Has a workplace injury worsened your pre-existing condition? Did you know that you may still be entitled to compensation? Because pre-existing conditions don't automatically disqualify you from WorkCover benefits. However, these claims require stronger evidence and involve more complex legal tests.
For aggravation claims, you need to understand:
- Evidence requirements to prove workplace injury worsened your condition
- How pre-existing conditions affect compensation amounts
- Options under WorkCover and common law pathways
- Critical documentation steps to protect your claim
You must prove your workplace injury materially contributed to worsening your condition, even if it wasn't the sole cause. Medical evidence and proper documentation are crucial for establishing this connection and securing compensation.
This guide explains your rights and essential steps when workplace injuries involve pre-existing conditions.
Understanding Workplace Aggravation of Pre-Existing Conditions
Already dealing with an old injury or health issue? If work makes it worse, you might still be covered.
When your job aggravates a pre-existing condition, like flaring up a dodgy back, worsening arthritis, or heightening anxiety, it counts. Even if the issue wasn’t caused at work, you could still have a valid claim if your job makes it harder to manage..
Example: Sarah works in aged care and has mild arthritis in her back. During a patient transfer, she injures her back, significantly worsening her arthritis pain and requiring surgery. Even though Sarah had pre-existing arthritis, she can claim compensation for the work-related aggravation that made her condition worse.
It’s not enough that your condition’s gotten worse, you need to show work played a real part in that. The key is proving your job actually made things worse, not that your condition just got worse on its own over time. That difference really matters when it comes to getting a claim accepted.
Understanding Statutory WorkCover vs Common Law Claims
So if your workplace injury aggravates a pre-existing condition, you may be eligible for compensation. If you are in this scenario, you have two separate legal pathways in Queensland to potentially take:
1. Statutory WorkCover Benefits
First up is the no-fault scheme, which is administered by WorkCover Queensland. If your claim is accepted, you could access the following:
- Medical treatment costs
- Weekly wage replacement (up to 80% of earnings)
- Rehabilitation services
- Lump sum compensation for permanent impairment (if applicable)
Remember, you don’t need to prove anyone was at fault. Instead, you just need to show that your work significantly contributed to the aggravation of your pre-existing condition.
2. Common Law Damages
If your employer was negligent, for example, by failing to provide a safe work environment, you may be entitled to more than just your standard WorkCover benefits. In these cases, you could be eligible to pursue a common law compensation claim, which allows you to seek additional damages beyond what’s covered under the statutory scheme.
Unlike statutory claims, which are “no fault” and cover medical costs and lost wages, common law claims are different. They require you to prove your employer’s negligence caused your injury. However, these claims can potentially result in significantly higher compensation, including:
- Pain and suffering
- Past and future economic loss
- Care and support needs
Although it is important to remember, common law claims are more complex, especially when a pre-existing injury is involved.
Also read: How Long Do I Have to Start a Workers' Compensation Claim in Australia?
How Pre-Existing Injuries Affect Common Law Claims
If a workplace accident aggravates a pre-existing injury, your ability to claim common law damages may be limited to the extent of the aggravation, rather than the full condition. This can result in a lower payout.
You must also meet eligibility thresholds based on your Degree of Permanent Impairment (DPI):
- If your DPI is under 20%, you must choose between a statutory lump sum or pursuing a common law claim, you cannot receive both.
- If your DPI is 20% or above, you may pursue a common law claim even after accepting a lump sum.
Importantly, proving your employer’s negligence caused a new or worsened condition, not just the natural progression of a pre-existing one, can be challenging. These claims require robust medical evidence and legal strategy.
That’s why we recommend seeking advice from a legal team experienced in Queensland workers’ compensation law.
Also read: What is the difference between a WorkCover claim and a common law claim?
Your Rights and Obligations
Your Rights
If work’s made an old injury or health issue worse, here’s what you could be entitled to:
- Medical expenses for treatment of the work-related aggravation
- Weekly benefits of up to 85% of your normal earnings (reducing to 80% after 26 weeks) while you're unable to work
- Rehabilitation services to help you return to work
- Lump sum compensation for permanent impairment (if applicable)
- Common law damages if negligence is involved
Your Obligations
On the other hand, you also have obligations to follow. You must:
- Report the injury promptly to your employer (ideally within 48 hours)
- Seek appropriate medical treatment and follow medical advice
- Cooperate with rehabilitation efforts where reasonable
- Provide honest disclosure if specifically asked about pre-existing conditions during employment
- Lodge your claim within time limits (6 months for WorkCover, 3 years for common law)
Practical Applications
What you’re entitled to comes down to proof, was work really a major reason things got worse?
You’ll need to show that your condition didn’t just naturally get worse over time, but that your job genuinely pushed it further
Common Situations and Questions
Can I claim if I never disclosed my pre-existing condition?
Brief Answer: It depends on whether you were specifically asked and whether the non-disclosure was intentional.
If your employer never asked about pre-existing conditions during hiring, your failure to volunteer this information won't affect your claim. However, if you were directly asked and failed to disclose, this could void your right to claim for aggravation of that specific condition. The key is whether the non-disclosure was material to the employer's decision to hire you.
What if my condition would have gotten worse anyway?
Brief Answer: You can still claim for the work-related acceleration or worsening of your condition.
Even if your pre-existing condition was degenerative and would have worsened over time, you can claim compensation if work accelerated this process or made it significantly worse than it would have been naturally. Medical evidence comparing your actual progression with expected natural progression is crucial.
How do I prove my work made my condition worse?
Brief Answer: Through comprehensive medical evidence comparing your condition before and after the workplace incident.
You'll need medical records showing your pre-injury baseline, evidence of the workplace incident or exposure, and post-injury assessments demonstrating measurable worsening. Independent medical examinations often play a crucial role in establishing causation.
Can I claim for both physical and mental health aggravations?
Brief Answer: Yes, both physical and psychological pre-existing conditions can be covered if aggravated by work.
Workplace stress can worsen pre-existing anxiety or depression, just as physical work can aggravate existing injuries. The same principles apply, so you need to prove work was a significant contributing factor to the worsening.
What happens if WorkCover denies my claim?
Brief Answer: You have appeal rights and may still pursue common law damages.
You can request an internal review by WorkCover, then appeal to the Industrial Magistrates Court if necessary. Even if statutory benefits are denied, you may still have a common law claim if negligence was involved.
Are there different rules for different types of pre-existing conditions?
Brief Answer: The basic principles are the same, but evidence requirements may vary.
Whether dealing with previous injuries, degenerative conditions, or mental health issues, the core requirement remains proving work-related aggravation. However, the type of medical evidence needed and the way causation is established can differ significantly.
Can I claim if multiple factors contributed to my worsening condition?
Brief Answer: Yes, as long as work was a significant contributing factor.
Work doesn't need to be the only cause of aggravation. If workplace factors significantly contributed alongside other causes (like aging or lifestyle factors), you can still claim for the work-related portion.
What if I'm approaching retirement age?
Brief Answer: Age doesn't disqualify you, but may affect the calculation of some benefits.
While you can still claim regardless of age, factors like remaining working life may influence calculations for future economic losses in common law claims.
Recent Changes and Developments
Legislative Updates
The Workers' Compensation and Rehabilitation Act has seen several amendments affecting pre-existing condition claims. Recent changes aim to bring more clarity and fairness to handling pre-existing conditions at work:
- Stronger rules around disclosure mean clearer guidance for when and how employers can ask about pre-existing health issues.
- Tighter causation standards now require more specific medical evidence to prove that work genuinely worsened the condition.
- A bigger focus on rehab and return-to-work planning helps ensure support takes your existing health needs into account
Important Cases
Recent Queensland court decisions have also clarified several important principles for this area, including:
- Medical evidence standards: Courts now require more sophisticated medical analysis. This helps compare actual disease progression with expected natural progression.
- Disclosure obligations: Recent cases have also emphasised that non-disclosure must be both material and intentional to void claims.
- Apportionment principles: Where multiple factors contribute to a condition's worsening, courts are more precisely calculating the work-related portion.
Future Outlook
The push for stronger medical proof isn’t slowing down, getting the right medical support early on matters more than ever. With stricter standards becoming the norm, seeing the right specialists early can make a big difference in getting your claim over the line
Practical Guidance
Immediate Steps After Injury
- Report the incident immediately to your supervisor or employer.
- Seek medical attention and inform your doctor about the workplace incident and your pre-existing condition.
- Document everything and keep records of the incident, your symptoms, and how they've changed.
- Notify WorkCover within the required timeframes.
- Preserve evidence including workplace surveillance footage if available.
Essential Documentation
Medical Records:
- Complete pre-injury medical history relating to the affected area.
- Emergency department records from the day of injury.
- All subsequent medical consultations and specialist reports.
- Imaging studies (X-rays, MRI, CT scans) both before and after injury.
- Independent medical examination reports.
Workplace Evidence:
- Incident report forms
- Witness statements
- Workplace policies and procedures
- Safety training records
- Employment records showing job duties
Red Flags to Watch For
- Delayed reporting: Report injuries as soon as possible to avoid complications.
- Inconsistent medical advice: Ensure all your healthcare providers understand both your injury and pre-existing condition.
- Pressure to return to work prematurely: Don't compromise your recovery.
- Disputes over causation: Early legal advice can prevent problems from escalating.
Building a Strong Claim
Focus on demonstrating clear connections between your workplace activities and the worsening of your condition. This often requires:
- Detailed medical opinions explaining how work factors contributed to aggravation.
- Functional assessments showing measurable changes in your capabilities.
- Workplace analysis identifying specific job factors that contributed to your condition's worsening.
When to Seek Professional Help
Warning Signs Requiring Legal Advice
You might need extra support if you're dealing with any of these situations:
- Your employer or insurer is arguing that work had nothing to do with your condition getting worse.
- You’re being questioned about not disclosing a pre-existing condition.
- The medical reports don’t line up or aren’t clear about what caused the aggravation.
- Your claim’s been knocked back, or your payments have stopped suddenly.
- Your condition has left you with lasting damage that could impact your ability to earn down the track.
Complex Situations Needing Expert Guidance
Multiple Contributing Factors: When various elements (work, age, lifestyle, genetics) may have contributed to your condition's worsening, legal expertise helps establish the work-related portion and maximise your compensation.
Serious Long-term Impacts: If your aggravated condition has resulted in permanent disability, you may be entitled to both workers' compensation benefits and Total and Permanent Disability (TPD) benefits through your superannuation.
Employer Negligence: Where your employer's breach of workplace safety duties contributed to aggravating your pre-existing condition, common law damages may provide significantly higher compensation than statutory benefits alone.
Also read: How is Permanent Impairment Calculated in Queensland WorkCover Claims
How Early Advice Prevents Problems
Early legal consultation can help you:
- Understand exactly what evidence you need to gather
- Avoid statements or actions that might compromise your claim
- Ensure proper medical documentation from the outset
- Navigate disclosure requirements appropriately
- Maximise your compensation through both statutory and common law avenues
What to Expect from Professional Consultation
A concise legal assessment should give you clear answers on things like:
- Your medical history and what happened at work
- Whether you met your obligations around disclosing existing conditions
- What kind of claims you might be eligible for (under both statutory law and common law)
- What medical evidence you’ll need, and how to get it
- How the claims process works, and how long things might take
- What kind of compensation you could realistically expect
Key Legal Framework
Primary Legislation
The Workers' Compensation and Rehabilitation Act 2003 (Qld) governs these claims, with several key sections specifically addressing pre-existing conditions:
- Section 571A requires workers to disclose pre-existing injuries or medical conditions if specifically asked by their employer during the hiring process
- Section 32 establishes that compensation is payable for the aggravation of pre-existing conditions caused by work
- Section 237 sets out the limitation periods for making claims
Regulatory Framework
WorkSafe Queensland administers the workers' compensation system and provides guidance on disclosure requirements for pre-existing conditions. The system operates on two levels:
- Statutory Claims: Immediate benefits through WorkCover Queensland regardless of fault
- Common Law Claims: Additional damages if negligence can be proven
Recent Developments (2023-2025)
Recent amendments have strengthened evidence requirements for proving that workplace factors contributed to the aggravation of pre-existing conditions. Courts are now requiring more detailed medical evidence to distinguish between natural disease progression and work-related worsening.
Key Takeaways
- You Can Still Claim: Having a pre-existing condition doesn't prevent you from claiming compensation if your workplace injury or work activities have made it worse.
- Disclosure Matters: Be honest about pre-existing conditions if specifically asked during employment, as non-disclosure can affect your ability to claim for aggravation of those conditions.
- Evidence is Critical: Strong medical evidence distinguishing work-related aggravation from natural disease progression is essential for successful claims.
- Multiple Pathways Exist: You may be entitled to both statutory WorkCover benefits and common law damages, plus potentially TPD benefits through your superannuation.
- Time Limits Apply: You have 6 months to lodge a WorkCover claim and 3 years for common law claims, so don't delay in taking action.
- Professional Help Pays: Complex cases involving pre-existing conditions often benefit significantly from early legal advice to navigate the evidence requirements and maximise compensation.
A workplace injury that affects an and pre-existing conditions results in tricky legal and medical questions that require careful navigation. While the law protects your right to compensation when work aggravates existing conditions, successfully claiming that compensation often requires strategic planning and expert guidance.
Unsure of your rights? Get expert help now: Smith's Lawyers offers claims checks to help you understand your options and all claims are run on a 100% risk-free basis with no upfront costs. Call anytime on 1800 960 482 or request a callback from the form below.
