Workers Compensation - A form of insurance providing wage replacement and medical benefits to employees injured in the course of employment in exchange for mandatory relinquishment of the employee's right to sue his or her employer for the tort of negligence. These laws were first enacted in Europe and Oceania, with the United States following shortly thereafter. The trade-off between assured, limited coverage and lack of recourse outside the worker compensation system is known as "the compensation bargain." While plans differ between jurisdictions, provision can be made for weekly payments in place of wages (functioning in this case as a form of disability insurance), compensation for economic loss (past and future), reimbursement or payment of medical and like expenses (functioning in this case as a form of health insurance), and benefits payable to the dependents of workers killed during employment (functioning in this case as a form of life insurance).
Workers' Compensation provides financial and medical benefits to employees who suffer a workplace injury or develop an occupational disease. The Pennsylvania Workers' Compensation System is set up to benefit both employees and employers: injured workers (or their families, in the case of a death) receive benefits without having to establish negligence or fault, and in turn, employers are granted immunity from negligent actions for pain and suffering that arise out of workplace accidents.
Of course, the workers' compensation system operates solely within the confines of the employer-employee relationship: benefits are only distributed to workers injured in the course of employment. Typically, injuries that occur in pursuit of personal endeavors are not compensable through workers' comp.
However, this general rule often leads to confusion about aggravation or exacerbation of preexisting conditions. Even when underlying juries are not work related, workers' compensation benefits may be available to employees whose work duties cause an already-existent condition to worsen and be disabling.
An Explanation of Exacerbation and Aggravation
Many times the terms "exacerbation" and "aggravation" are used similarly or simultaneously. Some doctors may make a distinction between the two. However, if it can be demonstrated that the work related injury aggravated or exacerbated an underlying pre-existing condition that can be compensable under the Workers' Compensation Act. Importantly, workers' compensation benefits should be available to employees who suffer either exacerbation or aggravation as a result of a work place injury which materially or substantially contribute to the cause of their condition and/or disability.
A simple example can help illustrate how workers' compensation claims from exacerbation or aggravation develop.
Imagine a worker who suffers from arthritis. It can be arthritis in the knee, neck, back, hand, etc... which occasionally causes discomfort and may result in treatment. One day at his place of employment, the worker is involved in an incident, lifting a heavy box, slipping and twisting, falling, a motor vehicle accident, etc... and now the area of the body which was suffering from the arthritis is experiencing more pain causing more limitations. The workers pain gets much worse resulting in an inability to work. If it can be proven that the underlying condition was materially or substantially aggravated by a work place activity or incident the worker should receive workers' compensation benefits. Even if the arthritis pre-existed the accident and predisposed the worker to a herniated disc or torn ligament, if it can be proven that the work injury aggravated or exacerbated the underlying arthritis and is a substantial contributing cause to the condition and disability it should be considered compensable. Practically speaking, however, judges like to see some sort of change anatomically such as a herniated disc, or torn ligament, etc... Even if there is medical testimony that the herniated disc or torn ligament could have come from the underlying progression of the arthritis again, if it can be proven that the work injury aggravated or exacerbated the underlying condition to the point where it substantially contributed to the current condition and disability it should be considered compensable.
Get the Workers' Compensation Benefits You Deserve
It can be difficult to sort out whether conduct at work contributed to the worsening of an existent condition, and unfortunately this confusion is sometimes exploited to deny perfectly legitimate exacerbation or aggravation claims. If a previous injury got worse while you were on the job, contact an experienced Pittsburgh workers' compensation lawyer to ensure you receive the full benefits you are entitled to.
Article provided by Dugan & Associates, P.C. - Visit us at www.dugan-associates.com
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