Workers Compensation Law Firm: Building a Strong Florida Claim with Pre-Existing Conditions

Florida’s workers compensation system does not require you to be a perfect specimen before you get hurt. The law recognizes that many of us carry medical history into the job, from prior back strains to degenerative knees to old shoulder surgery. The question is not whether you had a pre-existing condition, but whether your work accident aggravated it and to what extent. If you approach the claim the right way, you can secure treatment and income benefits, even if your MRI shows years of wear and tear.

I have sat in too many claim review meetings where a good case turned sideways because the worker tried to tough it out, delayed reporting, or let the insurer define the injury as “just degenerative changes.” On the other hand, I have seen thoughtful documentation, careful doctor selection within the rules, and steady advocacy convert an insurer’s initial denial into approved surgery and months of wage checks. Pre-existing conditions are not a dead end in Florida, but they demand discipline.
How Florida Workers’ Comp Sees Pre-Existing Conditions
Florida law compensates workplace injuries that arise out of and in the course of employment and are the major contributing cause of the need for treatment. Major contributing cause, often shorthanded as MCC, means more than 50 percent causation compared to all other causes combined. This is where pre-existing conditions enter the picture. If you have a degenerative disk and then lift a pallet at work and feel a sharp tear, the insurer will try to attribute your symptoms to degeneration. Your goal is to align the medical evidence so the work accident is identified as the primary driver of your treatment and disability, even if underlying degeneration exists.

Aggravation is compensable if the work incident accelerates or exacerbates the pre-existing condition. A common example is a warehouse worker with a quiet, asymptomatic bulging disk who develops sciatica after a single awkward lift. Another is a nurse with a battered knee from years of life who sustains a meniscal tear while pivoting during a patient transfer. In both cases, the baseline was imperfect, yet the work event changed the medical picture.

Insurers scrutinize these claims because they know degeneration shows up on imaging for many adults over 30. The presence of osteoarthritis or desiccated disks in an MRI is not the end of the conversation. What matters is the change in symptoms and function after the work event, the acute clinical findings, and a doctor’s opinion tying treatment to the work accident.
The First 72 Hours Decide the Tone of the Case
Most workers underestimate how much the first few days shape the claim. I have seen two cases with nearly identical facts go opposite directions purely because of timing and detail. In the stronger case, the worker gave immediate notice, described the specific mechanism of injury, and saw a doctor the same day. In the weaker case, the worker finished the shift, iced at home for a week, and then mentioned the pain to a supervisor without specifics, which allowed the insurer to argue the injury happened off duty.

Your strongest opening moves are straightforward: report promptly, be specific, and get evaluated under the workers compensation framework instead of through private insurance. Florida requires prompt notice to the employer, and delays invite doubt. Tell your supervisor exactly what you did when you felt the pain, where you felt it, and whether anything else contributed. If the incident involved lifting, twisting, or a fall, describe it plainly. Vague phrases like “my back hurts” leave room for the insurer to substitute their own story.

When you see the initial clinic or urgent care selected by the employer or insurer, resist the urge to be stoic. If your left leg is numb to the ankle, say so. If you had minor stiffness before but never shooting pain, say that out loud. Doctors rely on history to form causation opinions. A careful history that contrasts pre-incident baseline with post-incident change gives your claim structure.
The Magic Words That Matter on Paper
Doctors write the records that drive your case. Florida adjusters and judges focus on a few concepts: mechanism of injury, objective findings, change from baseline, and major contributing cause. If you want approval for an MRI or a specialist consult, the chart should connect those dots.

Mechanism of injury means the specific physical event that stressed the body. Think “while lifting a 60-pound box from waist level to shoulder height, I felt a pop in my right shoulder.” Objective findings are things a provider can measure or observe, like decreased range of motion, positive straight-leg raise, muscle spasm, swelling, bruising, or imaging showing a tear or fracture. Change from baseline compares the before and after in clear terms. MCC is the legal threshold, and doctors often need prompting to use that language.

I have seen cases get unlocked when a treating physician added two sentences to the chart: “In my opinion, the work injury on 4/2/2025 is the major contributing cause, greater than 50 percent, of the need for treatment for the L5-S1 herniation. The prior degenerative findings were asymptomatic and did not require treatment before the incident.” That kind of clarity moves adjusters because it hits the legal standard.
Imaging and the Degeneration Trap
Many MRIs read like they were written to deny claims. Phrases like “degenerative changes” and “desiccation consistent with age” appear often, even in healthy people. Insurers lean on those phrases to shift attention away from the discrete injury. Good medicine and good advocacy use imaging in context.

What counts is the concordance between the MRI and your symptoms, plus evidence of an acute process. A new annular tear, edema, or focal herniation that matches your pain pattern matters. If a radiologist’s report is ambiguous, a treating specialist can write an addendum explaining why findings are consistent with an acute aggravation.

I have guided clients to ask the doctor one careful question: does the imaging, combined with my sudden onset of symptoms after the lift, show an acute aggravation that is the major contributing cause of the current treatment? When physicians answer that on the record, it refocuses the case.
Earning Credibility With a Pre-Existing History
People worry that admitting prior issues will sink the case. In practice, denial usually comes from two problems: undisclosed prior care discovered later, or inconsistent stories across providers. If you had a back strain two years ago that resolved, say so. If a chiropractor treated you last spring, say so and describe resolution. Honesty builds credibility with the adjuster and the judge of compensation claims.

An honest baseline description often sounds like this: “Before the incident, I had occasional stiffness after yard work, which resolved with rest and over-the-counter medication. I had not missed work or needed medical treatment for more than 18 months. After the pallet lift on 7/15, I developed constant low back pain with shooting pain to the right calf and numbness in two toes. I cannot sit longer than 30 minutes and need medication daily.” That narrative acknowledges history but highlights the change in your function and symptom quality.
Authorized Doctors, Second Opinions, and IMEs
Florida gives the employer or insurer control over the initial treating physician. This is not a small detail. Some clinic doctors are thorough and fair. Others skew conservative with causation and push premature return to work. You have limited but real options if the doctor does not take your aggravation seriously.

You can request a one-time change of physician within the same specialty. The timing and wording of that request matter because the insurer then has a short window to select the new doctor. If they miss it, you may gain the right to select. You can also seek an independent medical examination from your side, though those are strategic and usually coordinated by a workers comp attorney. The insurer, for its part, can schedule compulsory medical examinations to contest causation or treatment.

An experienced workers compensation lawyer helps you navigate these choices. A single well-timed one-time change can alter the entire trajectory of treatment and benefits. I’ve seen cases where a one-time change from a walk-in clinic to a board-certified orthopedist led to accurate diagnosis of a rotator cuff tear and prompt surgical authorization after weeks of spinning wheels.
Apportionment: When The Insurer Tries To Split the Bill
Florida allows apportionment when part of your disability is due to a pre-existing condition. Adjusters sometimes push apportionment aggressively, especially with long-standing degeneration. The law, however, requires medical proof to divide impairment or disability, not just speculation. The physician must identify the portion attributable to the work injury versus prior condition.

This is another place where precise doctor language matters. If a doctor can identify that the work injury caused 70 percent of your current limitations and the pre-existing condition accounts for 30, benefits could be adjusted accordingly. But if the physician cannot reasonably apportion, the law often defaults to the work injury as the major contributing cause for the current treatment period. A skilled workers comp attorney can question the basis of an apportionment opinion and push for a more defensible analysis.
Light Duty, Real Job Offers, and the Paycheck Tightrope
Temporary partial disability benefits come into play when you can work with restrictions but earn less than 80 percent of your pre-injury wage. Employers sometimes offer light-duty positions. Those offers must be real, within your restrictions, and comparable in pay. I have walked clients through offers that looked legitimate on paper but required standing eight hours despite sit-stand restrictions, or heavy computer work for a worker on muscle relaxants that impede concentration.

If the offer does not match restrictions, document the mismatch in writing to the adjuster and the doctor. If the employer refuses a reasonable accommodation, that becomes part of the wage loss analysis. Showing your job search efforts, within your restrictions, also matters if your employer has no suitable work. Keep a simple log of applications, dates, and results. Clear documentation can be the difference between paid TPD benefits and a stalled claim.
Preparing for the Recorded Statement and Depositions
Soon after a report, insurers often request a recorded statement. The adjuster will ask about prior injuries and medical care, the incident details, and your symptoms. This is not a casual conversation. Words said here echo throughout the case. A workers compensation attorney near me once described it as the “first deposition without a court reporter,” and that rings true.

Keep your answers concise and accurate. Do not speculate. If you do not know a date, say you will check records. Avoid minimizing. Phrases like “it wasn’t that bad” get twisted into “no injury.” If you had prior treatment, say so and clarify resolution. Experienced workers compensation lawyers prepare clients with mock questions so there are no surprises. Later, if a deposition happens, that early consistency will pay dividends.
Seeing Beyond Medical: Mileage, Meds, and Small Items That Add Up
Workers’ comp is often viewed as surgery and wage checks, but small benefits matter. Florida workers can claim mileage to and from authorized medical visits and pharmacies. Save receipts and keep a simple spreadsheet with dates, destinations, and round-trip miles. Copays should not be charged for authorized care. If a pharmacy asks for one, call the adjuster from the counter and request an authorization fix.

Authorizations can stall for mundane reasons, like a missing fax or a typo in a birth date. When that happens, polite persistence works. Call the doctor’s office and the workers compensation law firm https://twitter.com/WorkInjuryLaw adjuster, document names and times, and ask for an updated date by which the MRI or therapy will be approved. A work accident attorney who stays on top of these details saves weeks of delay.
Return to Work After Surgery With a Prior Condition
Surgery for an aggravated condition is common in shoulder, knee, and spine claims. Postoperative care in the comp setting has a unique rhythm. The surgeon will set restrictions, and therapy will push function. Insurers sometimes press early return to light duty, particularly in office-heavy roles. Good cases show steady progress but respect the surgeon’s timeline.

For workers with prior conditions, post-op expectations require nuance. A shoulder with chronic impingement that finally had a rotator cuff repair after an acute tear may need an extra few weeks to reach safe overhead strength. That does not mean indefinite leave. It means using the surgeon’s objective milestones to justify the course. A strong workers comp law firm will line up therapy notes, work restrictions, and progress reports to keep benefits flowing until a genuine return is safe.
Settlements With Pre-Existing Conditions: Valuing the Risk
Many Florida comp cases end in a washout settlement that closes medical and indemnity in exchange for a lump sum. Pre-existing conditions influence value because they complicate causation and forecast of future treatment. Carriers discount for the chance a judge might accept an apportionment opinion, or that ongoing care relates to degeneration rather than the accident.

Fair settlement ranges account for wage benefits paid and owed, projected future treatment likely tied to the work injury, and litigation risk on both sides. I have seen shoulder cases move from low five figures to mid or high five figures when a treating physician wrote a clear MCC letter and an MRI showed a focal tear that matched the narrative. Conversely, I have watched a case lose steam when an IME doctor credibly attributed most symptoms to pre-accident neuropathy. The key is reliable medical opinions, not wishful thinking. Your workers comp attorney will weigh those factors with you.
When You Need a Lawyer and How to Choose One
Not every claim requires a lawyer on day one. But if the insurer disputes causation, stalls key imaging, pushes a return to work that contradicts restrictions, or hints at apportionment without solid medical support, you risk losing ground quickly. A workers compensation attorney knows which levers to pull and when to push for a one-time change, an IME, or a mediation.

People often search for a workers compensation lawyer near me after the first denial letter arrives. That is a fine time to call, but earlier is better. An experienced workers compensation lawyer can coach you before the recorded statement, set the tone with the first medical notes, and avoid unforced errors. Look for a workers comp attorney who regularly appears before Florida judges of compensation claims, knows local clinic tendencies, and can explain MCC and apportionment in plain English. Outcome histories are useful, but so is responsiveness. You want someone who answers calls and keeps you updated, not just a name on a letterhead.

If you prefer directories, terms like workers compensation attorney near me, workers comp lawyer near me, work accident attorney, and workers comp law firm will surface options. Ask whether they handle depositions and mediations personally, how they approach one-time changes, and how often they try cases rather than settling every file. The best workers compensation lawyer for your situation will marry medical literacy with negotiation skill and a calm courtroom presence.
Common Pitfalls That Undercut Good Claims
Most problems trace back to avoidable mistakes. Workers delay reporting because they hope rest will fix it, they leave out key mechanism details when seeing the first doctor, or they pretend prior issues never existed. Some get pulled into side arrangements with supervisors to “use sick time instead of comp,” only to find themselves without benefits and with a record that downplays the injury. Others ghost therapy sessions that would have proven ongoing need. Insurers pounce on gaps.

A tight, consistent pattern helps: prompt notice, detailed mechanism, full history, follow the authorized care plan, document restrictions and earnings, and keep your own notes of calls and visits. When something goes sideways, contact a work injury lawyer before it becomes a pattern. A single letter or conference call can correct a narrative.
A Brief, Practical Checklist for Florida Workers With Pre-Existing Conditions Report the incident to your supervisor immediately with specific details about how it happened and what changed in your symptoms. At the first medical visit, clearly contrast your pre-incident baseline with your post-incident limitations, and use plain descriptions of pain, numbness, or weakness. Ask the doctor to address major contributing cause in the chart and to explain why the work event is driving the current need for treatment. Keep records of mileage, missed work hours, and all communication with the adjuster and providers to avoid benefit gaps. If treatment stalls or causation is challenged, consult an experienced workers compensation lawyer to consider a one-time change or an IME. How a Workers Compensation Law Firm Builds the File
When a workers comp law firm takes a case with pre-existing issues, the first step is to anchor the narrative. That means obtaining prior records to define baseline, not to hide them. A sharp attorney will set a medical framework that distinguishes old, intermittent symptoms from new, consistent deficits. The firm will coordinate with the treating doctor to secure a causation letter that tracks Florida’s legal standard. If the doctor waffles, the attorney will consider the one-time change or an IME with a specialist who understands occupational aggravations.

On the benefits side, the firm monitors average weekly wage calculations. Errors here are common, particularly with overtime, shift differentials, or seasonal fluctuations. A low AWW ripples through every check. The firm also ensures light-duty offers align with restrictions and documents any mismatch. If an adjuster schedules a compulsory medical exam, the firm preps the worker so the history and symptom evolution are consistent.

Mediation is a waypoint in many cases. Good lawyers arrive at mediation with a realistic valuation that includes medical projections, risk of apportionment, and litigation timelines in that district. They carry a bottom line that protects the worker’s future, not just settles the file.
A Realistic View of Timelines and Expectations
Florida comp is not fast. Authorizations can take days to weeks. Therapy runs in six to 12 week blocks. Surgeries require several checkpoints. While this unfolds, insurers may approve some care and dispute other parts. Expect gaps and push for clarity. Your role is to attend every appointment, follow restrictions, and communicate changes in symptoms right away. The firm’s role is to move authorizations, secure supportive medical opinions, and protect wage benefits.

For many workers, a strong claim means being patient without being passive. A month of steady, documented care often produces better results than three angry calls. The goal is a record that tells a clear story to a skeptical adjuster or a judge: imperfect baseline, specific work event, objective change, MCC-supported treatment, and consistent effort to improve.
Final Thoughts From the Trenches
Pre-existing conditions are part of life. Florida’s workers compensation system accounts for them by asking a fair but exacting question: did the work event become the major contributing cause of your need for care? If you answer that question with precise history, early reporting, supportive medical opinions, and solid follow-through, your claim can succeed despite an imperfect spine, shoulder, or knee.

When the path turns technical, get help. A seasoned workers compensation attorney understands the medicine, knows how to speak to adjusters and judges, and can shape the file toward the care and wage protection you need. Whether you search for a workers compensation lawyer near me, a work accident lawyer, or the best workers compensation lawyer in your area, focus on experience with aggravation claims and a track record of turning “degenerative change” files into approved treatment plans. With the right approach, your medical history becomes context, not a verdict.