attorney Group, being a law firm specializing in personal injury and workers’ compensation cases, can provide valuable assistance if you have a pre-existing aggravation condition and are seeking compensation. Here are some ways in which the Pacific Attorney Group may be able to help:
- Legal Expertise: We have a team of experienced attorneys who are well-versed in workers’ compensation laws and understand how pre-existing conditions can impact your claim. They can provide expert legal advice tailored to your specific situation.
- Case Evaluation: The attorneys at the Pacific Attorney Group can assess the details of your case, including the nature of your pre-existing condition and how it has been aggravated by work-related activities. They will analyze the available evidence, medical records, and expert opinions to determine the strength of your claim.
- Gathering Evidence: To support your claim, we can help gather the necessary evidence to establish the aggravation of your pre-existing condition. This may involve obtaining medical records, conducting depositions, and consulting with medical experts who can provide opinions on the causal relationship between your work activities and the worsening of your condition.
- Negotiations and Settlements: Our group can engage in negotiations with insurance companies or employers on your behalf. The lawyers will strive to reach a fair settlement that compensates you for the aggravation of your pre-existing condition, ensuring that you receive the maximum benefits you are entitled to under the law.
- Litigation Support: If a fair settlement cannot be reached through negotiations, the Pacific Attorney Group can represent you in court. We will provide strong advocacy, present the evidence, and argue your case to seek a favorable outcome and fair compensation for your injuries.
Book a consultation with us today to discuss the details of your workers’ compensation due to aggregate pre-existing conditions.