If you’ve suffered a workplace injury but already had health issues, you may be asking:
“Can I still get workers’ comp if I had a pre-existing condition?”
The answer is yes — especially if your job aggravated, accelerated, or lit up your condition.
At Employees First Labor Law, we’ve helped thousands of California workers win benefits even when the insurance company tried to blame it on a prior issue.
Here’s what you need to know about workers’ comp and pre-existing conditions.
🔹 Are Pre-Existing Conditions Covered?
California workers’ comp does not require you to be in perfect health when you’re hired.
You’re still entitled to benefits if:
- A work injury worsens a chronic condition
- Your job duties accelerate the deterioration of a prior injury
- Your pre-existing condition becomes symptomatic because of work
This includes:
- Prior back or neck injuries
- Arthritis
- Carpal tunnel syndrome
- Heart disease
- Mental health conditions
- Old surgeries or sports injuries
🔹 What Is an “Aggravation” Under California Law?
An aggravation occurs when your work makes a pre-existing condition worse, as opposed to a mere recurrence or “flare-up.”
You’re eligible for workers’ comp if:
- Your condition becomes permanently worse
- You require new treatment
- Your doctor determines that work substantially contributed to the worsening
The standard is whether the workplace caused at least 35–40% of the disability — known as apportionment under Labor Code § 4663.
🔹 How Insurance Companies Use Pre-Existing Conditions to Deny Claims
Insurance adjusters may try to:
- Blame your injury on age, prior medical history, or degeneration
- Claim your symptoms are part of a “natural progression”
- Push for a lower disability rating based on “apportionment”
- Demand IME or QME evaluations with biased doctors
At EFLL, we know their playbook — and we fight back with:
- Detailed medical records
- Treating physician reports that clearly show work-related aggravation
- Vocational evidence showing how your ability to work was impacted
- Appeals and court appearances when needed
🔹 What If You Didn’t Know About the Pre-Existing Condition?
Even if you didn’t know you had a medical issue before the injury, you may still qualify.
Example:
- You had early-stage arthritis but no symptoms.
- Your repetitive work aggravated the joint and made it painful.
- Now you need surgery or permanent work restrictions.
That’s compensable. You shouldn’t be penalized for your body’s condition before the job — only what work did to make it worse.
🔹 EFLL Maximizes Value in Complex Injury Cases
Workers’ comp cases involving pre-existing conditions can be complicated — but they’re also often high-value.
That’s because they tend to involve:
- Permanent disability
- Multiple body parts
- Lifetime medical care
- Vocational retraining or total disability findings
We build strong cases with:
- Top QME/AME selection
- Rebuttals to biased evaluations
- Civil claims (like disability discrimination or retaliation) when your employer uses your medical condition against you
✅ Talk to a Lawyer Before You Settle
If your employer or insurer is blaming your injury on “pre-existing” conditions, don’t settle without legal help.
Contact Employees First Labor Law today for a free consultation.
