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pre-existing injury

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RHONDA GAGE

Junior Member
What is the name of your state? Chicago, Ill.
I have had a small hernia for about 8 years now. Generally it has not created a problem and would only pop out on occasion and then go back in. The last several years I worked for a home produscts supply firm in sales and this has involved much more bending/lifting then I had anticipated. This has aggravated this injury considerably. The bulge no longer recedes and it has grown to at least the size of an orange. This is uncomfortable to frequently painfull depending on what activity I'm doing. I have gone to my employer and explained this situation to him and told them that I thought that this should be covered under workmans comp. They flat out refused. I am going to bring a claim for this through the Illinios Workers Compensation Commission and I have been down to the State office and picked up the forms and informational booklet. I have read through all of this and find very little that is applicable to my particular situation.
Do I really need a lawyer?
What types of proof do I need? Affidavids from my general practitioner, surgeon, xrays ? Any suggestions?
I have not as yet had the opperation as paying the bill by myself would create a financial hardship for me. Those booklets make it sound very involved when I would have thought that it would just be a matter of deciding whether this injury was aggravated on the job. I appreciate and advice you can give. Thank you in advance
 
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tjr5150

Member
You explained your situation to your employer? You told them you had already had a injury and this just aggravated it even more.. Your out of luck.. Your employer or workman's comp will not cover and injury your employer did not cause, nor were you hurt on the job..
 

mlane58

Senior Member
"Your out of luck.. Your employer or workman's comp will not cover and injury your employer did not cause, nor were you hurt on the job."

tjr5150, Check out Sisbro, Inc. v. Industrial Comm’n (Rodriguez). The claimant in this case alleged that an accidental injury arising out of and in the course of his employment was causally related to the onset of a degenerative condition.

The OP needs to check with their state W/C board to see if this indeed a valid claim. Each state has different laws regarding pre-existing conditions and wether or not they are compensable.
 

tjr5150

Member
That's nice of you to tell me that.. In his post he stated he had a hernia for about 8 years.. You or he don't like what I say that's fine, I'm giving my opinion and he can consult with an attorney if he wants to by his own choice..
 
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mlane58

Senior Member
It doesn't matter that he had a hernia for 8 years. Some states including Illinois obvisiouly take into account pre-existing conditions that are inflamed by work related tasks.

Instead of feeling like you were insulted or something, do some research and not every issue needs to be solved by going to an attorney.
 

RHONDA GAGE

Junior Member
Illinios
According to the Illinios handbook on Workers' compensation and occupational Diseases, Pg #3, "These benefits are paid regardless of fault". On page 4 it states, "Workers may also be compensated for aggravation of a prexisting condition". Thats about the only time there is any reference to an existing condition. I have the benefit of knowing how bad the condition was before and how bad it has become and there is no doubt in my mind that my employer should be held accountable. My employer is a nation home supply chain and I'm sure they will have lawyers on staff. I have no experience with this kind of thing and really don't know what to expect. I have been honest in admitting that this was something I have had in a minor form. I'm not looking to make a profit, I simply want the surgury covered. My question is- How do I proceed, do I need a lawyer. What types of information/proof must I show. Again, thanks for your thoughts on this matter.
 

DEeyore

Junior Member
I totally agree. I originally injured my back in a car accident 8 years ago. I was rear-ended by a woman driving an SUV at 45 MPH while talking on her cell phone. At the time of the accident, I wasn't even aware of the fact that I was injured until three days later when my lower back began killing me and I started to experience numbness in both of my legs. I wound up missing four days of work over this, so my employer was well aware of my injuries. After seeing the insurance company doctors and receiving a diagnosis of "whiplash" and "soft-tissue damage," I was prescribed 800 MG Motrin and some muscle relaxers, and in about a week I started to feel fine.

Never at any time did anyone inform me that this was going to become a recurring problem or that my condition could get progressively worse over time. Two years after the accident, (after the statute of limitations wore out, of course) my symptoms returned, but much more severe than when I was first injured. I literally felt like if I had moved the wrong way I could become permanently paralyzed and was completely unable to walk in an upright position. I wound up missing even more work over this and consulted yet another doctor, who informed me that I was exhibiting the first signs of degenerative joint disease in my lower back. How she came to this conclusion is completely beyond me, since she never so much as gave me an X-Ray, let alone an MRI to diagnose my condition. All that she did was shoot me up with cortisone and send me home with a prescription for Vioxx.

It wasn't until almost four years later that I actually found out how severe my condition really is. After attempting to pick up a special needs child in my classroom and moving the wrong way, I found myself doubled over in pain and completely unable to walk without being in excruciating pain. Since I was not covered under my company's health insurance plan, I was directed to see a Doctor at an Occupational Health Center by my company. For the first 3 to 4 weeks, the doctor was treating me as if I had "sprained" my lower back, even though I had disclosed my complete medical history involving my back condition.

After I obviously hadn't shown any signs of improvement, he finally broke down and ordered me to have an MRI done. When the results came back and showed that I had herniations at the L4-S1 and L5-S1. It was explained to me that at the L4-S1 there was a loss of disc height and degenerative disc disease and a bulging disk at L5. The orthopedic surgeon that I was referred to informed me that while I am not currently a candidate for surgery at this time, that my condition will most likely deteriorate over time and I probably will need surgery in the future.

While all of this was going on, my caseworker with WC was very supportive of me and basically told me in not so many words that even though I did have a pre-existing back condition before I was injured in work, the fact remained that I aggravated my condition in work, thus making it a Worker's Compensation case. Never once did she accuse me of trying to defraud WC by using my pre-existing condition in order to collect a paycheck through SWIF. Because of the fact that I was honest with her about my previous back injury and even gave my former physicians permission to release my medical records to WC, she went above and beyond the call of duty to make sure that I was taken care of.

Now while I'm sure that there truly are people out there trying to defraud the WC system and caseworkers who resent the fact that they are trying to collect benefits and receive medical treatment under false pretenses, this was not the case with me at all. The bottom line: Honesty is the best policy in matters such as this. For every person out there who is knowingly committing WC fraud, there are many others out there who cannot get the treatment and assistance that they need because their motives are impure. What a shame that people like this have to go and ruin things for the people out there with legitimate needs.

~ Dee ~
 

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