Can Your Employer Hold You Responsible for Part of the Cost of Your Treatment If You Have a Pre-Existing Condition?

Florida, like many other states, is a comparative negligence state when it comes to car accidents.  Your car insurance company will take a detailed, recorded statement from you after a car accident to determine what percentage of the fault for the accident is attributable to you and what percent belongs to the other driver.  Your share of fault for the accident determines the settlement amount that the insurance company offers you, and if you file a personal injury lawsuit against the other driver, your share of fault affects the amount in damages that the court can order the other driver to pay you.  A central tenet of workers’ compensation law is that fault is not an issue, but pre-existing conditions are.  If you suffer a permanent injury, workers’ compensation law provides for apportionment, which is where a doctor determines how much of the injury is because of the work accident and how much is because of the worker’s pre-existing condition.  Workers’ compensation then holds the worker responsible for paying for a percentage of their treatment equal to the percent of the illness or injury that is attributable to a pre-existing condition.  The bad news is employers often try to nickel-and-dime workers out of payment for medically necessary treatments.  The good news is that, since apportionment can only start after you reach maximum medical improvement, it does not apply to temporary injuries.  If your employer is trying to get you to pay a percentage of your treatment for a work injury, contact a South Florida workers’ compensation lawyer.

When Multiple Temporary Injuries Add Up to a Permanent Injury

Randy’s job was delivery doors to retail stores statewide; this job, like most of them in his employment history, involved heavy lifting.  In November 2008, Randy suffered a lower back injury while carrying a door on his shoulders.  After providing initial treatment for the acute injury, his employer denied his claim, arguing that his symptoms were because of a pre-existing condition and not because of the work accident.  In fact, Randy had a history of back and neck injuries, some of them work-related:

• Work accidents in 1994 and 1996, resulting in muscle sprain injuries
• Slip and fall injuries in 1995 and 2003, neither of which happened at work
• A work accident in 2006, resulting in a back injury so severe that Randy was unable to work for several months

After recovering from the 2006 injury, Randy began working for the defendant in this case; his job duties were similar to the ones in the previous job, where he had been seriously injured.  For several months, until the November 2008 accident, he was asymptomatic and able to work.  In 2009, the workers’ compensation doctor determined that Randy needed back surgery.  The employer wanted to apportion the cost of the surgery because of Randy’s previous injuries.  Randy brought the case before the Judge of Compensation Claims, and the judge ruled in Randy’s favor, arguing that it was not possible to apportion the cost of treatment for an injury until the patient reaches maximum medical improvement.

Let us Help You Today

Only the youngest people are free of pre-existing conditions.  A Sunrise workers’ compensation lawyer can help you get the treatment you need for your work injury.  Contact the Law Offices of David M. Benenfeld for help with your case.

Resource:

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