Can I make a WorkCover claim if I had a pre-existing injury?

If you have an old back, shoulder, knee or other injury, you might assume that you can't make a WorkCover claim if that part of your body is injured again at work.



That isn't necessarily true.

We often speak with people who are worried that, because they had a problem before the workplace accident, WorkCover will simply say: “You were already injured, so it isn't our responsibility.”

It is not always that simple.

Your old injury doesn't necessarily stop you making a claim

Under Queensland workers' compensation law, an aggravation, acceleration, exacerbation or deterioration of a pre-existing condition can potentially be a compensable injury.

The important question is whether your employment was a significant contributing factor to the worsening of your condition.

Work doesn't have to be the only cause of your symptoms.

For example, perhaps you already had some problems with your lower back. You were managing them and continuing to work.

Then you lift something heavy at work, slip, fall or perform particularly strenuous duties.

After that incident, your pain becomes much worse. You need new treatment, you can't perform your normal duties and your doctor says your condition has deteriorated. You may still have a WorkCover claim.

What matters is what changed after the workplace accident

If you are making a claim for an aggravation of a pre-existing injury, it is important to be able to explain what your condition was like before the workplace incident and what happened afterwards.

Evidence may include:

• what your symptoms were before the accident;
• what happened at work;
• when your symptoms became worse;
• whether your diagnosis changed;
• whether you needed additional treatment;
• whether your ability to work changed;
• scans and other medical evidence; and
• what your treating doctor or specialist says about the role your employment played in making your condition worse.
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Having a pre-existing condition isn't something you need to hide.

Instead, the medical evidence needs to clearly explain the difference between the condition you had before the workplace event and the condition you have now. The issue is whether the workplace event or duties caused an aggravation or deterioration that is connected to your employment.

If you were managing your old injury reasonably well before the accident but have experienced a significant deterioration since, tell your doctor exactly what changed.

Can WorkCover pay for my treatment?

If your claim is accepted, WorkCover may pay for reasonable medical, hospital and rehabilitation expenses required because of the work-related aggravation. Depending on your circumstances, this can include:

• GP and specialist appointments;
• physiotherapy and rehabilitation;
• medication;
• scans and investigations;
• psychological treatment where relevant;
• approved surgery; and
• reasonable travel for treatment.

However, WorkCover is not responsible for treatment that relates solely to the underlying condition that existed before the workplace incident. That distinction can sometimes be difficult, which is why good medical evidence is important.

What if I can't work because my old injury has become worse?

If WorkCover accepts your claim and the work-related aggravation prevents you from working or restricts the work you can do, you may be entitled to weekly compensation for lost earnings.

You will generally need a current work capacity certificate that identifies the accepted injury or aggravation, your capacity for work and any restrictions on suitable duties.

If you can still work but need reduced hours or modified duties, you may potentially be entitled to partial weekly compensation depending on your circumstances.

If your injury has become significantly worse because of something that happened at work, don't assume that your previous injury means you have no claim. You may still be entitled to workers' compensation for the work-related aggravation.

You don't have to work out whether you have a claim on your own,

We can help you understand where you stand and whether you may have a claim.