Impact of Pre-existing Conditions on Nurses’ Workers’ Compensation Claims



When a nurse suffers a work-related injury or illness, they often rely on workers’ compensation benefits to help them recover both physically and financially. However, for nurses with pre-existing conditions, the process can be considerably more challenging. Understanding how pre-existing conditions impact Washington, D.C. workers’ compensation claims is essential for nurses and healthcare professionals in order to navigate the complex process.

What is a Pre-existing Condition?

A pre-existing condition is a medical complication that exists before a workplace accident and affects the same body part. Common pre-existing conditions include:

  • Herniated disks
  • Torn ligaments
  • Fractures
  • Arthritis
  • Spine degeneration
  • Knee injuries
  • Sprains and strains to arms or legs

It’s important to note that having a pre-existing injury does not necessarily prevent you from recovering workers’ compensation benefits if work-related issues aggravate it. However, it can make the process more complex and potentially impact the scope of the benefits received.

Common Challenges: Denials and Proving Causation

Workers’ compensation claims involving pre-existing conditions frequently face denial. Insurance companies are keen to attribute the impact of a workplace injury to an unrelated pre-existing condition so they can avoid providing benefits. As a result, it can be quite difficult to prove that a condition was caused or exacerbated by work activities.

For example, a nurse with a history of back pain may suffer a serious back injury while lifting a patient. To receive workers’ compensation benefits, they must prove that their current back condition is a direct result of the work incident and not just an existing issue that has naturally worsened with time.

In an effort to investigate the causation of the injury, insurance companies will require the release of relevant medical records. Additionally, they might ask the injured nurse to see their preferred doctor for further evaluation. Be prepared for this process and maintain a thorough record of your medical condition and treatment both before and after the work incident.

Tips for Navigating the Impact of Pre-existing Conditions

Navigating the impact of pre-existing conditions on a workers’ compensation claim can be challenging. Here are a few tips to help you along the way:

  1. Be honest and forthcoming: When discussing your medical history with a physician or an insurance adjuster, it’s vital to be open and honest about any pre-existing conditions that you have. This information can play a significant role in determining the outcome of your claim, so it’s essential to provide accurate information.
  2. Maintain thorough records: Keeping detailed medical records and documentation of any previous treatments or diagnoses is crucial when assessing the impact of pre-existing conditions on a workers’ compensation claim. Make a habit of saving any related paperwork and ensure all relevant information is made available.
  3. Seek legal advice: Workers’ compensation law can be quite complex, especially when it comes to cases involving pre-existing conditions. If you’re unsure about any aspect of your claim or the impact of a pre-existing condition, don’t hesitate to consult with an experienced workers’ compensation attorney. They can provide insight and guidance to help you navigate the process.

If you have a pre-existing condition and have suffered a work-related injury, consider seeking the guidance of a Washington, D.C. nurse workers’ compensation attorney who can help you better understand your options. For help, contact Lightfoot Law to schedule a free consultation.