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A comorbid condition can complicate a workers’ compensation claim

On Behalf of | May 8, 2017 | Medical Benefits, Workers' Compensation |

In recent years, the number of older workers has steadily increased. In April 2017, the percentage of people in the workforce aged 65 and older reached 19 percent – the highest it’s been since 1962.

Along with the increase in the number of seniors in the workforce, workers’ compensation risk managers are reporting an increase in the number of claims involving work injuries and comorbid conditions. What is a comorbid condition? It’s a disease or disorder that exists simultaneously with a primary injury, disease, or disorder. Some examples of comorbid conditions are obesity, diabetes, hypertension, and mental health issues. A comorbid condition can exist independently or be related in some way to the primary injury, disease, or disorder.

How does a comorbid condition affect a workers’ compensation claim?

 An injured worker who has a comorbid condition may require more time to recover and return to work. He or she may need a specialized medical care that takes the comorbid condition into account. In general, notes an article in Claims Journal, a website focusing on the insurance industry, claims with comorbidities will:

  • Last longer than other claims
  • Incur higher medical and indemnity costs
  • Require more temporary disability (TTD) days
  • Be more likely to be litigated
  • Require higher rates of surgery

What should you do?

 An injured worker who has a comorbid condition should:

  • Make sure that the doctor takes the condition into account when prescribing a treatment regimen.
  • Accurately describe the effect the condition has on the worker’s ability to perform work functions, as well as any pain or ill-effects the worker experiences.
  • Make sure that the doctor enters information about pain, limitations or other ill-effects into his or her medical record.
  • Take advantage of any wellness programs the employer offers or that are available through non-profit organizations.

Workers’ compensation insurance companies have a strong motivation to limit the amount of benefits they provide to injured workers. To get all of the medical care and benefits you deserve, you may need the services of an experienced workers’ compensation lawyer.


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