Ep 45 - Understanding Pre-Existing injuries in Workers’ Comp

In this episode, Bilal Kassem, President of Pacific Workers’ shares examples of how the CA Workers’ Comp System handles cases with pre-existing injuries.
Work injuries happen all the time. Some injuries are easy to recover from, but others are difficult especially if you have pre-existing injuries. This is one of those subjects within the workers’ comp system that no injured worker should dive into alone and in fact, Lawyers litigate this type of case often. You see, doctors need to determine the liability a workers’ comp insurance has for any industrial injuries that add to an existing injury.
Sometimes cases are dismissed due to the pre-existing injury. Doctors may determine that the industrial injury did not contribute to what happened. We highly recommend listening to this podcast and getting legal advice if you have pre-existing injuries and injured yourself again.
--------------------------------------------------------
LINKS:
www.pacificwor...
www.workcompta...
www.dir.ca.gov/
--------------------------------------------------------
--------------------------------------------------------
About the Sponsors
Work Comp Talk Podcast is presented by Pacific Workers', The Lawyers for Injured Workers, Northern CA's premier workers' comp law firm. With offices in Stockton, Oakland, Sacramento, Concord, Tracy and San Jose, they have recovered over $200,000,000 in benefits for injured workers in Northern CA. Call for a free case evaluation and get those questions answered 1-800-606-6999.

[@Txanca]

Thank you so much for posting this and providing a resource for workers comp. I work in healthcare as a receptionist and because I know proper documentation helps the WC patients I’ve been trying learn more. I found your podcast and am now following it! I can’t wait to hear more.

[@JimboJones2022]

I have tinnitus raining from the military but I've been working in a call center for over 16 years I have bilateral hearing loss. The call center was in an open office around other end users and people would complain constantly and then management moved us to another location in the corner of the building which was around a billing help desk and we are constantly fighting over volume.

[@WorkCompTalkPodcast]

Reach out and get all of your questions answered. :)

[@russellhess3829]

I was diagnosed with a 10% rating loss. But know my injury has gotten much worse, but my case is still ongoing. Do they re rate me now, or am i stuck with my initial rating

[@benalexender3046]

Thanks ❤

[@powell4661]

I went into surgery with blood sugar under control, came out with sky high numbers. It took me months to get it back under control.

[@WorkCompTalkPodcast]

Yikes, that's scary. What ended up happening?

[@bettymiranda4267]

I have a surgery approved now but I do not want it at this time for my personal situation, later on I want the surgery after the settlement stip. Can they denial surgery because of my preexisting condition , If that happen, Can I use my insurance? What other option I will have if I do not have Insurance?

[@WorkCompTalkPodcast]

There are two main reasons we fight over surgery authorization in workers comp: 1) utilization review says that the surgery is not medically necessary, even if the work injury caused the condition; or 2) even if surgery is needed, the condition was not caused by the work injury, therefore the need for surgery was not caused by the work injury. These two issues come up a lot. With an open medical award after settling by stipulated award, surgery will be subject to utilization review, so if it is denied, an IMR application would need to be filed. If surgery is denied because of preexisting conditions, then you would likely need to seek a second opinion, and/or go to a QME to address the dispute. It's a lot of headaches fighting to get even the most basic care which is why a lot of people end up choosing to settle out their medical rather than keep it open, especially when it comes to treatment like surgery. That being said, some people do go through their private insurance when they are stuck and treatment is being denied.

[@fanniegarcia1567]

What if you don't mention past injury cause you get scared to do so

[@bigrigsmog]

Do use guys have a good psychiatrist on the npn list?

[@WorkCompTalkPodcast]

Each employer/insurance company can have a different MPN. Sometimes there is overlap in providers, sometimes there isn't. So in addition to the location, we would need to know which MPN it is to make a recommendation. We would be happy to take a look at your case and give you a better answer with specifics. You can schedule a call at a time that works best for you, here is the link pacificworkers.co/book-your-appointment. You can also call the team at 800 606 6999.