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Does Having a Pre-Existing Condition Affect My Workers’ Compensation Claim?

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Archive: Jan 2019

Does Having a Pre-Existing Condition Affect My Workers’ Compensation Claim?

If you suffer an injury or illness due to your job, you may be eligible for workers’ compensation. These benefits provide funding for medical expenses and lost income while you recover from your condition. However, you must satisfy a series of eligibility requirements to qualify for workers’ compensation. If you have a pre-existing illness or condition, receiving these benefits can become complicated.

Unrelated Pre-Existing Conditions

If your pre-existing condition is not related to the claim you are filing, you likely will not face any issues. Your pre-existing heart disease, for example, will not affect a claim for a knee injury. You may need to see multiple providers for the pre-existing condition and the workplace injury. While complicated, multiple insurance pathways will keep your out-of-pocket costs low.

However, if your job function aggravates your unrelated pre-existing condition, you could seek additional compensation. For example, if you suffered a back injury during an unrelated car accident, you could aggravate the condition by performing heavy lifting functions at work.

You will have to meet additional eligibility requirements depending on your state. In some areas, you can only receive workers’ compensation benefits related to the aggravation, not the pre-existing condition itself. You will need to visit a doctor to evaluate your injury and determine if your job caused aggravation, if the condition is worsening, and what treatment you will need to seek.

Workplace-Caused Pre-Existing Conditions

If a workplace accident caused a similar injury previously and you claimed workers’ compensation for that incident as well, you may see reduced benefits. Your employer will still pay your medical expenses for the new injury, but you may see a reduction in your permanent disability benefits. However, your employer will still pay temporary disability benefits if you cannot work.

You can only receive compensation for an increase in disability at the end of your claim. For example, if your doctor examines your injury and states that you could receive $15,000 in permanent disability benefits and you received a $7,000 permanent disability award in the past, you will only receive $8,000. If your doctor does not notice an increase in disability, you will not receive any award.

California-Specific Rules for Pre-Existing Conditions

According to the California requirements for workers’ compensation benefits, the state considers aggravated pre-existing conditions as separate injuries. As a result, California will not limit your potential benefits to the specific instance of aggravation.

Under California law, an aggravated pre-existing condition must satisfy one of the following factors.

  • The aggravated injury must cause a temporary or permanent disability increase.
  • The aggravated injury must create a need for additional medical treatment or a new treatment plan altogether.
  • The aggravated injury must change the existing course of treatment.

With a new workers’ compensation claim, you can seek funding for medical expenses related to your aggravated injury, as well as temporary and permanent disability benefits. You will need to visit a physician and receive a medical report to prove these claims.

However, flare-ups or recurrences for pre-existing conditions are not a new injury under California law. These are known as exacerbations. If your current employer did not cause the injury originally, you cannot seek benefits for a pre-existing condition exacerbation.

Discuss Your Workers’ Compensation Claim With a Lawyer

If you are unsure if your aggravated pre-existing condition qualifies for workers’ compensation benefits or if the condition will affect your claim, contact a workers’ compensation attorney in Orange County. These cases can be quite complex, and you want to ensure your employer honors your rights as an employee. Hiring an attorney early on will help facilitate your claim process.

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What Mental Health Issues Fall Under Workers’ Compensation?

You may suffer injuries at work due to faulty equipment, a slip and fall, or another physical act. When this happens, workers’ compensation covers expenses for your treatment and allows you time to recover. States cover different injuries and illnesses based on their unique compensation systems.

A physical injury does not always cause our ailments, however. Stress, anxiety, depression, and other mental illnesses can severely impact our productivity and ability to work. Even if the illness is work-related, many states have limited regulations about the use of workers’ compensation for mental health issues.

If you believe that you are suffering from stress and anxiety as a result of your job, speak to an Orange County workers compensation lawyer to find out how we can help.

An Overview of Workers’ Compensation

To qualify for workers’ compensation, your injury must be work-related. Your injury must also be severe enough to affect your job performance. Usually, this type of injury requires medical attention beyond a single visit.

  • Injuries that happen while engaging in work-related events and activities
  • Illnesses developed due to long-term exposure to toxic substances, such as cleaning chemicals or asbestos
  • Injuries developed due to extreme physical stress during work
  • Injuries due to repetitive motions performed during work, such as carpal tunnel syndrome
  • Pre-existing conditions that working aggravates

Common types of workers’ compensation injuries include fractures and broken bones, concussions, severe lacerations, and strained muscles, especially in the back. Usually, the employer will require you to visit a doctor to confirm the injury and assess its severity. Injuries can happen due to accidents, negligence, toxin exposure, repetition, and multiple other causes.

Mental Health Claims Under Workers’ Compensation

How do mental health issues fit into the workers’ compensation system? Work-related activities can give rise to conditions such as anxiety, post-traumatic stress disorder, depression, and extreme stress. If a work-related activity or incident caused or aggravated the condition, you could file a workers’ compensation claim.

Depending on the state, your workers’ compensation could cover mental health issues that arise due to both ongoing conditions and singular events. However, proving that you suffer from these illnesses is more complex than physical injuries. In particular, gathering evidence that your job caused your mental health issues can be quite difficult.

A link must be established between your illness and your job function based on the evidence requirements by your state. Courts will require an explanation as to how the illness is work-related and detail the work conditions that could have objectively led to the illness.

California Workers’ Compensation for Mental Health

Under California labor law, employees can receive workers’ compensation for diagnosed mental illnesses that require treatment or led to disability. To establish the validity of your claim, you will need to establish the following facts.

  • You have a mental illness diagnosed by a medical professional.
  • Your mental illness is severe enough to require treatment or leave you disabled.
  • The primary causes of your illness are work-related conditions or events.

To qualify for workers’ compensation benefits in the state of California, you must have worked for the employer for at least six months. To prove your claim, you will need to have the following pieces of evidence.

  • Testimony from the treating physician to verify the illness
  • Medical records
  • Performance reviews
  • A physician’s report containing information about your background, development history, and personal issues
  • Any documentation to support your physician’s diagnosis and your claim

Since mental illnesses are not as objective as physical injuries, proving the link between your work and your condition is complex and difficult. Some people may cast doubt upon your illness and question the validity of your claim.

If you intend to pursue a workers’ compensation claim, discuss your case with an attorney. A workers’ compensation attorney can guide you through the process, help you gather evidence and testimony related to your claim, and provide advice on proving your condition.

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New California DMV Laws for 2019

The beginning of 2019 signals major changes for California. Effective on January 1st, the state ushered in a series of new laws that govern everything from gun control to plastic straws in restaurants. The California Department of Motor Vehicles will enact a series of new laws and changes that will affect California vehicles, licenses, and drivers.

To learn more about these laws, contact our Orange County personal injury lawyers for more information.

New Regulations for Passing Sanitation Trucks

Under Assembly Bill 2115, the state will apply new traffic laws for passing waste service vehicles. If a driver approaches a sanitation truck with its amber lights flashing, the driver will need to move into another lane and pass the truck at a distance. If a lane change is not possible, the driver will have to slow down. This law is to prevent sanitation workers from collisions with oncoming traffic.

Greater Gender Identity Options

According to Senate Bill 179, people who apply for a California driver’s license or identification card can select their own gender. Applicants can choose between male, female, or non-binary for their gender options. On licenses and ID cards, the state will mark non-binary as an “X” in the gender category.

Low Emissions Vehicle Sticker Program

Under Assembly Bill 544, California will circulate new decals for low emission vehicles to travel in carpool lanes, also known as High Occupancy Vehicle lanes (HOV). Low emissions vehicles have used green and white decals for HOV travel since 2017. Drivers will have to upgrade to a red decal, which increases their HOV eligibility until 2022. Drivers can also opt for a light violet decal with HOV access until 2023.

DMV Written Exam Updates

The DMV will have to update 20% of their written exams to include at least one question about California’s unsecured load code, according to Assembly Bill 1925. The purpose of this update is to verify that new drivers understand that dumping or abandoning an animal is a crime.

Paper Plates at Dealerships

Under Assembly Bill 516, authorized car dealerships will have to provide temporary paper license plates to each vehicle they sell. This rule applies to both new and used vehicles. The paper plate must include a number and an expiration date. Hopefully, this will reduce the number of crimes committed by vehicles without a license plate, such as passing through toll booths without paying.

Restored License Privileges for Minors

According to Assembly Bill 2685, more minors will receive timely driver’s licenses. Prior to this law, California courts could delay, restrict, or suspend the issue of a minor’s license for up to one year due to truancy or being a guardian of the state. Courts will no longer have this power. However, license delays and suspensions prior to the start of 2019 will remain valid.

Motorized Scooter Helmets

Under Assembly Bill 2989, the state will no longer require adults over the age of 18 to use a bicycle helmet when operating a motorized scooter. The law will also allow people to operate motorized scooters on highways with speed capabilities up to 35 miles per hour.

Breathalyzer Requirements for DUI Offenders

According to Senate Bill 1046, repeat DUI offenders will need to install a breathalyzer on their engine ignition for at least 12 to 48 months. First-time DUI offenders who caused injuries will be subject to this requirement as well. The law is effective between January 1st, 2019 to January 1st, 2026.

Smog Check Exemptions

Assembly Bill 1274 will extend exemptions for smog verifications on new vehicles. Exemption timeframes will increase from six years to eight years. During the first six years of exemption, new vehicle owners will not have to receive a smog check, but they will need to pay a fee of $20. During the last two years of exemption, the fee will increase to $25.

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