Back and Spine
Unfortunately, workers compensation insurance companies constantly try to deny claims for the back and spine on the basis of a pre-existing condition.
In particular, regarding proof that the accident caused the back injury, the workers comp insurer will often contend that the back injury or disability was the result of some preexisting disease (such as degenerative disc disease) rather than an accidental injury on the job.
Now, if the worker was healthy at the time of the accident, then proof of causation is usually relatively simple to prove. But even in those cases, the insurance company will try to claim that the worker was not healthy at the time of the accident.
And often, if the injury is serious enough to disable the employee, then the condition or injury often becomes apparent immediately at the time that the accident occurs. Such an immediate appearance of full-blown symptoms, often established by testimony of fellow employees, is almost always accepted as sufficient proof of both the accident and the fact that the accident caused the injury.
Pre-Existing Conditions in the Back and Spine
But more often than not, instead of agreeing that the accident caused the injury, the insurance company will claim that the worker was suffering from an existing back condition at the time of the alleged accident, and that such condition (rather than the accident) is the cause of the employee's disability.
In cases like these, the problem of proving causation becomes extremely difficult. In fact, medical science finds that the symptoms of a traumatic accidents are not all that different from degenerative or longstanding back disease and ailments.
For these reasons, the outcome of these types of cases depends largely upon a a judge deciding which of the conflicting doctors to believe.
Fortunately, employees benefit from the presumption that: if an otherwise healthy employee suffers an accident and is thereafter disabled, it is presumed that the accident caused the injury, so long as the medical testimony establishes a reasonable possibility of such a connection. But, if the medical testimony does not supportive a reasonable possibility that the accident caused the injury, then this presumption does not arise.
In back and spine cases, medical expert opinion testimony (the sworn testimony or certified written records of the employee's physician) is absolutely critical in determining whether the accident caused the injury of the employee. In fact, unlike hernia cases, the medical opinions are so important that other circumstantial evidence (such as testimony of family or friends) barely counts for much.
Sometimes, testimony as to how soon after the accident the employee complained to coworkers or reported the injury to the employer can be helpful. But mostly, the workers compensation judge will just be much more focused on the medical records and sworn testimony of the physicians.
So for an employee, it is extremely important who the employee's treating physician is, and an experienced workers compensation attorney can often be extremely helpful in choosing the right doctor.