When treatment for a work injury causes subsequent injuries, illnesses, or complications that require additional medical care or result in a longer time off work, an employee may be able to recover workers’ compensation benefits to recover for those losses.
Claims for Subsequent Injuries
Consequences, including subsequent injuries caused by treatment for the original injury and the worsening of an existing condition, that flow from the primary work injury are compensable. If a compensable workplace injury gets worse after the employee returns to work and causes further disability, for example, the entire disability may be covered by workers’ compensation benefits. If a primary injury occurs during the course of regular employment duties, all related consequences are also related to employment.
Physical injuries often result in treatments that lead to further injury and pain. Examples include:
- Infections from medical treatments
- Side effects from medications
- Inflammation and swelling
- Overuse of injured limbs and muscles
- Headaches and neck immobility from head trauma
- Falls from leg, knee, ankle and foot injuries
To obtain benefits, all workplace treatments and injuries must be documented in medical records from a licensed physician or medical professional. Records must show proof of a direct connection between original and subsequent injuries.
Denied Claims
When a primary work injury, or treatment for that injury, causes harm, some employers and insurance companies may deny the claim to avoid liability. They may attempt to blame later injuries on unrelated circumstances or negligence, especially if subsequent injuries are not carefully documented. If a claim is denied, a work injury lawyer can file an appeal for workers’ compensation benefits or petition to reopen the claim.
In Illinois, employers are required to provide workers’ compensation insurance for their employees. Employers purchase workers’ compensation insurance from private insurance companies, so when an employee is injured on-the-job, it’s the insurance company that approves or denies benefits.
Workers’ comp claim denials happen for various reasons including: failure to promptly notify the employer of injuries; failure to file a timely claim; uncovered medical conditions; non-serious injuries; and lack of medical documentation. However, even when a claim is denied it can be reopened if an injury returns or worsens at a later date, alternate job duties are not available, or new evidence proves the injury claim. Reopening a workers’ compensation claim is altogether different from appealing a denied claim.
