Work injury "lights up" preexisting arthritis or other degenerative condition -- Is it covered?

It’s a common situation, especially among middle-aged workers. You have preexisting arthritis in your knee, back, shoulder, neck or other joint but no symptoms from it. The arthritis is there but doesn’t really bother you and doesn’t keep you from doing your job. It is asymptomatic. Then you have a workplace injury that aggravates the preexisting arthritis or “lights it up.” The injury likely will be covered for worker’s compensation purposes but what about the preexisting and now symptomatic arthritis?

The short answer is that the aggravation of your preexisting arthritis or other degenerative condition should be covered as well.

BUT BE CAREFUL – in our experience, the Washington State Department of Labor and Industries frequently rejects responsibility for the aggravation of a preexisting condition.

There are two long-standing rules about allowing or rejecting a preexisting condition:

  1. Impairment resulting from the “lighting up” of a preexisting but latent and asymptomatic condition, or from aggravation of a preexisting symptomatic condition, is to be attributed to the industrial injury.
  2. Impairment which preexisted or which resulted from the progression of a preexisting condition which worsened or became symptomatic independently of the industrial injury, is not attributable to the industrial injury.

The department and employers hate the first rule. To get around it, they choose IME doctors who reliably say the worker’s injury did not aggravate the underlying arthritis. The IME doctors usually write something like this:

The injury was just a strain, which has now healed. Future pain symptoms are due to the natural progression of the claimant’s arthritis, which hurts independently of the industrial injury.

This is hogwash and if you see it in an IME report or a department order, you should challenge it. If your preexisting condition was not causing you pain or functional limits before the injury but it does after the injury, do not accept rejection by the department or your employer for the preexisting condition.