Florida Workers’ Comp Denied for a Pre-Existing Condition? What to Do Next

Bryan Greenberg Personal Injury Workers’ Compensation

For many injured workers, the most confusing part of a Florida workers’ compensation claim isn’t the injury itself — it’s the language used to deny it.

One phrase in particular stops people in their tracks: “pre-existing condition.”
It often appears after pain has already made work difficult or impossible, and it can feel less like a medical explanation and more like a judgment. Workers hear it and wonder whether their injury somehow “doesn’t count,” or whether being honest about their medical history has now been used against them.

That reaction is understandable — and common.

What many Florida workers don’t realize is that a pre-existing condition denial is often the beginning of a dispute, not the end of a claim.

What “Pre-Existing Condition” Really Means in Florida Workers’ Comp

In everyday language, a pre-existing condition simply means a medical issue that existed before something else happened. In a Florida workers’ compensation claim, however, the term has a narrower and more procedural meaning.

Florida’s workers’ compensation system does not require work to be the sole cause of an injury. Instead, disputes often focus on whether work meaningfully aggravated, accelerated, or contributed to a condition — rather than whether the condition existed at all. This distinction is built into how Florida workers’ compensation claims are evaluated, especially when symptoms develop gradually rather than after a single accident.

A pre-existing condition does not mean:

• You were not hurt
• Your pain is exaggerated
• Your job played no role in your condition

Instead, insurers often use the term to describe anything in your medical records that existed before the claim — old imaging, prior complaints, resolved injuries, or age-related changes that may never have interfered with work before.

In short, “pre-existing” often reflects how a condition is categorized on paper, not how your body functioned on the job.

Why Workers’ Comp Claims Are Commonly Denied for Pre-Existing Conditions

Many workplace injuries don’t happen all at once. Back problems, joint injuries, nerve conditions, and repetitive stress injuries often build slowly over time until the body can no longer keep up with job demands.

From a worker’s perspective, the job caused the breakdown.
From an insurance perspective, the absence of a clear starting point creates uncertainty.

Labeling a condition as pre-existing simplifies that uncertainty.

“When injuries don’t happen in a single moment, insurance companies tend to focus on medical history,” explains Bryan Greenberg, a board-certified workers’ compensation attorney who previously represented insurance companies. “What often gets overlooked is how the job changed what the worker could actually do day to day.”

This is why pre-existing condition language appears so frequently in denials — particularly in physically demanding jobs common throughout Southwest Florida.

Having a Condition vs. Being Hurt by Your Job

Many people live with manageable medical conditions for years. Mild arthritis, occasional back pain, or an old injury may never interfere with earning a living — until something changes.

Longer shifts, heavier workloads, repetitive movements, or physical strain can push a manageable condition past a breaking point. What once required rest or over-the-counter medication may suddenly make working impossible.

“We see this all the time,” says Brian O. Sutter, a board-certified workers’ compensation attorney certified since 1990. “People work full duty for years. Then something changes at work, and their ability to function changes. To the worker, it feels like a work injury — because their ability to work has changed.”

In Florida workers’ compensation cases, that change in functional ability is often central to how claims are evaluated and disputed.

Injuries Most Often Labeled Pre-Existing

Certain conditions are especially likely to be classified as pre-existing, even when workers were performing their jobs before symptoms worsened.

Back and Neck Conditions

Degenerative disc disease, arthritis, bulging discs, and chronic spine pain commonly appear on imaging. Insurers often rely on older scans or medical notes to argue the condition existed before work-related strain.

Repetitive Stress Injuries

Shoulder, wrist, elbow, and hand injuries frequently develop over time, particularly in healthcare, construction, warehousing, and service jobs common in Southwest Florida.

Prior Injuries or Surgeries

Even fully recovered injuries or surgeries may resurface in a denial if new symptoms involve the same body part.

Does a Pre-Existing Condition Automatically Disqualify a Claim?

No.
A pre-existing condition by itself does not automatically disqualify a Florida workers’ compensation claim.

Florida law recognizes that workers arrive on the job with medical history. Disputes often focus on whether work changed the condition in a meaningful way, not whether the condition existed beforehand.

Because of this, many claims turn on how medical opinions are framed, which records are emphasized, and how job demands are described — rather than on pain alone.

Why Claims Are Sometimes Approved First, Then Denied

Early in a claim, insurers often have limited information. Initial treatment may be authorized while medical records are gathered. As more history is reviewed, prior conditions may be identified and used to reframe the claim.

For injured workers, this shift can feel sudden and confusing. From the insurer’s standpoint, it reflects how claims evolve as documentation increases.

What a Pre-Existing Condition Denial Does — and Does Not — Decide

Being told a condition is “pre-existing” can feel final, but the label itself does not tell the whole story.

It does not erase pain.
It does not change the fact that you were working before symptoms escalated.
And it does not automatically resolve whether work played a meaningful role.

All Injuries Law Firm has represented injured workers across Port Charlotte, Fort Myers, Sarasota, and Southwest Florida for more than 35 years, with workers’ compensation cases led by board-certified attorneys who have handled thousands of claims involving disputed causation and pre-existing conditions.

For many injured workers, understanding what this language actually means is the first step toward regaining a sense of control. At All Injuries Law Firm, that clarity is part of what Victory for the Injured means — helping people understand where they stand, how the system is evaluating their claim, and what options may exist after a denial.