Is it legal for a company to claim an injury as pre-existing if it happened while on the job?

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Is it legal for a company to claim an injury as pre-existing if it happened while on the job?

My husband works in landscaping and hurt his knee when he took a bad fall while at work. They sent him to the company doctor who recommended physical therapy. They are scheduling an MRI due to suspicions that he tore his meniscus. The manager told him that if it is a meniscus tear, they will claim it was a pre-existing condition. My husband has hurt his knee before, but that was 4 years ago and was fixed with surgery. He has had no problems with it until he fell. My question is is it legal for them to do that even though his meniscus was not torn before this incident?

Asked on September 21, 2010 under Personal Injury, Kansas

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 10 years ago | Contributor

No, it's not legal to claim something was a pre-existing condition if you know it was not. On the other hand, it is legal to have a different opinion as to whether somethinng was pre-existing, to dispute another person's version of events, etc. as long as its done in good faith--the company is not required to accept  your husband's claim at face value. So whether this is investigation to resolve a good faith dispute or whether it is fraud depends on the circumstances--whether it is a good faith inquiry or disagreement, or whether it is a cynical (and knowingly deceptive) attempt to avoid responsibility. However, remember that just as the company does not need to accept what your husband says, you don't necessarily need to accept what they say: you can appeal, litigate, etc. if you feel you're getting a raw deal.


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