Does Pennsylvania workers’ comp cover a pre-existing condition?

On Behalf of | Aug 18, 2023 | Claims Process

People don’t generally understand workers’ compensation benefits unless they have had to make use of the program previously. The basics that most people understand include how workers’ compensation coverage applies to any injury that occurs on the job and to conditions that a doctor diagnoses that are a direct result of someone’s employment.

However, there are many medical concerns related to work that may fall into a sort of gray area and leave people feeling unsure about whether they have a right to claim benefits or not. One example would be a scenario in which someone already had a condition, like carpal tunnel syndrome before starting their job, that their job duties have aggravated.

Medical evidence could help someone obtain benefits

The more documentation that someone has about the nature of their pre-existing condition and the symptoms they have historically experienced, the easier it may be for them to pursue workers’ compensation benefits. As a general rule, coverage is not available for those who have consistent symptoms that remain the same even after starting a new job.

If someone’s job responsibilities worsen their symptoms or result in a previously-controlled medical condition flaring up again, they may be able to file a claim for benefits. So long as there is documentation helping to connect their new or worsening symptoms to their job, they may potentially be eligible for coverage. Seeing a doctor and communicating with supervisors about symptoms are both steps workers may need to take to address a progressing pre-existing condition.

Sometimes, claims related to pre-existing conditions may face challenges because the professionals managing the claims might question whether or not the health issue really relates to someone’s employment. With the right support, workers can appeal unfavorable determinations and get benefits even when there are challenges during the process.

Learning the rules that govern Pennsylvania workers’ compensation coverage can make a big difference to those dealing with medical issues related to their job responsibilities, whether they involve pre-existing conditions or not.