Key Takeaways:
- Having a pre-existing condition doesn’t automatically disqualify you from receiving workers’ compensation benefits in South Dakota.
- It can, however, complicate your claim and make it more challenging to prove the extent to which your current condition is work-related.
- Thorough medical documentation and a clear understanding of South Dakota law are essential for navigating these complexities.
- Working with an experienced workers’ compensation attorney can significantly improve your chances of a successful outcome.
A loyal construction worker who has been with his company for 15 years has suddenly experienced severe back pain due to an injury on the job. He has lived with back pain for the last 20 years, and he has documented pre-existing herniated disks. When he is injured on the job, it can be more challenging for him to prove that his flare up in back pain is a result of the injury and not his preexisting condition. This is where a lawyer can be invaluable in supporting the construction workers claim for workers’ compensation in South Dakota.
Millions of American employees live with preexisting conditions. But having any type of underlying medical issue does not disqualify you from workers’ compensation, however. It can be more challenging for someone with a preexisting condition to prove to an insurance carrier that their injury exacerbated or aggravated their condition.
If you have become injured on the job this guide will help you understand your rights to seek workers’ compensation in South Dakota with a pre-existing condition.
South Dakota Workers’ Compensation and Pre-Existing Conditions
Workers’ compensation is a type of insurance that employers carry to cover lost wages and medical expenses for injured employees. South Dakota does not mandate employers to carry any type of workers’ compensation, but they can be held liable in a personal injury claim if an employee decides to take legal action against them. Because the cost of civil liability can be far more expensive than workers’ compensation, most employers choose to carry coverage.
The purpose of workers’ compensation is to provide payment in the form of benefits to injured employees. That helps them maintain financial stability and a good quality of life as they recover from and work related injury or illness. In some cases, workers’ compensation may turn into a type of temporary or permanent disability benefit.
Regarding pre-existing conditions, South Dakota law has measures in place that protect individuals. In the legal world, abbreviation is a term used to describe the worsening of a condition due to a work related injury or working in a hazardous environment.
An important note in South Dakota workers’ compensation law refers to the selection of medical personnel or surgeons. Section 62-4-43 states that if an employee does not avail themself to medical care, then they could be barred from collecting benefits.
Simply put, this means that the employee is responsible for seeking appropriate medical care in relation to their injury. If they do not take necessary steps to treat their injury, then they cannot hold their employer accountable for the resulting damages or negative impacts on their life.
In summary, any individual with a pre-existing condition has a right to pursue workers’ compensation benefits if their job aggravates or exacerbates that condition.
Proving Your Claim
You will want to keep comprehensive medical records that support your claim, both before and after the workplace incident. This is important for illustrating the impact that the injury had on your health and pre-existing condition.
Your employer or their insurance company can request an exam by an independent medical examiner. This is a doctor who has been chosen by your employer or the insurance carrier to assess your injury and the extent of its impact on your preexisting condition.
Independent Medical Examinations (IMEs) can serve as supportive evidence in your claim for workers’ compensation. However, if your claim is denied and you feel that the IME was inaccurate, then you can pursue legal action with the help of a workers’ comp lawyer in South Dakota.
Under South Dakota law, you have one year from the date of injury to file a claim. Your employer will have seven days from the date of injury to notify their insurance carrier. However, if the employer provided medical care for the injury or you were able to work following the injury, the deadline is extended.
Generally speaking, it is advisable for an injured employee to request workers’ compensation as soon as possible. The longer they wait to file a claim, the harder it can be for them to justify their request for benefits. This is especially true in cases where the employee continued to work for several months after their injury.
You can consult with an attorney who will help you understand the statute of limitation surrounding workers’ compensation in S Dakota as well as the ideal timeline for requesting benefits in your unique case.
Can I request workers’ compensation if the injury was my fault?
In some cases, an employee may be able to still recover some benefits if they are partially or fully responsible for their injury. The unique circumstances surrounding the case will ultimately determine their eligibility. If you are unsure whether your specific injury qualifies for workers as compensation, it’s best to speak with an experienced attorney who can help.
Addressing Challenges and Potential Pitfalls
There are challenges that employees can face when seeking benefits after being injured on the job. This can happen whether or not they have a pre-existing condition. However, individuals who do have underlying medical conditions might find that proving their work-related injury aggravated that condition is more challenging.
Employer disputes could be a common issue that you may face. employers and insurers may try to attribute your condition to the injury and thereby deny you or reduce the amount of benefits you qualify for. They may also try to claim that you should have taken greater care to avoid injury because of your condition, and that because you were partially responsible for your injury, you are not entitled to maximum benefits.
Another common pitfall that employees face is the apportionment of benefits. Apportionment refers to the reduction of benefits based on the extent to which a preexisting condition contributed to a disability.
If you feel like the amount of workers whose compensation you’re being offered does not accurately reflect the extent of damage your injury has caused, then you can work with a lawyer who could help you justify the maximum possible benefit.
Remember that it is critical to file your claim within the statute of limitations. Failure to not file a claim within one year of the injury can result in you being barred from benefits.
The Role of a Workers’ Compensation Attorney
At Alvine Law Firm, our job as a workers’ compensation attorney is to fight for people’s rights. We believe that every individual has the right to work in a safe environment, And when accidents happen, they deserve to have the peace of mind that comes from appropriate benefits.
Your attorney will play multiple roles throughout the duration of your case. They can help you gather evidence and build a strong case, negotiate with your employer and their insurance carrier, represent you in workers’ compensation hearings or appeals, and protect your rights throughout the entire process.
They are also a source of knowledge for you as an employee, so you can understand exactly what your rights are and what you have legal justification to ask for. Knowing a full extent of your rights can help you from being denied coverage.
Conclusion
Employees have a right to seek benefits for a work-related injury in South Dakota, even if they have a pre-existing condition. If your work injury has exacerbated or aggravated your condition, then you can seek benefits through South Dakota workers compensation. If your employer or their insurance carrier are denying you coverage, then you have the right to take legal action.
Reach out to our law firm to schedule a free consultation. One of our lawyers will be happy to discuss your case with you and let you know how they may be able to help. Contact Alvine Law Firm in Sioux Falls, SD, online or call 605-275-0808.
Resources
- South Dakota Department of Labor and Regulations – South Dakota Workers’ Compensation
- Employee’s Guide to Workers’ Compensation in South Dakota (SDLR)
Sources