How Pre-Existing Conditions Affect Your Right to Workers’ Compensation Benefits in Colorado

If you’ve been injured at work in Colorado, you may wonder how your past health issues could affect your claim for workers’ compensation benefits. Many employees worry that a pre-existing condition will automatically disqualify them from receiving coverage. The truth is more nuanced. Colorado law protects injured workers, but insurance companies often scrutinize claims involving prior injuries or medical conditions. Here’s what you should know.

Pre-Existing Conditions Don’t Eliminate Your Rights

Having a pre-existing condition does not mean you’re ineligible for workers’ compensation. Colorado’s system is designed to cover work-related injuries or aggravations of existing health issues. If your job duties make your condition worse, you may still qualify for benefits.

For example, if you already had back problems but suffered a fall at work that worsened your pain or caused new complications, the aggravation may be considered a compensable injury.

The Key Question: Aggravation vs. Natural Progression with Pre-Existing Conditions

When pre-existing conditions are involved, the central issue is whether your current symptoms stem from:

• The natural progression of your prior injury or illness, or
• A new, work-related aggravation or acceleration of that condition

Insurance companies often argue that your pain or limitations would have occurred anyway, regardless of your job duties. To counter this, medical evidence is critical. Doctors can help establish whether work activities significantly worsened your condition beyond its normal course.

The Role of Medical Evidence

Your medical history will be closely examined in these cases. That includes prior medical records, diagnostic tests, and physician notes. While insurers may use this history against you, it can also strengthen your case. If you can show that your symptoms worsened after a workplace incident, or that new symptoms developed, your claim becomes stronger.

Independent medical evaluations (IMEs) are also common in disputed cases. Having an experienced attorney guide you through this process can help ensure your rights are protected.

Apportionment of Benefits

In some situations, benefits may be apportioned—meaning divided—between your pre-existing condition and the new workplace injury. This can affect the amount of compensation you receive. However, you’re still entitled to coverage for the portion directly tied to your work-related aggravation.

Common Examples of Pre-Existing Conditions

Certain conditions frequently come up in Colorado workers’ comp cases, including:

• Back and neck injuries
• Arthritis
• Repetitive stress injuries (like carpal tunnel)
• Previous fractures or joint damage

Employers and insurers may attempt to blame your current symptoms on these prior issues, but that doesn’t automatically bar your claim.

Protecting Your Claim

If you have a pre-existing condition and suffer a workplace injury:

1. Report your injury promptly. Follow Colorado’s deadlines to preserve your rights.
2. Be honest about your medical history. Concealing past conditions can hurt your credibility.
3. Seek medical care quickly. Make sure doctors document how your job aggravated or worsened your condition.
4. Consult an experienced workers’ comp attorney. They can help gather evidence, challenge denials, and advocate on your behalf.

Final Thoughts

Pre-existing conditions add complexity to a workers’ compensation case, but they do not erase your right to benefits in Colorado. The key is proving that your job aggravated or accelerated your condition. With timely reporting, strong medical evidence, and legal support, you can still protect your health and secure the compensation you need.