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Can You Claim WorkCover for an Old Injury?

You could claim workers compensation benefits when a pre-existing injury or illness is worsened by your job. Learn when and how it works.
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You could be eligible to make a workers’ compensation claim when your job worsens a pre-existing injury. However, this type of personal injury claim can be quite challenging, as you must prove that your employment was a significant contributing factor to the aggravation of an old medical condition.

Our legal guide to WorkCover claims for old injuries explains:

  • The impact of pre-existing injuries on workers’ compensation claims
  • The importance of medical evidence from your treating doctor
  • If you could have a compensable injury that qualifies for a new claim

Obligation-Free Consultation

The Workers Compensation Lawyer QLD offers a free case review for legal matters affecting an employee’s health, including aggravation of a pre-existing condition. Our WorkCover legal team can explain if you may be entitled to compensation and the available benefits, once approved.

Furthermore, all 100% no-win, no-fee lawyers offer a no-financial-risk guarantee. Pay for a win and zero if you lose. It’s free to learn where you stand. Call 1800 575 023

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About the WorkCover Compensation Scheme

WorkCover is the name of the QLD workers’ compensation scheme that can help employees who experience work-related injuries or medical conditions, regardless of whether it’s a new one aggravation of a pre-existing condition. The main goal of the plan is to make sure:

  • Eligible injured workers can receive fair compensation
  • They have financial support for medical treatment, so they can recover

All employers must have workers’ compensation insurance to protect the interests of employees who suffer accelerated, worsened or aggravated injuries. As a result, they can be eligible to make a compensation claim and receive WorkCover benefits.

What is a Pre Existing Injury for WorkCover Claims?

Section 571A of The Workers’ Compensation and Rehabilitation Act 2003 (Qld) defines a pre-existing injury or condition as:

  • A medical condition or injury that existed during the period of employment
  • That someone would reasonably suspect would be aggravated by their work duties

Workers' Compensation Claims for Pre-existing Injuries

Workers’ compensation legislation covers both new injuries and pre-existing injuries or medical conditions that have been:

Under certain circumstances, employers may be liable for compensation when specific legal criteria are met.

  • Eligible employees could then have access to treatment and income support without consideration of their medical history.
  • Legislation is also designed to ensure employers are protected from claims where pre-existing injuries are not aggravated by work.
  • To have an eligible workers’ compensation claim, their employment must be the significant contributing factor to the aggravated injuries or medical condition.
  • If this requirement is met, the worker may be entitled to compensation.
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Can I Claim WorkCover for Aggravation of a Pre-Existing Injury?

If you have a pre-existing injury that has been aggravated because of your work duties or a work-related incident, you may be able to file a new claim for WorkCover benefits. For this kind of personal injury claim, you need strong medical evidence that:

  • Explains the pre-existing condition and how it impacts your daily life
  • How the worker’s employment has made the injury worse

To have a successful claim, first you need to report the aggravation or recurrence to your employer as soon as possible and ensure it is logged in the register of injuries. You will also need the following:

  • A current Certificate of Capacity from your treating doctor details your condition and its work-related cause for a WorkCover claim.
  • Medical evidence that could come from your treating doctor, or you may need to attend an independent medical examination.
  • Records of the period that include when and how the aggravation occurred.

NOTE: Once you have an accepted WorkCover claim, you usually are not required to pay any legal costs. You also have the right to seek legal counsel from an experienced work injury lawyer.

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Aggravating of a Pre-Existing Condition at Work: What's Next?

If you have aggravated a pre-existing condition at your job (or during work-related duties), making a workers’ compensation claim requires proving how your work duties made your old condition worse. This process is the same whether you have an existing physical or psychological injury.

  • Employees must report the aggravation or recurrence to their employer as soon as possible.
  • Then make sure the incident is logged in the work injury register.
  • Next, a treating doctor would assess the medical condition and provide a WorkCover medical certificate.
  • You have to seek legal advice about your situation because the claim process for a work-related injury that involves a pre-existing condition can be particularly challenging.
  1. Your medical history can help prove the pre-existing nature of an injury and how it could be aggravated by your job.
  2. To have a successful claim, you must also prove that your job significantly contributed to the aggravation of the old injury.

Why You Must Disclose Pre-Existing Medical Conditions to Employers

Employees are legally obligated to tell the truth about pre-existing medical conditions when applying for a job with a new employer. Specifically, any pre-existing injuries or illnesses that could impact your capacity to do your work duties. Non-disclosure can result in your WorkCover claim being rejected or denied.

  • For example, you could have a denied claim when you don’t tell your employer about an old back injury and then a work-incident makes it worse.
  • Claims can also be rejected when an aggravated injury is assessed as a natural progression, i.e., your job was not a significant contributing factor.

Employer Obligations

A new employer also has obligations to do the following:

  1. Prospective employees should receive a detailed position description in their pre-employment information packages. This information helps them understand the risks of a new role.
  2. They should allow the applicant to disclose any relevant medical conditions that could prevent them from doing their new role.

Can I Claim Workers' Compensation for the Same Injury Twice?

In Queensland, you can be eligible to claim workers’ compensation benefits for the same psychological or physical injury more than once. This can happen when:

  • Symptoms return in the same location as the original injury
  • If you have an existing claim and the injury has been further aggravated, deteriorated or otherwise worsened by your job

NOTE: It may not help your situation to lodge more than one claim. You can speak with a work injury lawyer about your options when you experience aggravation of a prior injury.

How to Define Pre-Existing Injuries

A pre-existing injury is considered to be any injury, illness or medical condition that existed before there was a new incident at work.

  • Queensland’s workers’ compensation law covers the re-emergence of symptoms from a pre-existing injury.
  • Eligibility includes previous injuries, illnesses, mental health conditions and any related chronic conditions.
  • As a result, impacted workers can seek compensation for aggravated injuries when they have the required documentation.

An old injury can be worsened by a work-related incident in one of five ways.

  • Recurrence is when a pre-existing injury occurs again in the same manner. For example, you previously had a shoulder injury that had already healed but flared up again because of your work duties.
  • Aggravation refers to when a pre-existing injury has been worsened beyond its prior state. For example, you had a previous mild back injury that became more severe.
  • Acceleration refers to a condition worsening at a faster rate than it would have normally. For instance, if your degenerative elbow condition is predicted to worsen over ten years, but becomes noticeably worse in just five years.
  • Exacerbation: When the effects or symptoms of a previous condition worsen, it’s called an exacerbation.
  • Deterioration occurs when a medical condition has caused either new or worse symptoms than you had previously. This situation is often linked to the repetitive nature of a task.

The exception to the above is when there was no new incident that made a previous condition worse, in which case there may be a continuation of an original claim.

You could reopen a WorkCover claim when an original injury has been aggravated or exacerbated, and this occurs at work.

  • You will need to provide fresh medical evidence that shows how your condition has been altered by your job.
  • In this type of case, the workers’ compensation insurer typically raises doubts by arguing that work did not contribute to the condition to a significant degree.
  • You have the right to seek legal advice regarding your circumstances.

First, all incidents that exacerbate a pre-existing condition should be reported to your employer within 30 days. Then, the time limit to lodge a claim for WorkCover benefits is generally within 6 months of the injury.

  • Your employer can also report the injury to WorkCover, but this does not start your case.
  • WorkCover common law claims have a general time limit of three years.
  • For cases involving serious and permanent disablement, claims might be possible even after the three-year time period if there is a reasonable excuse for the delay.

What are Prospective Employer Obligations?

Prospective employers have a legal obligation to manage workplace risks that could impact pre-existing injuries and medical conditions. During the employment process they should follow specific steps, particularly when recruiting new employees

  • For example, they should formally request a written disclosure of any pre-existing health concerns that could affect the employee’s employment.
  • They should also provide a clear explanation of the particular tasks involved in their new role.

Non-disclosure by employers or prospective workers is likely to impact any future workers’ compensation claims and entitlements. In fact, properly disclosed information of any existing injuries, diseases or other applicable medical conditions by all parties can:

  • Reduce the risk of aggravating injuries at work.
  • Lower the risk of a workers’ compensation claim for undisclosed pre-existing conditions.

How do WorkCover Claims Impact Future Employment

There should be no impact on future employment after making a WorkCover claim. That’s because employers are generally not allowed to discriminate based on the medical history of prospective workers.

You should be aware of your rights under Australian discrimination laws if your medical treatment history prevents you from being employed.

QLD Personal Injury Claim Advice for a Prior Injury

In Queensland, you have the right to seek legal advice before proceeding with a workers’ compensation claim for aggravation of a pre-existing condition. A qualified workers’ compensation lawyer can help you understand:

  • Do you meet the eligibility criteria
  • How to prove that your job was a significant contributing factor to your condition
  • Your right to medical treatment and support
  • Any other matters you wish to discuss related to your case
  • Your recommended next steps

Free Initial Consultation

Workers Compensation Lawyers QLD offers a free initial consultation for employees who have been injured in the course of their employment, including those who have suffered aggravation from a pre-existing injury, disease, or illness.

We fund all our WorkCover compensation legal services on a 100% no-win, no-fee basis. Pay for a win and nothing if you lose. Call 1800 575 023

QLD WorkCover Pre-Existing Condition FAQs

Does workers' comp cover pre-existing conditions?

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A pre-existing injury is considered to be any injury, illness or medical condition that existed before there was a new incident at work.

  • Queensland’s workers’ compensation law covers the re-emergence of symptoms from a pre-existing injury.
  • Eligibility includes previous injuries, illnesses, mental health conditions and any related chronic conditions.
  • As a result, impacted workers can seek compensation for aggravated injuries when they have the required documentation.

It is highly unlikely that you can claim for a work injury after five years because:

  • The time limits for workers’ compensation claims are much shorter
  • Common law claims have a three-year time limit

There may be a rare exception for:

  • Late discovery of an injury
  • If you had a reasonable reason for the delay
  • If the injury leads to death or a permanent impairment

An old back injury can be aggravated in multiple circumstances, which can then worsen the condition.

This means the new incident makes the pre-existing condition more severe in relation to its prior state, causing further medical problems or disability.