Getting hurt at work is frustrating under any circumstances. But it can be even more stressful if you’ve injured a body part that was already hurt.
Many injured workers with pre-existing conditions worry that the insurance company will blame their current pain on the old injury and deny their claim. That concern is understandable. Insurance carriers often review past medical records, looking for anything they can use to argue that your condition isn’t connected to your job.
Here’s the reality: An old injury can affect how your claim is handled, but the outcome depends on what happened and how your condition changed afterward.
Below, we’ll explain how prior injuries are treated, what separates a new injury from an aggravation of an old one, and what evidence can help support your claim.
This Is How Old Injuries Affect Workers’ Comp Cases in Texas
In many cases, old injuries give the insurance company extra room to argue about what it should and shouldn’t have to cover.
The insurance company may admit you were hurt at work but still argue that the injury isn’t as serious as you claim. They may agree that you suffered a minor strain while refusing to cover a damaged disc, aggravated arthritis, or a worsened old injury.
Texas workers’ comp only pays for medical problems that were caused or worsened by the job injury. The insurance company doesn’t have to cover an unrelated condition, but they also can’t point to an old injury and ignore the new damage.
Note: Workers’ comp claims work differently from personal injury lawsuits. In a lawsuit, you may need to prove that someone else was careless. You don’t have to do that with workers’ comp.
Can I Still Receive Workers’ Comp Benefits If I Had an Old Injury?
Yes. Having an old injury doesn’t automatically prevent you from receiving workers’ comp benefits.
You don’t have to show up to work in perfect condition to be protected. If something happens on the job and makes an old problem worse or causes new damage, you may still qualify for medical care and income benefits.
The benefits you can receive will depend on which injuries workers’ comp covers, whether your doctor limits what you can do, and whether you can still earn your usual wages.
What’s the Difference Between a New Injury and an Aggravation of an Old One?
A new injury is a separate medical problem caused by the recent workplace incident. An aggravation happens when that incident makes an old condition worse.
For example, suppose you injured your knee years ago but recovered and returned to work. If you later fall on the job and tear a ligament, that may count as a new injury. If the fall worsens damage that was already there, it may be treated as an aggravation.
A temporary flare-up is different. Pain may return for a few days without causing any new or lasting damage. A true aggravation usually leads to a measurable change, such as added damage, new work restrictions, reduced movement, or treatment you didn’t need before.
Your injury classification can affect what workers’ comp covers. The insurance company may argue that you only had a brief flare-up so it can avoid paying for more treatment or benefits. A doctor’s opinion can help show whether the workplace incident caused a new injury or made the old one worse.
What Medical Evidence Is Important in Cases with Pre-Existing Conditions?
These cases require records from before and after the workplace incident.
Earlier records may include imaging, surgery reports, physical therapy notes, specialist evaluations, and prior work restrictions. They highlight the history of the condition and how it was initially treated.
Newer records should document the new incident, your diagnosis, physical findings, treatment plan, and current limitations. Emergency room notes, updated scans, specialist reports, and written restrictions may all be important to your case.
A clear medical opinion is often more useful than a long stack of records with no explanation. Your doctor’s notes should identify the condition being treated and explain whether the recent incident caused it or made it worse.
When doctors disagree, the Texas Division of Workers’ Compensation may appoint a designated doctor to address specific medical questions. That opinion can carry significant weight during a dispute.
Learn about other evidence that matters in a Texas workers’ comp case.
Should Injured Workers Tell Their Doctor About an Old Injury?
Yes. Hiding an old injury can hurt your workers’ compensation claim.
Your doctor needs the full story to figure out what changed after the work incident. Explain how the old injury affected you before, what pain or limitations you have now, and what treatment you need.
Being honest and consistent also makes it harder for the insurance company to claim you changed your story.
Which Medical Conditions Commonly Lead to Disputes?
Back, neck, shoulder, and knee injuries often lead to disputes because those body parts commonly show signs of old damage.
For example, an MRI may reveal arthritis, a bulging disc, scar tissue, or an old rotator cuff injury. The insurance company may then argue that those findings were already there and weren’t caused by the work incident.
Claims involving chronic pain or degenerative conditions can also be difficult. The carrier may say your symptoms came from aging or normal wear and tear instead of something that happened on the job.
Having one of these conditions doesn’t give the insurance company an excuse to deny your claim. It just gives them more room to argue over which problems were already there and which ones came from the work incident.
Contact Grossman Law Offices Today
The insurance company may try to turn your old injury into the entire story. Don’t let them ignore what actually changed after you got hurt at work.
Grossman Law Offices has spent more than 35 years helping injured Texans fight disputed workplace injury claims. We know how to challenge arguments about pre-existing conditions, disputed medical records, and denied treatment.
Call us anytime to discuss what happened and find out what options may be available. We’re available 24/7, and you won’t pay us unless we win your case.
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