My Workers' Compensation carrier denied my claim due to a "pre-existing condition" that I did not even know that I had.What is a "pre-existing condition"?

The Oregon Workers' Compensation law sets out different kinds of claims that can exist if you suffer an injury on the job.

If you suffer an injury over a discrete period of time, like in a fall or other industrial accident, then your injury will be classified as an "injury" claim. This is important because it is easier for an injured worker to prove this kind of claim. However, if the injured worker suffers an injury that combines with a "pre-existing condition," then the claim is considered a "combined condition" claim. This can make it more difficult for an injured worker to get benefits.

Many people ask us how can it be that they have a "pre-existing condition" when they did not even know of the condition, have symptoms,or treat for the condition. That is a very good question.

There are two kinds of "pre-existing conditions" in Oregon Workers' Compensation law. The first is where the injured worker did actually treat for a problem with the area of the body that was injured on the job. This is pretty straightforward. However, another type of pre-existing condition exists when there is "arthritis."

"Arthritis"  for the purposes of workers' compensation and Oregon is defined as an "inflammation of the joint." Many battles rage back and forth between employers and injured workers as to whether not the degenerative joint and disc disease or some other degenerative changes in an injured body part constitute an "inflammation of the joint." In some cases, this can make the difference between having the claim accepted or denied.

Sorting out whether there is in fact "arthritis" in the legal sense often involves conferring with physicians and other experts. If you are in the middle of an Oregon Workers' Compensation case,  and wonder if benefits are being denied because of some mystery pre-existing condition, call us at 503-325-8600. We handle these issues every day, and know what questions to ask the physicians.