If you’ve been injured on the job in California and you already had a medical condition — back problems, a prior injury, arthritis, or even anxiety — you may be wondering: Can I still qualify for workers’ compensation?
The short answer: Yes, but your case may face extra scrutiny.
Pre-existing conditions are common. Many workers have old injuries, chronic pain, or degenerative conditions — especially in physically demanding jobs. Fortunately, California workers’ compensation law recognizes that a work injury can aggravate or accelerate an existing medical issue, and you may still be entitled to benefits.
In this article, we’ll explain how pre-existing conditions affect your claim, what rights you have under California law, how insurance companies try to use your medical history against you, and how to protect your benefits with the help of an experienced attorney.
Can You Get Workers’ Comp With a Pre-Existing Condition?
Yes. California law allows workers to receive workers’ compensation if their job duties aggravate, accelerate, or light up a pre-existing condition.
This is a critical legal principle known as the “aggravation rule.” You do not need to be in perfect health before your injury. If your work made an old injury worse or turned a dormant condition into an active problem, you can file a claim.
Example:
- You had mild, manageable back pain from a car accident years ago.
- At your warehouse job, repeated lifting causes a herniated disc.
- Your condition worsens to the point where you need surgery or time off.
- You may still qualify for workers’ comp benefits—even though you had a prior issue.
What If Your Employer Claims It Wasn’t Work-Related?
Employers and insurance companies often try to deny claims by saying the injury was due to a “pre-existing condition”and not work-related. This is one of their most common strategies to avoid paying benefits.
They may argue:
- “This was a personal medical issue, not a workplace injury.”
- “You’ve had this problem before — work didn’t cause it.”
- “You didn’t report the problem soon enough.”
- “It’s a degenerative condition, not caused by work.”
This is why medical evidence and legal representation are so important. Just because you had a pre-existing condition doesn’t mean your claim should be denied. If your job made your condition worse, the law is on your side.
The “Lighting Up” Standard in California
California workers’ compensation courts use the concept of “lighting up” to determine whether a pre-existing condition is compensable.
Here’s what that means:
- If a prior condition was asymptomatic (you had no symptoms or limitations), and
- A work injury caused it to become symptomatic, painful, or disabling,
- Then the employer may be responsible for the resulting medical treatment and disability.
Even if the condition was present before, if it didn’t require care or interfere with your ability to work until the job made it worse — it’s likely covered.
Types of Pre-Existing Conditions That Commonly Affect Claims
Some of the most common pre-existing conditions that become issues in workers’ comp claims include:
- Chronic back or neck pain
- Arthritis or degenerative disc disease
- Old joint injuries (knees, shoulders, hips)
- Carpal tunnel syndrome or repetitive strain injuries
- Psychological conditions (e.g., anxiety, PTSD)
- Prior surgeries or injuries from car accidents or sports
In many cases, workers aren’t disabled or limited by these conditions — until a workplace incident pushes them past their threshold.
What Benefits Can You Receive?
Even with a pre-existing condition, you may be eligible for full workers’ compensation benefits, including:
- Medical care for your worsened condition
- Temporary disability payments while you recover
- Permanent disability compensation for lasting impairment
- Supplemental job displacement benefits (SJDB) if you cannot return to your prior job
- Vocational rehabilitation support in qualifying cases
In some cases, your disability rating may be adjusted if a portion of your condition is attributed to your pre-existing issue. However, the insurance company must prove that part of your injury would have existed regardless of the work injury—and that’s not always easy.
Apportionment: What It Means and How It Affects Your Compensation
In California, doctors who evaluate permanent disability must determine if any portion of your impairment is “apportionable” to a pre-existing condition.
Here’s how it works:
- A doctor assigns a percentage of disability to your current work injury.
- If part of that disability is caused by a prior injury or unrelated condition, the doctor may apportion a portion of the disability to that cause.
- You are only compensated for the percentage related to the work injury.
For example:
- You’re found to have a 30% disability.
- The doctor says 10% is due to an old injury, and 20% is due to your recent workplace injury.
- You would be compensated for the 20% work-related portion.
Important: Apportionment does NOT apply to medical treatment. The insurance company must still pay for all reasonable and necessary care, even for conditions that have been aggravated.
How to Strengthen Your Claim If You Have a Pre-Existing Condition
Insurance carriers will look for any opportunity to argue that your injuries aren’t work-related. Here’s how to protect yourself:
Report Your Injury Immediately
Don’t wait. Reporting your injury right away helps establish that work contributed to your condition.
Disclose Your Medical History Honestly
Lying about pre-existing conditions can damage your credibility. Be transparent — and let your attorney explain how your job made things worse.
Seek Medical Attention
The sooner you get treated, the easier it is to prove that your condition was triggered or worsened by work.
Get Help From a Workers’ Comp Attorney
A skilled attorney can fight apportionment errors, challenge unfair denials, and ensure your medical rights are protected.
What If You’ve Already Been Denied?
If your workers’ comp claim was denied because of a pre-existing condition, don’t give up. Many denials are based on flawed logic or incomplete evidence.
You have the right to:
- Request a hearing before the Workers’ Compensation Appeals Board (WCAB)
- Dispute medical reports through a Qualified Medical Evaluator (QME)
- Appeal the denial with legal representation
At CA Workers Compensation Attorney, we can review your claim, request a second opinion, and fight for the benefits you deserve.
Protecting Your Right to Compensation
Having a pre-existing condition doesn’t disqualify you from workers’ compensation benefits in California. In fact, the law specifically protects injured workers whose jobs aggravate or accelerate existing medical issues.
Whether you’ve suffered a repetitive strain injury, aggravated a chronic back condition, or re-injured an old joint, you still have the right to receive medical care, wage loss benefits, and disability compensation.
The key is proving that your job contributed to the worsening of your condition and having an experienced workers’ comp attorney on your side makes all the difference. Contact us today to help with your needs!