I don't practice WC law in your state. I have practiced WC law in Virginia for 35 years. You should definitely appeal the denial and talk to a WC lawyer in your state. You have not given much information but it appears the claim is being denied due to the diagnosis of arthritis, a pre-existing condition. However, if the tear you suffered was due to the accident and not the arthritis then you should have a good claim. You probably need a medical opinion from your doctor addressing this issue.
This response is meant to be information only and should not be considered to be legal advice. This information is not meant and should not be construed to be the formation of an attorney client relationship. I practice Virginia Workers compensation law and Social Security Disability law.
You must contact an attorney who handles workers' comp cases.
Likely, the insurer relied on their choice of doctor to deny you treatment, something they can do if you do not know how to respond.
Stephen L. Hoffman
Law Office of Stephen L. Hoffman LLC
This answer posted on Avvo is for informational and educational purposes only. There is no attorney-client relationship created or formed and you should not rely on this as legal advice. The suggestion is made that if you wish to protect your rights, you consult with an attorney immediately.
We see this all the time. You have a traumatic injury and WC blames some concurrent condition like arthritis. No doctor is going to tell you that your arthritis tore your meniscus! That is just crazy. You need an experienced WC attorney who is willing and able to fight for your rights. Make sure you feel comfortable with a lawyer before you agree to have them represent you. Make them explain what they can do for you. Good luck.
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I agree that the WC carrier is likely using a doctor that is focusing on the osteoarthritis as a factor. However, even if you have a preexisting condition, you can usually still recover for an on-the-job injury to the same area, despite a lingering, benign condition such as osteoarthritis.
Consult with a worker's compensation attorney as soon as possible.
John J. Hansen
Mr. Hansen is licensed to practice law throughout the state of Illinois with offices in Cook and DuPage Counties, with a particular focus on personal injury, worker's compensation, and medical malpractice, state wide. His phone number is (877) 205-6625 and his email address is email@example.com, his website for more personal injury and estate planning articles is at www.jhansenlawfirm.com, and his blog is at jhansenlawfirm.wordpress.com.