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What if I Had a Pre-existing Injury?

Under Tennessee’s Workers’ Compensation Reform Act, an employee who suffers an injury may recover workers’ compensation benefits. An “injury” means “an injury by accident, a mental injury, occupational disease including diseases of the heart, lung and hypertension, or cumulative trauma conditions including hearing loss, carpal tunnel syndrome or any other repetitive motion conditions, arising primarily out of and in the course and scope of employment, that causes death, disablement or the need for medical treatment of the employee.” In many situations, it is clear when an employee suffers an injury that entitles the employee to workers’ compensation benefits. An example would be a machine falling on and breaking an employee’s hand. Here, the employee would be entitled to workers’ compensation benefits.

There are other situations, however, where it may not be as clear as to whether an employee is entitled to workers’ compensation benefits. These often involve situations where the employee had a pre-existing injury. Insurance companies may try to deny a workers’ compensation claim because of an employee’s pre-existing medical condition. Under Tennessee workers’ compensation law, however, a worker is entitled to claim workers’ compensation benefits, even if the employee had a pre-existing medical condition prior to the accident. For example, if a worker has a prior back condition and hurts their back while performing their job duties, the employee can still seek workers’ compensation benefits. The prior back condition does not preclude a worker from filing a workers’ compensation claim.

Nevertheless, not all injuries involving pre-existing conditions are compensable. The Tennessee Supreme Court has explained that an injury is not compensable “where the work activity

aggravates the pre-existing condition merely by increasing the pain.” But if “the work injury advances the severity of the pre-existing condition, or if, as a result of the pre-existing condition, the employee suffers a new, distinct injury other than increased pain, then the work injury is compensable.” The key parts are that there must be “advancement” or “anatomical change” of the pre-existing injury. Pain alone is insufficient to claim workers’ compensation benefits.

Employers and insurance companies will often wrongfully deny workers’ compensation claims on the basis of a pre-existing injury. They often try to claim that the work injury only increased the pain of the pre-existing injury, as opposed to advancing the injury. It is important to know, however, the a pre-existing injury does not automatically prevent an employee from seeking workers’ compensation benefits. Notably, the more distinct that a workplace injury is from the pre-existing condition, the more likely it is that the workplace injury will be compensable under Tennessee’s workers’ compensation law.

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