Once you file a Pennsylvania workers’ compensation claim, the insurance company is entitled to any and all “relevant medical records” concerning your prior physical condition. The defense will dig into your past to determine whether or not you have sustained a similar injury to the same area of your body. In insurance lingo, there is a system for tracking (known as the “index system”) your Social Security number, your name, and other injuries you may have had for which you filed an insurance claim. It makes no difference if the claim arose as a result of a medical malpractice action, a motor vehicle action, a slip and fall/civil suit, or because of a prior workers’ compensation claim. You will be asked about whether or not you sustained any prior injuries to the same area of your body. The defense attorney and company doctor will not care if the injury was ten years ago, involved entirely different symptoms or medical conditions, required no work loss, or lasted only a brief period of time.
So what do you do to combat this problem of a pre-existing injury or condition? When you first report your injury to a doctor, whether it is your own doctor or the company’s treating doctor, you must try to include any and all injuries you have ever had to that area of the body or any areas close to that area of the body. Honesty is the best policy. Your doctor and lawyer have to be aware of prior conditions to determine whether they are distinguishable from the work injury.
Failure to disclose prior conditions to your doctor and attorney will almost always cause you to lose your case. Your attorney will prepare you for testimony regarding your prior problems in the best light noting relevant differences. Legally, an aggravation of a pre-existing condition, even if prior surgery was performed, is a NEW COMPENSABLE WORK INJURY.
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For more than 20 years, our attorneys have been helping injured workers navigate the complex Pennsylvania workers’ compensation system. We empower workers with the information and the representation they need to make the best decisions for themselves and their families’ future.
