What Is a Pre-Existing Condition in a Workers’ Compensation Claim?


When you’ve been hurt at work, your first course of action is typically to file for workers’ compensation benefits. But there are some legal hurdles you need to clear before you qualify for payments.

You Must Have Been Hurt on the Job

The Workers’ Compensation system is set up to address only injuries suffered on the job. If you have an injury or illness unrelated to work that keeps you from doing your job, you may qualify for benefits through the Social Security Administration.

The first requirement to receive workers’ compensation benefits is that you must have a job-related injury or illness. That injury need not be suffered in the actual performance of your job. For example, if you are hired to load and unload trucks, you can still file a Workers’ Compensation claim if you slipped and fell in the lunchroom or on the way to the bathroom, or were hurt in a job-related motor vehicle accident.

You Must Have Been an “Employee” of the Company from Whom You Seek Benefits

Under the Workers’ Compensation laws in New Jersey, the definition of an employee is pretty broad. If you are an hourly or salaried worker and are on the company’s payroll, you will qualify. However, even if your role resembles that of an "independent contractor," or even if you are called an independent contractor by your employer, you may still qualify for workers’ compensation benefits. New Jersey looks at two primary factors to determine whether you are a qualifying employee—the amount of control the employer has over your duties and actions, and the relative nature of the work you perform. The more control your employer exercises—hours, location, assignments—the more likely you will be an employee. In addition, if the work you perform is an integral part of the business, you will likely be a qualified employee for Workers’ Compensation benefits.

Your Employer Must Have Had or Been Required to Obtain Workers’ Compensation Insurance

Under state law, all New Jersey employers must either have a policy of workers’ compensation insurance or be approved for self insurance.

Contact Us

At Taylor & Boguski, we bring more than 70 years of combined legal experience to injured people throughout New Jersey. For a free initial consultation, contact our office online or call us at 856-200-8989.

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