Florida’s workers’ compensation system recognizes that employees do not walk into work as blank slates. Bad knees from high school football, a herniated disc from a decade-old car crash, degenerative arthritis that quietly advances every year, asthma that flares when the pollen spikes — these are part of real life. The law does not punish workers for their medical history. It sets a standard for when a work event transforms that history into a covered claim.
I have spent years working with injured employees, adjusters, and physicians in Florida. The same questions surface again and again: If I had this condition before, do I lose my rights? How do I prove the job made it worse? Why is the insurance carrier insisting my MRI just shows “degeneration”? The answers live in a handful of statutes, a stack of medical records, and the honest story of how your symptoms changed after the incident.
This guide explains how Florida treats pre-existing conditions under workers’ comp, where the pitfalls lie, and what experienced counsel does to build a successful claim. Whether you search for a workers compensation lawyer near me because your back pain flared after lifting a pallet, or you wonder if your carpal tunnel counts after years of typing and one bad week of overtime, the framework below will help you understand the landscape.
The legal foundation: major contributing cause, apportionment, and objective proof
Florida workers’ compensation turns on a central idea: causation. The statute uses a phrase with sharp edges, major contributing cause. In plain terms, the work accident or exposure must be more than just one factor among many — it must outweigh all other causes combined in driving the need for treatment or disability at a given time.
When a pre-existing condition exists, two concepts enter the picture.
First, major contributing cause still applies. If you had mild, manageable knee osteoarthritis and then tore your meniscus stepping off a loading dock, the question becomes whether that step-down injury is the major contributing cause of your current symptoms and need for surgery, not whether the arthritis disappears from the narrative. We do not erase anatomy, we allocate responsibility.
Second, apportionment may reduce certain benefits. Apportionment means dividing the responsibility for permanent impairment between the pre-existing condition and the work injury. Florida permits apportioning permanent impairment ratings between an old condition and the new accident when medical testimony supports it. Temporary benefits like treatment and wage loss during acute recovery are often less affected by apportionment, but the permanent outcome may be. This is why the language in the doctor’s notes matters.
The practical burden falls on the injured worker and their medical providers to show, with reasonable medical certainty, that the work accident is the major contributing cause of the current need for care. Adjusters will scour prior records for mentions of similar complaints. Carriers may send you to an independent medical examiner to argue that your MRI looks like the same WorkInjuryRights.com Experienced workers compensation lawyer degenerative picture many people your age have. Countering that requires more than “it hurts more now.” It requires documentation that tells a before-and-after story in concrete terms.
How carriers use the “degeneration” defense, and how to answer it
In files where pre-existing issues are present, insurers often point to imaging and age-related changes. Disc bulges at L4-5, osteophytes around the knee, degenerative changes at the AC joint, tendinopathy in the shoulder: these findings are common past your mid-30s and sometimes earlier. Insurers argue that if the structure looked worn before, the accident did not truly change the condition, it simply “lit up” an old problem.
There are two weaknesses in that narrative. First, imaging is a snapshot, not a timeline of symptoms. Many people have radiographic degeneration with no pain or limited functional complaints. Second, the law does not require that the job create a pristine new injury. It permits recovery when work combines with a pre-existing condition and the work event becomes the major contributing cause of the current need for treatment. The shape of a disc on MRI matters less than the shift in clinical picture: new neurological deficits, a clear increase in pain intensity, a loss of range of motion, a work-related event that matches the mechanism of injury.
I often ask clients to write down, in simple terms, what they could do the week before the accident and what they cannot do now. Climb stairs? Sleep more than two hours without waking up? Work a full shift without alternating heat and ibuprofen? If your left shoulder went from occasional soreness after yardwork to burning pain with overhead reach after a warehouse lift, that change is evidence. Doctors can tie it to the job in their notes, but only if you tell them the details.
When a pre-existing condition becomes compensable
Three broad scenarios recur in Florida claims, and understanding them helps anticipate how the carrier will evaluate your case.
The first is an aggravation of a dormant or asymptomatic condition. Picture a truck driver with quiet lumbar degeneration that never limited his runs. Then he pulls a heavy fifth wheel pin in a tight lot and feels a sharp pop. By the next morning he has radiating pain down one leg, weakness in the foot, and numbness in the calf. Even if the MRI shows longstanding changes, the accident may still be the major contributing cause of the new radiculopathy and the need for epidural injections or surgery. The timing, the mechanism, and the new neurological findings carry weight.
The second is an acceleration of a progressive condition. A nurse aide with mild, manageable carpal tunnel syndrome might function with braces and occasional rest breaks for years. If staffing shortages push her into weeks of heavy charting and constant transfers, and her symptoms escalate from nighttime numbness to constant tingling and decreased grip that now requires surgical release, the work-related acceleration can be compensable. The acceleration must be supported by medical opinion, and the chart should capture the workload spike and symptom progression.
The third involves a combination injury where both the pre-existing condition and the work event create a new need for treatment. A warehouse worker with chronic right knee arthritis twists on a spill and tears the medial meniscus. The arthritis still exists, but the meniscal tear is acute. Treatment, whether conservative or surgical, targets the tear. The accident likely stands as the major contributing cause of that intervention. Later, when a permanent impairment rating is assigned, apportionment may divide portions of the impairment between degenerative arthritis and the tear.
Evidence that moves the needle
Carriers and judges do not decide cases on hunches. They look for patterns in records. The strongest aggravation or acceleration claims share a few traits.
The first is a clear, contemporaneous report. If you felt a pop, told your supervisor the same day, and sought treatment within 24 to 72 hours, the chain of causation tightens. Delays invite arguments that something else happened at home.
The second is medical documentation that compares before to after. If you had a primary care visit three months before the accident noting “occasional low back ache, no radiculopathy,” and an ER visit after the accident documenting “new-onset leg pain to the foot, positive straight leg raise,” the contrast supports the claim. Objective findings, even small ones, matter: decreased sensation in a dermatomal distribution, reduced strength in a specific muscle group, swelling, reduced range of motion measured with a goniometer.
The third is consistency. Statements to your supervisor, the urgent care provider, the workers compensation attorney, and the adjuster should align. Inconsistencies are not fatal when explained, but unexplained shifts from “I hurt my back lifting a box” to “I don’t know when it started” erode credibility. If an intake form asks about prior issues, answer honestly and briefly. A prior sprain ten years ago, resolved with rest, is less damaging than the carrier discovering it after you deny it.
Finally, expert medical opinion ties it together. Florida allows each party one independent medical examination in litigated claims. Treating physicians also carry significant weight. When a doctor articulates that the work event is the major contributing cause of the current need for care, and explains why, carriers listen. Vague statements like “could be related” rarely suffice.
Real-world examples from Florida claims
A delivery driver with a history of mild knee arthritis caught his foot on a curb and pivoted awkwardly. He felt immediate pain, managed to finish the route, then could barely get out of bed the next morning. MRI showed both tricompartmental arthritis and a new complex medial meniscal tear. The carrier initially denied based on degeneration. The orthopedic surgeon documented mechanical locking and a positive McMurray test, both new. After a brief dispute, the insurer authorized arthroscopy. Post-surgery, the permanent impairment rating was apportioned between the arthritis and the tear, but wage benefits during recovery were covered.
A call center worker with intermittent wrist numbness for years reported a spike in overtime due to a system rollout. Two weeks later she developed constant tingling, nocturnal pain, and weakness. Nerve conduction studies confirmed significant median nerve compression. The carrier questioned whether her condition was simply progressive. Her treating physiatrist correlated the symptom escalation with the workload surge and documented failed conservative measures. The claim was accepted, surgery authorized, and ergonomic modifications instituted. The apportionment question affected only the final impairment rating.
A warehouse selector with long-standing low back pain, well controlled with stretching, lifted a heavy case above shoulder height and felt an electric shock across the back. He described immediate referral into the left thigh and knee. Imaging revealed degenerative discs and a small annular fissure. The carrier argued nothing new had occurred. The neurologist documented new reflex asymmetry and weakness in the quadriceps. The objective change supported injections and a short course of physical therapy. The employee returned to full duty with restrictions lifted over six weeks.
Each example underscores the same point: details win cases. The story you tell in the clinic and on the form must match what happened on the floor.
What an experienced workers compensation lawyer actually does in these cases
Clients sometimes think a workers comp lawyer just files forms and argues statutes. In pre-existing condition cases, the value often comes from early case architecture. The best workers compensation lawyer or work injury lawyer approaches these files like a builder: foundation, framing, inspections.
The foundation is the initial interview and record retrieval. A good workers compensation attorney will gather not only the post-accident treatment but also targeted prior records. We look for baseline function, prior imaging, and symptom levels. When a client says, “I had back pain before, but I never had leg numbness,” we find the note that supports that statement.
The framing is medical alignment. We speak with treating physicians, provide concise timelines, and ask focused questions that invite medically sound, documented opinions on causation. The goal is not to coach anyone, it is to ensure the doctor sees the whole picture. If the carrier orders an independent medical examination, we prepare the client with what to expect and how to give accurate, succinct histories that match the records.
The inspections are procedural. Florida’s workers’ compensation system runs on deadlines and specific forms. Petitions for benefits, requests for independent medical exams, and responses to denials must be clean and on time. When an adjuster issues a denial based on pre-existing degeneration, the response is not bluster. It is a packet with curated records, a physician’s opinion, and a succinct argument grounded in statute and case law. If surveillance appears, we review it, address any perceived inconsistencies, and, when appropriate, neutralize it with context.
In my practice, the most effective workers comp law firm teams include paralegals who know what to flag in a 500-page chart, a network of physicians comfortable explaining complex conditions clearly, and a disciplined approach to communication. When you search for a workers compensation attorney near me, ask prospective counsel how they handle pre-existing condition disputes specifically. You want an experienced workers compensation lawyer who can talk plainly about major contributing cause and apportionment, not just promise a quick settlement.
The doctor’s role, and how to make those visits count
Medicine is the gatekeeper of workers’ comp benefits. Judges and adjusters lean heavily on physician opinions. You can influence that process by how you prepare for visits.
Describe the mechanism of injury with concrete action words. “I stooped to lift a 60-pound box from the second shelf, twisted left, and felt a sharp pull” is better than “I hurt my back at work.” Be precise about timing. Mention prior issues without minimizing or exaggerating. Distinguish prior symptoms from current ones: “I had stiffness before, but no tingling into my hand until the date of injury.”
If the job pushed you into unusual intensity, say so. An uptick from 6-hour shifts to 12-hour shifts, or from lifting 30-pound boxes to 50-pound ones, matters. Doctors often write what you tell them in the note, which becomes the record the adjuster reads. Ask the doctor to document objective findings, no matter how small. If the physician believes your job is the major contributing cause, suggest that they write it plainly in the plan section with the basis for the opinion.
What happens to your benefits when apportionment applies
Temporary total or temporary partial disability benefits, medical treatment, and mileage reimbursement hinge on current need. When apportionment is in play, the primary impact usually falls on permanent impairment and sometimes on settlement valuation.
In Florida, a doctor assigns a permanent impairment rating using standardized guides. If pre-existing arthritis accounts for part of your lasting limitations, the doctor may assign an overall rating and then apportion a percentage to the prior condition. If your overall impairment is 6 percent and the physician apportions half to pre-existing degeneration, you may receive benefits based on a 3 percent rating. This is not automatic. It requires a rational, evidence-based apportionment analysis. If the apportionment looks speculative, a workers comp attorney can challenge it and, in some cases, secure an independent medical opinion that provides a more accurate split.
Apportionment rarely reduces authorized medical care during the active treatment phase. Carriers sometimes overreach and attempt to deny particular modalities by labeling them “for the arthritis, not the tear.” That is where a workers compensation lawyer steps in to refocus the claim on the treatment that addresses the work-related aggravation or new injury. Even when the anatomy overlaps, the reason for the treatment controls.
Settlement dynamics with pre-existing conditions
When parties discuss settlement, carriers price risk. Pre-existing conditions inject uncertainty: How will a judge view causation at trial? Will a medical examiner split the impairment 50-50 or 80-20? Are there credible alternative causes? Carriers often leverage that uncertainty to discount offers. An experienced workers compensation attorney counters with documented improvements under work-related care, the clarity of the mechanism, and the strength of medical opinions on major contributing cause.
If you are looking for a workers comp lawyer near me and foresee settlement discussions, ask how they document damages beyond the impairment rating. Travel time for ongoing care, the need for future injections, or permanent work restrictions that reduce your earning capacity all influence the numbers. A seasoned work accident lawyer builds a settlement demand around data: CPT codes for procedures performed, pharmacy records, projected care plans, and wage records that show actual post-injury earning patterns.
When a denied claim can still succeed
Denials based on pre-existing conditions are not the end of the story. I have seen flat denials turn into full acceptances after focused litigation. The turning points are often small.
A therapist’s initial evaluation notes “new weakness in ankle dorsiflexion” that no one highlighted. A previous MRI report from two years earlier shows no meniscal tear, while the new scan does. A treating doctor clarifies in a short letter that the accident, not the degeneration, is the major contributing cause of the current need for arthroscopy. The claim shifts. Carriers respond to organized facts.
There are times when a condition truly is not work-related in the legal sense. If a progressive disease advanced on its own trajectory and the timing of symptoms around the work incident is coincidental, pursuing the case may waste energy. Part of the value of a seasoned workers compensation law firm is candid advice. A trusted work accident attorney explains likely outcomes early and steers you toward realistic paths, whether that is building the case aggressively or conserving your time and focusing on alternative benefits like short-term disability.
A short, practical checklist you can use today
- Report the incident the same day, in writing if possible, and keep a copy. Seek prompt medical care and give a precise, consistent history with specifics. Gather prior records that show your baseline function and any asymptomatic periods. Keep a simple symptom journal for the first 30 to 60 days, emphasizing function. Consult an experienced workers compensation lawyer early to align the medical narrative with the legal standard.
Special issues: heart and lung conditions, repetitive trauma, and toxic exposures
Certain occupations bring unique presumptions or hurdles. Florida recognizes presumptions for firefighters and some law enforcement officers regarding specific heart and lung conditions. These presumptions can shift the burden of proof, even with pre-existing risk factors. If this touches your situation, you want a workers comp law firm familiar with statutory presumptions and how to document qualifying service and exposures.
Repetitive trauma claims, such as tendinopathies, carpal tunnel, or degenerative spine issues exacerbated by years of material handling, require more robust proof. Courts look for evidence of repetitive work that is greater in quantity or quality than everyday non-occupational activities and medical testimony linking that pattern to your condition. Workload logs, timecards showing overtime spikes, and ergonomic evaluations become critical. If your employer recently changed equipment or staffing, document it. An experienced workers compensation lawyer near me with a track record in repetitive trauma can make the difference.
Toxic exposure cases, like occupational asthma in custodial staff exposed to strong chemicals, hinge on industrial hygiene data and pulmonary testing. Pre-existing asthma does not bar recovery if work exposures become the major contributing cause of the current need for treatment. Peak flow logs at work versus home and changes in medication regimens provide persuasive evidence.
What to look for when choosing counsel
Credentials and results matter, but so does fit. When you interview a workers comp attorney, listen for clarity. Do they explain major contributing cause without jargon? Can they outline a strategy for your specific facts within minutes? Do they emphasize communication with treating doctors and thoughtful record collection? A best workers compensation lawyer for pre-existing condition cases is not necessarily the loudest one; they are meticulous in building timelines, selective in medical battles, and honest about apportionment risk.
Ask whether the firm has handled similar injuries. A work accident attorney with a portfolio of spine aggravation cases will anticipate carrier tactics around imaging. A work injury lawyer who regularly tries repetitive trauma claims will know which ergonomic details sway judges. The right workers compensation law firm combines experience with your type of injury and the bandwidth to move your case forward.
Common mistakes that hurt otherwise strong claims
Two patterns cause trouble. The first is minimizing prior issues on intake forms. If you had occasional shoulder soreness before, say so. It is better to frame it accurately and show the qualitative change after the incident than to appear evasive.
The second is disorganized medical care. Skipping follow-ups, missing physical therapy, or ignoring work restrictions gives carriers ammunition to argue that your condition is not serious or that you failed to mitigate. Life is busy, and not every missed appointment is fatal, but communicate and reschedule. If a treatment is not helping, tell your doctor and ask for alternatives rather than simply stopping.
A third, subtler mistake is letting the claim turn into a battle of adjectives. “Severe” versus “mild” means less than specific limitations: how far you can walk, how long you can stand, whether you can lift your child, or sleep through the night. Objective anchors carry more weight than adverbs.
The bottom line for Florida workers with medical history
A pre-existing condition is not a scarlet letter in Florida workers’ comp. It is part of the story that demands careful proof. If work turns a quiet condition loud, if a specific incident or a period of extraordinary workload shifts your symptoms and function in measurable ways, the law can protect you. The path runs through clear reporting, consistent medical documentation, and focused legal strategy.
If you are weighing whether to call a workers compensation attorney near me, consider the stakes. Done right, these cases secure treatment that restores function and wage benefits that stabilize your finances while you heal. Done haphazardly, they drift into denials and delays. An experienced workers compensation lawyer will help you distinguish what is legally significant from what is noise, and will build the record you need to meet Florida’s standard.
When the insurance adjuster points to your MRI and says “degeneration,” remember that workers’ comp is not about perfect spines and joints. It is about responsibility. If your job carried the major weight in causing the need for care you face now, you deserve coverage. And with a diligent workers comp lawyer at your side, you can prove it.