The primary purpose of workers’ compensation insurance is to cover medical expenses and most lost income caused by a work-related injury or illness in exchange for releasing the employer of the injured or sick worker from direct civil liability for their condition. However, one of the most common reasons workers’ comp claims are denied in Nevada is that an employer or an insurance company believes the injury or illness a specific claim is built around was a “pre-existing condition.”
Pre-existing conditions for workers in Las Vegas can significantly complicate the process of seeking workers’ comp benefits—especially if you try to pursue your claim on your own. Fortunately, you have help available from the experienced workers’ compensation attorneys at Shook & Stone to understand and nullify this roadblock to recovery.
What Does State Law Say About Pre-Existing Injuries for Workers?
Thanks to Nevada Revised Statutes § 616C.177, workers’ compensation insurance providers are allowed to ask claimants in Las Vegas if they have any pre-existing conditions. Claimants must disclose such conditions and provide relevant medical records when asked to prevent their claim from being rejected. However, having a pre-existing medical condition does not automatically disqualify a person from seeking workers’ comp benefits for a separate work-related condition. Insurers are not allowed to reject workers’ comp claims solely because a claimant has a pre-existing condition unrelated to the injury or illness their claim is built around.
Furthermore, N.R.S. § 616C.175 requires insurers to cover work-related injuries and illnesses that significantly aggravate or accelerate harm caused by a pre-existing condition. Insurers who want to reject such claims have the burden of proving the pre-existing condition was not actually made worse by the incident in question. If necessary, one of our skilled attorneys at Shook & Stone can help effectively appeal any claim rejection based on these invalid grounds.
How Pre-Existing Conditions Might Affect Workers’ Comp Benefits
Having a pre-existing condition can sometimes affect the value of disability benefits that a Las Vegas workers’ comp claim is eligible to receive for a work-related injury. For example, suppose someone has a pre-existing chronic illness that was already negatively impacting their working capacity before they got hurt on the job. In that case, the “rating” assigned to them, which would determine the value of their disability benefits, might only take into account how much working capacity they lost specifically because of their new injury, rather than how disabled they are compared to a completely healthy worker without any chronic illnesses.
Similarly, workers are not allowed to seek benefits for harm caused by a condition they began suffering from before they were involved in a workplace accident. For example, the costs of medical care received for the condition before it was aggravated by a work-related accident. A seasoned workers’ comp lawyer can provide more specific information about how a particular claim might proceed during a free consultation.
A Las Vegas Lawyer Can Help Manage a Claim Around a Worker’s Pre-Existing Condition
Even if you have valid grounds to seek benefits through workers’ compensation for what technically counts as a “pre-existing condition,” you will likely have a hard time getting a favorable claim result alone. Even well-prepared claimants often find themselves hindered by the fierce opposition they get from the insurance company and, sometimes, even their own employer. When your future and financial security are on the line, you cannot afford to get caught up in procedural red tape.
That, among many other reasons, is why you should make contacting the team at Shook & Stone your top priority if you need help pursuing a workers’ comp claim. Call today to learn more about pre-existing conditions for workers in Las Vegas.
