Maryland Workers’ Compensation and Pre-Existing Conditions: What You Need to Know

August 18, 2023

You are entitled to Workers’ Compensation benefits when you show you suffered a work-related injury. The insurance company interprets this to mean that your condition must be a new one that comes from a job or some injury-causing event that has just happened. Pre-existing conditions are generally not included in Workers’ Compensation coverage. Still, you can receive benefits if your previous issue was worsened or re-aggravated by your current job.

The insurance company will review the medical records that you submit. They are looking for evidence that your injury is work-related. If the insurer believes you were injured elsewhere or did not see evidence of an injury that would keep you from working, they may deny the claim. The insurance company does not want to pay for injuries you may have suffered elsewhere.

Not Every Pre-Existing Condition Results in a Denied Claim

However, there is no blanket prohibition on coverage any time a pre-existing condition is involved. For example, you may have had a back condition in the past or even be suffering from one right now. Something could have happened at your job that could aggravate this condition. In this case, you could still be entitled to injury benefits. The same thing goes if you have reinjured an old injury.

Here are some examples of situations where you may still be able to receive Workers’ Compensation benefits when you have some form of existing medical

• You have a lower back condition and aggravated or worsened it because you were doing heavy lifting at work.
• You already had vision problems, but exposure to toxic substances on the job worsened them.

However, if your claimed injury stemmed solely from a pre-existing condition, it would not be work-related. If you have always dealt with a herniated disc in your back, you could not claim Workers’ Compensation benefits for it now since it was not an injury related to your job.

You Can Appeal if Your Claim Was Improperly Denied

The insurance company may wrongfully deny you benefits, claiming you are suffering from a pre-existing condition. In that case, you have the right to appeal the denial. You can appeal to the Maryland Workers Compensation Commission, and an administrative law judge will decide your case. You can expect that your appeal will depend heavily on the medical evidence. Your attorney would work with medical experts to explain why your current medical situation is not solely due to a pre-existing condition.

Baltimore Workers’ Compensation Lawyers at LeViness, Tolzman & Hamilton Help Clients With Claims, Appeals, and Settlements

Our Baltimore Workers’ Compensation lawyers at LeViness, Tolzman & Hamilton can help with complex claims, appeals, and settlements. Call us at 800-547-4LAW (4529) or contact us online to schedule a free consultation.

We have offices in Baltimore, Glen Burnie, Lanham, and Owings Mills, allowing us to represent clients in Maryland, including those in Anne Arundel County, Baltimore County, Carroll County, Harford County, Howard County, Montgomery County, Maryland’s Western Counties, Prince George’s County, Queen Anne’s County, Southern Maryland, and the Eastern Shore, as well as the communities of Catonsville, Essex, Halethorpe, Middle River, Rosedale, Gwynn Oak, Brooklandville, Dundalk, Pikesville, Nottingham, Windsor Mill, Lutherville, Timonium, Sparrows Point, Ridgewood, and Elkridge.