Composite X-ray montage showing multiple views of bones with surgical hardware (rods, screws, and prostheses).

How Preexisting Conditions Affect DC Workers’ Comp Claims

Publicado en Indemnización por accidente laboral.

A preexisting condition can affect your workers’ compensation claim, but it does not automatically mean your claim should be denied.

In Washington, D.C., you may still be able to get workers’ comp if your job made an old condition worse, caused new symptoms, or turned a condition you did not know about into a serious injury.

This can feel scary when you are already hurt, missing work, and trying to get medical treatment approved. Insurance companies often use preexisting conditions against injured workers. They may point to an old injury, arthritis, age-related changes, or something in your medical history and try to say your job had nothing to do with your pain.

The real question is: did your work injury make the condition worse?

What Is a Preexisting Condition?

A preexisting condition is a health issue, injury, or medical problem that existed before your work accident.

This could include an old back injury, arthritis, a prior knee problem, a shoulder condition, a herniated disc, degenerative changes in your spine or joints, or a condition you did not even know you had.

A lot of people hear “preexisting condition” and think their workers’ comp case is over. It is not that simple.

Having a preexisting condition does not automatically stop your D.C. workers’ compensation claim.

How Can It Affect Your Workers’ Comp Claim?

A preexisting condition can affect your workers’ comp claim because the insurance company may use it to question whether your injury is really work-related.

They may argue that your pain came from your old condition, not your job. They may also try to deny benefits, delay treatment, or argue that your current symptoms are not related to work.

If your job made your condition worse, caused new symptoms, made your pain worse, or created a need for treatment, your claim may still be covered.

For example, someone may have arthritis in their knee but still be working full duty with no major pain. Then they fall at work, land on that knee, and suddenly need treatment, time off, injections, therapy, or surgery.

The insurance company may say, “That was arthritis.” But the real issue is whether the fall made that condition worse.

Why Your Doctor or Specialist’s Opinion Matters

When a preexisting condition is involved, your doctor or specialist’s opinion can make a big difference.

Your doctor or specialist needs to clearly explain how the work injury relates to your current symptoms, treatment, and work restrictions.

This is called causation. Causation means the connection between the work injury and the medical problem.

In simple terms, your doctor or specialist needs to help answer this question: did the job make the condition worse?

They may need to explain what your condition was like before the work injury, what happened at work, what changed after the injury, and why you now need treatment.

This information is general and is not medical advice. Your doctor or specialist is the right person to answer medical questions about your diagnosis, treatment, and whether your work injury made your condition worse.

What to Do If Insurance Blames Your Preexisting Condition

If the insurance company is blaming your injury on a preexisting condition, do not assume they are right.

Focus on the things that help show what changed after the work injury:

Tell your doctor or specialist exactly what happened at work.
Explain what symptoms started or got worse after the injury.
Keep copies of work notes, restrictions, and medical records.

The important thing is showing the difference between before and after the work injury. Were you suddenly unable to work? Did your pain get worse? Did you need treatment for the first time? Did your doctor or specialist put you on restrictions?

Those details matter.

Call Donahoe Kearney

If you were hurt at work in Washington, D.C. and the insurance company is blaming your pain on a preexisting condition, call Donahoe Kearney.

We help injured workers understand their rights, deal with the insurance company, and build the medical evidence needed to support their claim.

Call 202-393-3320 or book your free consultation here: Book Free Consultation.

Rick’s Story

Rick was a delivery driver in Washington, D.C. who spent years doing heavy physical work. He had no symptoms and was doing his job, until one heavy delivery caused serious back pain.

After Rick got medical care, the insurance company tried to blame a preexisting condition instead of the heavy lifting he did at work. They argued his back problems came from aging, not the job.

We helped show that Rick’s back pain started after the work incident and that his job made the condition worse. His doctor connected the work injury to his symptoms, and we gathered the medical evidence needed to push back against the insurance company.

The issue was not simply whether Rick had something in his medical history. The issue was whether his work caused the condition to become painful and disabling.

Watch the video below to hear Attorney Frank Kearney explain how Rick’s work injury made his preexisting condition worse and how we helped prove the connection.