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Does Georgia Workers Compensation Cover Preexisting Conditions?

We hear a lot about preexisting conditions in the news.  We hear debate about whether health insurance has to cover them.

But, what about Georgia workers compensation insurance? Does it cover preexisting conditions?

What is a preexisting condition?

Basically, it is a medical condition that you already had.  It could be diabetes, high blood pressure, a bad back, or any number of things.  The preexisting part looks at the timing of when you developed the medical condition.

Back painIf you had diabetes before your injury at work, it is a preexisting condition from a workers compensation standpoint.  If you developed diabetes after your work injury, it is not a preexisting condition.

Often, preexisting conditions in workers compensation claims focus on the parts of the bodies where work injuries most commonly occur such as:

  • Back
  • Neck
  • Shoulder
  • Knee
  • Elbow
  • Ankle

But, any medical condition in any part of your body can be preexisting.  It just depends on whether the condition existed before your workers compensation injury.

What if I did not know I had the preexisting condition?

Sometimes you know about the preexisting condition.  You may have received medical treatment for the condition in the past.

Other times, you do not know about the preexisting condition.  You find out about the condition after your injury.

This often happens after diagnostic testing like an MRI or x-ray.  Your doctor may tell you that you have arthritis or some other degenerative condition.  If the condition was “asymptomatic” before your injury, you probably will not even know you had it.

The preexisting condition receives the same treatment under the workers compensation law whether you knew about it or not.  However, if you did not know you had it and have not received any treatment for it, the insurance company may have more difficulty proving that the condition was “preexisting” .

Does Georgia workers’ compensation law cover preexisting conditions?

Technically, Georgia law does not cover the preexisting condition itself.  However, it does cover aggravations of preexisting conditions.

What does that mean? An aggravation of a preexisting condition covers when you have an injury that makes a preexisting condition worse.

Suppose you had a preexisting back condition.  Maybe it causes you problems.  Maybe it does not.

Then, you suffer an injury an injury at work to your back.  Your injury at work makes the back condition worse.  Georgia law covers that “aggravation of your preexisting condition”

Doctor therapist examining leg of patient in cast and wheelchairWhat’s the difference between covering the aggravation and covering the preexisting condition itself?

It comes down to what the insurance company has to pay.  They have to pay workers compensation benefits due to the aggravation of the condition.  In other words, they are responsible for the worsening caused by the injury at work.

So, suppose you did not need any medical treatment for your back condition before your injury.  If your back injury at work causes you to need medical treatment, the workers compensation insurance company should pay for that treatment.

The same rationale applies if you have to miss work because of the work injury.  If the work injury causes your inability to work, the insurance company should have to pay you temporary total disability benefits

The big difference between covering the preexisting condition itself and covering the aggravation is that the insurance company can get off the hook if they can prove that your aggravation resolved.  How does the insurance company try to do that?

Man with neck injury and woman reading letterThey will try to show that your medical condition returned to “baseline”.  If you had a preexisting condition, the insurance company will try to prove that your work injury was just temporary and that you have returned to the same place you were before you got hurt.

If they successfully prove this, they may show that your aggravation injury has resolved and your case may end. However, the insurance company often has difficulty proving your aggravation injury has resolved.  It usually will come down to a question of what your workers compensation doctor says.


What if I have other questions about workers compensation?

Georgia’s workers compensation system can be very confusing.  You have to worry about getting the treatment you need and paying your bills while also worrying about not missing any deadlines that could cause you to lose your right to receive workers compensation benefits.

If you have questions, I would recommend that you try to get answers.  To find out more about how to schedule a time to talk to me about your workers compensation questions, just read this short article.

Jason Perkins is an attorney who specializes in representing injured workers.  He regularly publishes videos and write blog articles about Georgia’s workers compensation system and issues that are important to injured workers and their families.

To be notified of Jason’s new workers compensation videos, subscribe to his Georgia Workers Compensation Video Series channel on YouTube by clicking the subscribe button below.

Brittney-lee orourkeBrittney-lee orourke
05:23 18 Feb 22
Amazing! Jason and his team were very helpful and had the best communication by far. Walked me though every step with great detail and had answers for any question I had. They handled my case better then I could imagine, it was a weird case and they stayed on top of it and kept me updated every step of the way! Highly recommend this Team! Thanks so much to Jason and his Awesome team!-Brittney
China JonesChina Jones
18:58 08 Feb 22
I absolutely love this group of attorneys, when I was at my lowest they did everything they could to help me get justice for my injury. I believe if I were to have never picked my phone up and called the amazing group that helped me I definitely would not have received my idea of rights. If you have an issue and are just not sure please understand that they will help you, stay in contact, answer any question you have, and for sure get you the justice you deserve I thank them from the bottom of my heart and I will definitely refer them to anyone who has been hurt because they most definitely care about their work and clients.
Luv LocsLuv Locs
16:08 15 Jan 22
The entire law office was attentive and responsive to all of my concerns dealing with my workers compensation case.
21:14 02 Jan 22
If you must get a lawyer involved, you’d do well to work with Jason Perkins and his team at Perkins Studdard Law.They were thorough in gathering information and in sharing all the steps in the workers comp process specific to my case. Jason and the team were responsive to my bevy of questions and concerns.I appreciated the informative videos and consultations provided by Jason over video meetings and multiple phone calls.I hope I’m never injured on the job again. However, if I am and if my employer responds as my previous employer did, I’ll contact Perkins Studdard Law immediately to handle the case.
Dana BessDana Bess
23:57 10 Dec 21
Everyone at Perkins Studdard was kind and professional. They were always extremely responsive and answered all questions that I had and followed up to make sure I had an understanding of what was going on along with emailing videos to explain every step of my case so I would know what to expect and be prepared. Jason is a very genuine person and I trusted him with my case. He answered so many questions for me even before I retained him as my WC lawyer. I highly recommend him and his associates at Perkins Studdard.

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Jason Perkins

Workers' Compensation Attorney

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