What is the Impact of Pre-Existing Conditions on Workers’ Compensation Claims in Florida?

In Florida, workers’ compensation benefits are designed to help employees recover from injuries that happen on the job. They cover medical care, lost wages, and rehabilitation costs. But what happens when the injured worker already had a pre-existing condition before the accident?

Many injured employees worry that their prior medical history will automatically disqualify them from receiving benefits. The truth is more nuanced. You can still receive workers’ compensation benefits in Florida even if you had a pre-existing condition, as long as the workplace accident worsened or aggravated that condition.

How Does Florida Law Treat Pre-Existing Conditions in Workers’ Compensation Cases?

Under Florida Statutes § 440.09, an injury is compensable if the work-related accident is the “major contributing cause” of the need for medical treatment or disability. This means it must contribute more than 50% to the condition requiring care.

If an employee had a pre-existing injury or illness, their claim may still be valid if the workplace accident made that condition worse or accelerated its progression.

For example, if you already had a disc bulge in your lower back but a workplace fall herniates the disc, making the pain severe and disabling, the aggravation of the prior injury would likely qualify as compensable.

However, insurance companies often use pre-existing conditions as a reason to delay, reduce, or deny benefits. This is where having an experienced workers’ compensation attorney, like RTRLAW, makes all the difference.

What Are Common Pre-Existing Conditions That Can Affect Workers’ Comp Claims?

Certain medical issues are more likely to draw scrutiny in workers’ compensation cases, including:

  • Chronic back or neck pain
  • Degenerative disc disease or arthritis
  • Previous fractures or joint injuries
  • Mental health disorders, such as anxiety or PTSD

Even if these conditions existed before your workplace accident, you may still be entitled to benefits if your job duties or incident aggravated the injury or triggered a flare-up.

Attorney Gregory Blackburn explains: “We see employers and insurance carriers deny claims simply because someone had a prior injury, but that’s not how Florida law works. If your job made your condition worse, you deserve benefits. It’s that simple.”

How Do Insurers Use Pre-Existing Conditions to Deny Workers’ Comp Claims?

Insurance companies frequently argue that the worker’s current symptoms are solely due to a pre-existing condition rather than the workplace injury. They may:

  • Request access to prior medical records to downplay the work-related cause
  • Claim that your symptoms were already present before the accident
  • Hire doctors who perform independent medical exams (IMEs) to challenge your claim
  • Offer partial benefits instead of full compensation

These tactics can make it feel like the system is designed to make it impossible for injured workers to get the care and financial help they need. RTRLAW’s attorneys know how to counter these strategies with medical evidence, qualified testimony, and legal documentation proving that your job caused or worsened your condition.

What Evidence Helps Prove Your Workers’ Compensation Claim?

To successfully argue that your work injury aggravated a pre-existing condition, evidence is key. Supporting documentation may include:

  • Medical reports showing how symptoms worsened after the workplace accident
  • Doctor testimony stating that the work injury is the “major contributing cause”
  • Diagnostic imaging (X-rays, MRIs, CT scans) showing new or aggravated damage
  • Employment records or witness statements confirming the workplace incident

Attorney Matthew Sosonkin notes: “One of the strongest forms of proof is your doctor’s opinion. If your physician can clearly state that the workplace injury aggravated your condition, that’s often enough to establish your right to benefits under Florida law.”

What Tips Do You Have for Workers with Pre-Existing Conditions Filing Claims in Florida?

If you have a pre-existing medical issue and suffer a workplace injury, follow these steps to protect your rights:

  • Report your injury immediately to your employer. Delays can lead to denials.
  • Be honest about your medical history. Concealing prior injuries can hurt your credibility.
  • Seek medical care from an approved provider as soon as possible.
  • Keep records of all doctor visits, test results, and work restrictions.
  • Consult an experienced workers’ comp attorney before making statements to the insurance company.

An attorney can ensure your condition is properly classified as work-aggravated and that you receive the full range of benefits you’re entitled to under Florida law.

Contact RTRLAW for Help with Your Florida Workers’ Compensation Claim

At RTRLAW, our Florida workers’ compensation attorneys have decades of experience representing injured employees, and that includes those with pre-existing medical conditions. We understand how insurers try to minimize claims, and we know how to fight back with the right medical and legal evidence.

We work to:

  • Prove that your job injury was the major contributing cause of your condition
  • Gather expert medical opinions to support your case
  • Ensure you receive proper medical treatment and wage benefits
  • Fight denials or underpayments from the insurance carrier

Our goal is simply to make sure your past doesn’t stop you from getting the help you need today.

If you’ve been injured at work and have a pre-existing condition, don’t assume your claim will be denied. You still have rights under Florida law, and RTRLAW is here to protect them.

Call RTRLAW today at 1-833-HIRE-RTR (1-833-447-3787) to schedule a free, confidential consultation. Our attorneys will review your case, explain your options, and help you recover the benefits you deserve.