The Impact of Pre-Existing Conditions on Federal Workers’ Compensation Claims

Workers’ Compensation in the U.S.

Workers’ Compensation in the U.S.

How Pre-Existing Conditions Affect Federal Workers’ Compensation Claims

Do you have questions about federal workers’ compensation? Understanding this program can feel overwhelming, no matter your illness, injury, or concern. Pre-existing conditions are just one of several things that can throw a wrench into getting compensation after a workplace accident. These conditions can change the trajectory of your claim, and it’s important to understand their implications. The team at Aumiller Lomax is here to help you file a claim under the Federal Employees’ Compensation Act (FECA), regardless of pre-existing conditions. Learn more about the Influence of prior conditions on federal workers’ comp claims.

FECA Benefits Explained

Before we examine the impact of pre-existing conditions, it’s essential to understand FECA. FECA is administered by the Office of Workers’ Compensation Programs (OWCP) and provides comprehensive workers’ compensation coverage to federal employees who suffer job-related injuries and diseases. The law covers medical expenses, provides compensation for lost wages, and offers vocational rehabilitation services to assist injured workers in returning to work.

Under FECA, federal workers are entitled to compensation regardless of who is at fault for the injury or illness. The key is demonstrating that the injury was directly connected to employment in the federal government.

Types of Compensation Available Under FECA

If you’ve been injured on the job, you may qualify for several types of benefits under FECA. Every case is different, and the experienced team at Aumiller Lomax can help you determine what you’re eligible for. Our past clients have earned the following forms of compensation:

  • Medical Expenses—FECA covers all medical expenses related to the diagnosis and treatment of a work-related injury or illness. This includes hospital bills, medical treatments, and medications.
  • Lost Wages—If your injury has resulted in an inability to work, you may receive disability wage compensation. This is typically a percentage of your pay at the time of the injury.
  • Schedule Awards—For permanent partial disabilities resulting from work-related injuries, employees may be eligible for a schedule award. This compensation benefit based on permanency is determined, in part, by the type and severity of the injury or disease.
  • Vocational Rehabilitation—In the case that you’re unable to return to your previous employment because of the injury, you may be eligible for vocational rehabilitation services. This might include retraining, job placement assistance, and counseling. This program is utilized at the discretion of the OWCP.
  • Death Benefits—Has a loved one passed away due to a work-related injury or illness? FECA provides benefits to the surviving family members in the form of compensation for lost wages and a provision for funeral expenses.

How Pre-Existing Conditions Come into Play

Pre-existing conditions play a significant role in federal workers’ compensation. A condition is pre-existing when it predates the work-related injury. These conditions can range from previous injuries to chronic illnesses such as arthritis or hypertension. When a work incident or work factors aggravate or accelerate a pre-existing condition, the situation quickly becomes complicated. It becomes difficult for doctors to determine how much of employee’s condition is related to the injury and how much was already present.

Can I Still File a Claim If I Have a Pre-Existing Condition?

If you have a pre-existing medical condition, you may still qualify for benefits. However, your condition may make the process more complicated. Claimants must prove their job duties contributed to their current disability beyond any pre-existing issues. Once you present evidence to the OWCP, they will review medical records, accident reports, and expert reports to discern the impact of the work-related injury on the pre-existing condition.

Helping You Gather Relevant Evidence

Pre-existing conditions and their role in federal workers’ comp claims are challenging to navigate alone. Thankfully, Aumiller Lomax is here to help clients across the United States build strong cases for compensation. We’ll work with you to gather relevant evidence to prove your claim. Our team may help you secure the following records and documentation:

  • Medical Evaluations—Be sure to keep all medical records pertaining to your injury. A physician’s statement will be crucial in determining the extent to which your injury was work-related.
  • Medical History—A comprehensive medical history that predates your work with the federal government is essential. This document can offer a baseline for understanding the severity of your pre-existing condition. This may include records of previous treatments, diagnoses, and any prior compensations or claims related to the condition.
  • Employment Records—This documentation provides a detailed account of the injured worker’s job description, duties, and working conditions. These records establish a direct link between the work environment and the exacerbation or aggravation of the pre-existing condition.
  • Expert Reports—In some cases, the opinion of a medical expert may be necessary. These professionals can offer an authoritative perspective on how a work-related incident could have impacted the pre-existing condition.
  • Rehabilitation Reports—For employees undergoing rehabilitation, reports detailing the progress and outcomes of such treatments can illustrate the severity of the work-related injury.
  • Witness Statements—If there were witnesses to your injury, their written statements may be helpful as you build a case for compensation.
  • Functional Evaluations—These evaluations assess the employee’s capacity to perform job-specific tasks before and after the incident. This can be crucial in demonstrating how the work-related injury has affected your ability to work.

Can I Appeal a Denied Claim?

You have every right to appeal a denied claim. Often, obtaining additional medical opinions and clarifications can be instrumental during the appeals process. If your claim has been denied, reach out to the team at Aumiller Lomax. We can help you build a solid appeal and present your case in the best light. Over the years, countless clients nationwide have benefitted from our counsel.

How Legal Counsel Can Help

Considerations of previous ailments in federal workers’ compensation claims are complex. That’s why it’s vital to partner with an attorney specializing in these claims. Their experience not only helps in accurately preparing and filing the initial claim but is also invaluable when dealing with denials or appeals. Skilled legal professionals are adept at navigating the complexities of FECA and can ensure you have all the required documentation in place. Aumiller Lomax is dedicated to helping United States federal employees uphold their rights and gain compensation whenever possible. We’ve worked with thousands of clients in the Northeast, and we have assisted workers from all sorts of agencies and departments, including:

Reach Out to Aumiller Lomax Today

Don’t wait to file a federal workers’ compensation claim because of a pre-existing condition. While these issues are certain to impact your case, they aren’t a sign that hope is lost. Many of our clients have secured compensation despite pre-existing conditions, and Aumiller Lomax would be glad to help you as well. Contact us today to schedule your free initial consultation.