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How Do My Prior Injuries Affect My Claim?

If your accidental injury or occupational disease aggravates a previous injury, the increased injury you are now experiencing is covered as a new workers' compensation claim. Any new treatment you need caused by the aggravation will be covered as part of your claim. However, if you have sustained any additional permanent disability, the employer/insurer will not have to pay for the permanent disability that existed before your injury.

Sometimes, an employee has a prior history of significant medical problems before the most recent injury on the job. If the prior problems are extensive and the most recent injury results in significant permanent disability then a separate insurance company called the Subsequent Injury Fund may be brought into your case. This Fund may have to pay you for the permanent disability that pre-existed your most recent injury. However, the claimant must prove that his/her permanent disabilities amount to at least 251 weeks of permanent disability benefits and that at least 125 of those weeks are for problems that pre-date the injury on the job and at least 125 weeks are as a result of the injury on the job.

An example of Subsequent Injury Fund responsibility is when the injured employee has a serious back injury on the job, but when employee was a child he lost all vision in one eye. The back injury might result in a 25% disability award (125 weeks of benefits). The loss of vision in one eye would entitle him to 250 weeks of benefits. In this example the employer and its insurer would pay the employee 125 weeks of money (at 2010 rates approximately $38,000) and the Subsequent Injury Fund would pay an additional 250 weeks of money (approximately $76,000). As you can see, a careful analysis of all of your medical problems is required to bring you the best possible result!