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Apportionment and pre-existing conditions in workers’ compensation law

In our last post, we began speaking about a proposal that would close a loophole in state workers’ compensation law regarding pre-existing conditions. As we noted, the bill aims to prohibit employers from reducing claims involving conditions that mostly affect women. The idea is connected to apportionment, which is a workers’ compensation principle which allows claims administrators to tailor workers’ compensation payments to the degree that workplace injuries result in worsening of a pre-existing condition.

One of the biggest points of contention is the claim that proponents of the bill are attempting to expand workers’ compensation so that it effectively covers disabling conditions which are not work-related. Those who oppose the bill on such grounds, of course, voice the interests and reasoning of employers. Proponents say the bill is not about expanding coverage by about equality or parity of coverage. 

Under current workers’ compensation procedure, apportionment is worked out based on a physician’s report, which includes a determination of the percentage the worker’s permanent disability was caused by the on-the-job injury and the degree to which it was caused by other factors. The employer is liable for compensating the injured worker to the extent the disability was directly caused by the on-the-job injury.

Workers who run into problems with receiving a fair determination concerning apportionment from their claims administrator should know that they have the ability to challenge the decision. It is wise to always work with an experienced workers’ compensation attorney, though, to ensure that one’s rights and interests receive the advocacy they deserve. 

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