What Happens When a Work-Related Injury Exacerbates a Pre-Existing Condition in New York?

Aug 7, 2023

Pre-existing conditions do not stop New York workers from receiving benefits. Workers’ compensation is even required to pay when a workplace injury exacerbates a pre-existing condition.

That’s not to say that a pre-existing condition helps your claim or makes it easy. You can expect employers to challenge whether your injury arose “out of and in the course of employment” unless the pre-existing condition is completely unrelated to the injury. For example, a pre-existing knee injury doesn’t touch a broken arm.

Nevertheless, you should never hide a pre-existing condition from your employer. If you do, employers can accuse you of insurance fraud, worsening your problems. Share the information during your medical exams.

What happens if the pre-existing injury has nothing to do with my workplace injury?

You’re owed full, normal workers’ compensation benefits.

The courts affirmed this principle in the 2015 case, Lattanzio v. Consolidated Edison of N.Y., et al., which involved a pre-existing neck injury and a back injury that arose out of and in the course of employment.

Mr. Lattanzio had a pre-existing neck condition requiring surgeries and intermittent treatment but worked full-time with restrictions until he fell at work and sustained injuries to his back. The courts could find no record at all that his pre-existing injuries caused him to perform his work duties less than satisfactorily.

The courts affirmed that he was entitled to workers’ compensation benefits.

Which pre-existing conditions might be aggravated by a workplace injury?

Almost any pre-existing condition could be aggravated, including RSIs, back pain, arthritis, heart disease, high blood pressure, diabetes, asthma, and chronic diseases of every kind.

Does the aggravation of a pre-existing condition reduce workers’ compensation benefits in New York?

Yes. The New York Workers’ Compensation Board can “apportion” benefits, essentially reducing them by a percentage. This will depend on how much your pre-existing condition is responsible for the injury versus your employer being responsible for the injury.

What if the pre-existing condition was a previous work injury?

Workers’ compensation will divide your claim between the two injuries. This could mean a reduction in your current claim.

Calling a workers’ compensation lawyer when you have a pre-existing injury is always a good idea.

By its very nature, your case is more complicated than the average New York workers’ compensation case. You can expect the workers’ compensation insurance company to use the pre-existing condition in any way it can to reduce the value of your claim. They may even try to deny the claim.

You should also document your case to the fullest extent that you can at every point during your claim so that we have as much evidence as possible to work with.

The Law Offices of Sher, Herman, Bellone & Tipograph