If an employer intends to contest a Workers' Compensation claim, they will file a Form 43. The fact that they are contesting the claim does not mean that all is lost. Frequently, a Form 43 is filed by the insurance company simply because they have not made time to fully investigate a claim within the allotted 28 days.
On the Form 43, the insurance company will recite phrases such as "claim is personal in nature", "claim did not arise out of and in the course of employment", and "pre-existing condition". Many injured workers with prior injuries to the same body part conclude that they have no claim based on these denials.
Our law compensates injured workers for initial injuries and aggravations. An aggravation is anything that permanently worsens a condition or makes medical care necessary that would not otherwise have been necessary. For example, an injured worker may have ultimately needed a total joint replacement as a result of a prior condition but comes to need it sooner as a result of an injury at work. That worker is eligible for compensation under our Workers' Compensation laws. Whether or not an incident qualifies as an aggravation can be a complicated determination that pivots on both medical and legal considerations.
An injured worker should not give up just because they received a Form 43. The receipt of a Form 43 frequently signals the need for qualified legal advice. Similarly, the receipt of a Form 36 (Notice of Intent to Discontinue or Reduce Benefits) may signal the need for legal advice. If this has happened to you, you can contact the Law Offices Of Mark Merrow to schedule a FREE