Pre-existing injuries can significantly impact workers’ compensation claims in Queensland, adding complexity to an already challenging process. When an employee sustains an injury at work, the presence of a pre-existing condition can raise questions about the extent of the employer’s liability and the worker’s entitlement to compensation. In this article, we’ll explore how pre-existing injuries are addressed in Queensland’s workers’ compensation system and the key considerations for injured employees.
Understanding Pre-Existing Injuries
A pre-existing injury is any medical condition or physical impairment that an employee had prior to sustaining a work-related injury. These conditions can range from chronic illnesses like diabetes or arthritis to previous injuries, such as back or knee problems. Pre-existing injuries may be known to the employee and employer at the time of hiring, or they may be undiagnosed or undisclosed.
In the context of workers’ compensation, a pre-existing injury becomes relevant when it is aggravated, accelerated, or exacerbated by a work-related incident or the nature of the employee’s job duties. For example, if an employee with a history of back problems lifts a heavy object at work and experiences a severe back spasm, the pre-existing condition has been aggravated by the work-related activity.
Disclosure of Pre-Existing Injuries
Employees have a legal obligation to disclose any known pre-existing injuries or medical conditions to their employer, particularly if they are relevant to the job duties they will be performing. Failure to disclose a pre-existing condition can have serious consequences for an employee’s workers’ compensation claim.
If an employee knowingly withholds information about a pre-existing injury and later aggravates that condition at work, the employer and insurer may argue that the employee’s entitlement to compensation is limited or void.
Aggravation vs. New Injuries
When an employee with a pre-existing injury sustains a work-related injury, the first step is to determine whether the incident has aggravated the pre-existing condition or caused a new, separate injury. This distinction is critical because it impacts the employee’s entitlement to compensation and the employer’s liability.
If the work-related incident has aggravated a pre-existing injury, the employee may be entitled to compensation for the extent to which the aggravation has increased their symptoms or impairment. The employer’s liability may be limited to the aggravation itself, rather than the entire pre-existing condition.
For example, if an employee with a pre-existing knee condition suffers a torn meniscus at work, the employer may be liable for the treatment and compensation related to the torn meniscus, but not for the pre-existing arthritis in the knee.
On the other hand, if the work-related incident causes a new injury that is separate from the pre-existing condition, the employee may be entitled to full compensation for the new injury, regardless of the pre-existing condition.
Medical Evidence and Causation
Determining the relationship between a work-related incident and a pre-existing injury requires a thorough evaluation of the employee’s medical history and the circumstances of the incident. Medical evidence is crucial in establishing causation and the extent of the employer’s liability.
Employees should seek medical attention promptly after a work-related injury and inform their doctor of any pre-existing conditions that may be relevant. The medical practitioner will assess the employee’s condition and provide an opinion on whether the work-related incident has aggravated the pre-existing injury or caused a new, separate injury.
Employers and insurers will typically require the employee to undergo an independent medical examination (IME) to assess the nature and extent of the injury and its relationship to any pre-existing conditions. The IME report will be a key piece of evidence in determining the employee’s entitlement to compensation and the employer’s liability.
Apportionment of Liability
In cases where a work-related incident has aggravated a pre-existing injury, the employer’s liability may be apportioned based on the extent to which the aggravation has contributed to the employee’s overall impairment or incapacity. This process, known as apportionment, aims to ensure that the employer is only responsible for the portion of the injury that is directly related to the work incident.
Apportionment can be a complex and contentious issue, particularly when there are multiple contributing factors to an employee’s condition. In some cases, the employer may argue that the pre-existing condition was the primary cause of the employee’s incapacity, while the employee may assert that the work-related aggravation was the main contributor.
Navigating the apportionment process requires the expertise of experienced legal and medical professionals who can evaluate the evidence and present a strong case for the appropriate allocation of liability.
Rehabilitation and Return to Work
When an employee with a pre-existing injury sustains a work-related aggravation, the goal of the workers’ compensation system is to support their recovery and return to work as quickly and safely as possible. Rehabilitation and return-to-work planning should take into account both the work-related injury and the pre-existing condition.
Employers have a legal obligation to provide suitable duties and accommodations to support an injured worker’s return to work, regardless of whether the injury is related to a pre-existing condition. This may involve modifying job duties, providing ergonomic equipment, or allowing for a gradual return to full duties.
Employees should actively participate in their rehabilitation and return-to-work planning, communicating openly with their employer, medical practitioner, and rehabilitation provider about their capabilities and any concerns they may have.
Seeking Legal Advice
Navigating a workers’ compensation claim involving a pre-existing injury can be a complex and stressful process. Employees who find themselves in this situation should consider seeking the advice of an experienced workers’ compensation lawyer who can help them understand their rights and entitlements. At GC Law, we’re very experienced in the complexities involved in workers’ compensation claims where there may be a pre-existing injury. Importantly, very strict time limits apply in these matters and seeking legal advice promptly is crucial.
