Many civilian contractors begin overseas assignments with previous injuries or medical conditions. A worker may have experienced back pain years earlier, undergone knee surgery, injured a shoulder at a previous job, or received treatment for another condition before accepting an overseas position.
Having a pre-existing condition does not necessarily mean that a later workplace injury is unrelated to employment. Physically demanding duties, repetitive activity, heavy lifting, accidents, and other working conditions can aggravate an existing problem. When overseas employment makes a pre-existing condition worse, the circumstances may raise important questions under the Defense Base Act.
Pre-Existing Conditions Are Common Among Workers
Contractors come to overseas assignments with different medical histories. Some have worked for years in construction, logistics, security, aviation, mechanical trades, or other physically demanding occupations.
Previous injuries may have healed completely, while others continue to cause occasional symptoms. A worker might have experienced intermittent lower back pain but still been capable of performing a full-time job without restrictions.
The existence of an earlier condition does not by itself explain what happens after a new workplace accident or period of demanding work.
Overseas Work Can Place Significant Stress on the Body
Many overseas contracting jobs involve strenuous physical activity. Contractors may repeatedly lift equipment, climb ladders, work from elevated platforms, operate machinery, enter and exit vehicles, or remain on their feet for long shifts.
These activities can place additional stress on joints, muscles, and previously injured areas.
A contractor with an old knee injury, for example, may experience significantly worsening symptoms after months of climbing stairs and carrying equipment. Another worker with a history of back problems could suffer a substantial increase in pain after lifting heavy supplies.
A New Accident Can Aggravate an Old Injury
Sometimes the change in a contractor’s condition follows a specific workplace accident.
A worker with previous back pain might slip from a ladder and develop new symptoms. Someone who previously underwent shoulder surgery could reinjure the same shoulder while moving equipment. A contractor with an old knee injury could experience increased pain and instability after falling on uneven terrain.
The fact that the same part of the body was injured previously does not necessarily mean the new symptoms are simply a continuation of the earlier problem.
Medical evidence can help determine whether workplace events aggravated, accelerated, or otherwise affected the condition.
Aggravation Can Occur Gradually
Not every worsening condition can be traced to one accident. Repetitive duties may gradually increase symptoms over weeks or months.
Warehouse workers may repeatedly lift heavy boxes. Mechanics may spend long periods bending or working in awkward positions. Construction contractors may regularly carry tools and materials. Other workers may repeatedly climb in and out of vehicles or perform physically demanding tasks throughout extended shifts.
A contractor may initially experience mild discomfort and continue working until the condition becomes difficult to ignore.
Changes in Symptoms Should Be Documented
When a pre-existing condition becomes worse, medical documentation can be particularly important.
Contractors should accurately explain their medical history while also describing how their symptoms changed during overseas employment. Information about when the worsening began, what work activities were being performed, and how the condition now affects everyday activities can help healthcare providers evaluate the situation.
Diagnostic testing may also identify new injuries or changes in an existing condition.
Prior Medical Records May Become Important
Because the contractor already had a medical condition, records from before the overseas assignment may become relevant.
These records can help establish the worker’s condition before the alleged aggravation. They may show previous treatment, diagnostic findings, symptoms, work restrictions, or periods when the worker was functioning without significant limitations.
More recent records can then document how the condition changed following an accident or during the overseas assignment.
A complete medical history can provide a clearer picture than simply focusing on the fact that an injury existed before the contractor went overseas.
Do Not Hide a Previous Injury From Your Doctor
Contractors may worry that mentioning a previous injury will automatically undermine a Defense Base Act claim. That can lead some workers to minimize or omit important medical history when speaking with healthcare providers.
Providing an accurate history is generally important to medical evaluation. Doctors need to understand previous injuries and treatment in order to determine what has changed.
If symptoms became more severe, changed in character, began occurring more frequently, or started interfering with work after an overseas incident, those details should also be clearly explained.
Pre-Existing Conditions and the Defense Base Act
The Defense Base Act provides workers’ compensation protections to many civilian employees working overseas under qualifying U.S. government contracts. Claims are not necessarily limited to workers who were completely free of medical problems before beginning their assignments.
A work-related aggravation of a pre-existing condition may qualify as a compensable injury, depending on the circumstances and supporting evidence.
These cases can be more complicated because employers and insurance carriers may argue that the contractor’s symptoms are entirely attributable to the earlier condition rather than overseas employment.
Medical Evidence Can Help Establish What Changed
Medical records and professional opinions can become especially important when distinguishing between a pre-existing condition and a work-related aggravation.
Doctors may consider previous diagnostic studies, new imaging, changes in symptoms, physical examination findings, the contractor’s work activities, and the circumstances of any workplace accident.
The question is not simply whether the contractor had an earlier injury. The relevant issue may include whether overseas employment contributed to a worsening of the condition.
Worsening Symptoms Can Affect the Ability to Work
An aggravated condition can have significant consequences for a contractor’s career.
A worker who previously managed occasional back discomfort may eventually be unable to lift equipment or work a full shift. A worsening knee condition could make climbing or walking long distances difficult. Shoulder problems may interfere with overhead work or the operation of tools and machinery.
When an injury prevents a contractor from returning to previous employment or reduces the ability to earn wages, disability benefits may become an important part of a Defense Base Act claim.
Do Not Assume a Previous Injury Prevents a Claim
Contractors sometimes assume that they cannot pursue Defense Base Act benefits because they had previously injured the same part of their body. The existence of a prior condition does not necessarily resolve whether overseas employment contributed to the current disability or need for treatment.
The circumstances of the work, changes in symptoms, medical evidence, and any new workplace accident can all be important when evaluating a potential claim.
If a previous injury or medical condition became worse while performing covered overseas contract work, contact Barnett, Lerner, Karsen, Zobec, P.A. to learn more about Defense Base Act rights and potential benefits.
Disclaimer: This article is for informational purposes only and does not constitute legal advice. Each Defense Base Act claim is unique. For advice specific to your situation, consult a qualified attorney.