How does a Pre-Existing Medical Condition Affect a Workers' Compensation Claim (QLD)

How does a Pre-Existing Medical Condition Affect a Workers' Compensation Claim (QLD)?

Answers to Frequently Asked Questions

Suffering an injury at work can be stressful enough, but when you already have a pre-existing condition, it can make the workers’ compensation process seem even more complicated.

Many injured workers worry that their prior medical history will either prevent them from lodging a claim with WorkCover Queensland (or a self-insurer) or prevent them from pursuing a common law or compensation claim, but this isn’t usually the case.

Below are some answers to frequently asked questions about pre-existing conditions.

What is a pre-existing condition?

A pre-existing condition is any injury, illness or medical condition that existed prior to sustaining injuries in a work-related incident. This might include physical injuries like a back strain or knee injury, degenerative conditions such as arthritis, or psychological conditions such as anxiety or depression.

Does a pre-existing condition disqualify me from lodging a workers' compensation claim?

No. Having a pre-existing condition doesn’t automatically disqualify you from lodging a workers’ compensation claim.

How does a pre-existing condition affect my workers’ compensation claim?

A pre-existing condition can affect WorkCover Queensland’s (or self-insurer’s) decision to accept or reject your statutory claim, and should you pursue a common law or compensation claim, it can affect the amount of compensation you receive.

In other words, while the existence of a pre-existing illness or injury won’t preclude (stop) you from pursuing a claim, it may be taken into account and be reflected in the amount of compensation you are entitled to.

What if an existing medical condition is aggravated by a work injury?

If you have a pre-existing injury or condition and a workplace incident causes an aggravation or significant worsening of this condition, you may still have a valid workers’ compensation claim and the right to pursue a common law claim for damages or compensation.  

However, the employer’s responsibility to compensate an injured worker may be reduced based on the extent to which the aggravation has contributed to your overall impairment or incapacity. 

This means you may be compensated for the increased disability or impairment caused by the work-related aggravation, but not for the effect of the pre-existing condition.

Can I make a compensation claim for a pre-existing injury?

Yes, you can make a compensation claim for a pre-existing injury, but only if your work has caused the condition to worsen.  

The work-related incident or ‘over time activity’ must be a significant contributing factor to the aggravation of the pre-existing injury. Also, there must be clear medical evidence which shows your job has made the condition worse, not just that your symptoms have naturally intensified or deteriorated over time.

My pre-existing condition is from a previous compensation claim. Can I claim compensation for the same injury twice?

Once you settle a compensation claim for a particular injury, that claim is considered forever closed. You do not get a proverbial second bite of the cherry, if you later realise the settlement amount wasn’t enough to cover your ongoing treatment, loss of income, or other expenses into the future.

If, however, there has been a new work-related event or ‘over time activity’ that causes an aggravation, acceleration or recurrence of your pre-existing injury or condition, the new event may be treated as a new injury giving rise to a fresh claim.

Do I need to disclose my pre-existing injuries to my employer?

Certainly, if asked, you should disclose any pre-existing injuries or medical conditions to your employer, especially if they may affect your ability to safely perform your job.

Being honest about your medical history helps your employer meet their legal duty to provide a safe workplace and to make reasonable adjustments where necessary.

Ultimately, honesty and transparency protect both you and your employer. If your pre-existing condition is aggravated by your work, having a clear record of disclosure can actually support your workers’ compensation claim.

Summary

Pre-existing conditions don’t automatically prevent you from being successful in a workers’ compensation claim, but they can make the process more complex.

What matters is whether your work has caused or aggravated your condition, and to what extent.

Be transparent about your medical history with prospective employers.

If this situation applies to you, seek legal advice from an experienced lawyer who works in compensation claims litigation.