Getting hurt at work is bad enough. If you already have a medical condition, your claim may face even more resistance. In Pennsylvania, injured workers have protection regardless of fault. That doesn’t stop insurance companies from pushing back. If they deny your claim, it means the insurer doesn’t believe your job made the condition worse. That’s a serious problem – and it won’t fix itself.
Why insurers deny claims involving pre-existing conditions
Insurance companies don’t like risk. When they see a prior injury or condition, they often look for ways to avoid paying. They may use the following arguments:
- Your injury didn’t happen at work.
- Your job didn’t make the condition worse.
- Your medical records don’t show a clear change.
- Their doctor disagrees with yours.
These common tactics are designed to delay, discourage and deny your workers’ compensation claim.
How Pennsylvania defines aggravation of pre-existing conditions
You don’t need a new injury to qualify for workers’ compensation. You need proof that your job made an existing condition worse in a way that can be documented. That may include lifting, bending, standing or any task that strains your body beyond its usual limits.
Medical records, job duties and witness accounts help show how your condition changed. Aggravation of a pre-existing condition may qualify as a compensable injury under Pennsylvania workers’ compensation law if your work caused a clear and provable shift in your physical health.
What to do after a denial
A denied claim is not the end – but it is a warning. You can file a petition and present your case before a Workers’ Compensation Judge. The process involves strict deadlines, legal procedures and evidence review. If you wait too long or go in unprepared, you risk losing benefits you may need to survive.
These cases are hard to win alone. Speaking with an attorney helps you build a strong case, challenge insurer tactics and protect your health and income. If your claim was denied, take action now.