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How do pre-existing conditions affect workers' comp claims?

California's workers' compensation program helps workers who suffer a work-related injury get the financial assistance they need to deal with medical expenses and lost wages. For an injury to be covered by the program, it must either prevent a person from doing their job or interfere with their ability to do it.

The employee must have suffered the injury while on the job or performing duties required for their job. This might include suffering an injury while lifting large boxes containing supplies for a conference you're leading or even an injury suffered at a mandatory company social event like a softball game or picnic.

Some types of injuries, even when they occur on the job, aren't covered by workers' comp. These include injuries suffered while an employee is under the influence, those suffered in a fight they started or while involved in criminal activity and intentionally self-inflicted injuries. Further, workers' comp doesn't cover injuries suffered while someone is off-duty and engaged in a nonwork-related activity, even if they are in their workplace.

One area where things can get tricky when it comes to seeking workers' compensation involves pre-existing conditions. Often, a work-related injury will exacerbate a previous injury or previously diagnosed medical condition. An employee who has a bad knee due to an old football injury, for example, can experience a serious aggravation of that injury if they fall off a ladder while working.

An employee can't be denied workers' comp if they require new or further medical care for their pre-existing condition because of a work-related injury and that injury suffered at work caused them further disability. That's good news for the millions of people who have some sort of pre-existing condition.

However, don't be surprised if your employer and/or the insurer try to minimize the amount you're paid because you already had a medical condition or even what could be considered a disability. If you believe you're being denied adequate workers' compensation benefits because of a pre-existing condition, it might be wise to seek the guidance of an experienced workers' compensation attorney.

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