Most injured workers assume that if they got hurt on the job, their workers' compensation claim will be approved. In Florida, that isn't automatically true with any relevant prior medical history. State law requires the injury be the “major contributing cause” of the current condition, and Orlando workers' compensation attorney Thomas A. Vaughan says that standard remains one of the most frequent reasons Florida workers see benefits reduced or denied.
“A lot of people come to me after they've already told an adjuster about an old back strain from ten years ago, thinking that kind of honesty won't matter,” said Thomas Vaughan, founder of Vaughan Law Group in Orlando, Florida. “The insurance company's medical team is going to find that history either way. The real question is whether the record clearly shows the workplace accident is what actually caused the disability now — and that has to be established early, or it becomes very difficult to fix later.”
What the “Major Contributing Cause” Standard Requires
Under Florida Statute §440.09(1), a workplace accident must be the major contributing cause of an injured worker's disability or need for treatment for benefits to apply — meaning it must be responsible for more than 50 percent of the current condition, weighed against all other factors combined, including any pre-existing injury or degenerative condition.
A pre-existing condition does not automatically disqualify a claim. Florida law recognizes that a workplace accident can aggravate or accelerate an existing condition, and benefits can still apply. The dispute in most of these cases isn't whether the worker had a prior condition, but whether the medical evidence shows the job incident is now more than half responsible for the disability or treatment being sought.
Why the Standard Trips Up So Many Workers
Attorney Vaughan, a Florida workers' compensation lawyer with more than 35 years of experience, said the pattern is constant: a worker with a documented history of back pain or prior joint surgery suffers a new injury to the same area, and the carrier's medical examiner concludes the symptoms relate to the old condition rather than the new one. Once that opinion is in the file, the burden shifts to the worker to produce equally strong medical evidence.
“This is usually decided in how the medical records are built from the first visit, not in a courtroom,” Attorney Vaughan said. “If the doctor's notes don't address causation directly, the insurance company fills that silence with their own version of events.”
A Former Insurance Defense Attorney's Perspective
Before founding his practice in 1985, Attorney Vaughan spent two years as an assistant state attorney in Florida's Orange/Osceola County and two more years defending insurance companies. That experience gave Florida workers' compensation attorney Thomas Vaughan a direct view of how carriers challenge these exact disputes — insight he's applied for injured workers for the 35-plus years since. Vaughan Law Group is rated AV by Martindale-Hubbell, its highest rating, and handles cases on a contingency basis.
Protecting a Claim
Attorney Vaughan recommends injured workers with relevant prior history disclose it honestly, ask the treating physician to directly address major contributing cause, avoid gaps in treatment, and consult a workers' comp lawyer before giving a recorded statement if a prior injury to the same body part is involved.
Frequently Asked Questions
What does “major contributing cause” mean in a Florida workers' compensation claim?
The workplace accident must be responsible for more than 50 percent of the current disability or need for treatment, compared to all other causes combined. It's the standard set out in Florida Statute §440.09(1).
Can I still get workers' compensation if I had a pre-existing injury?
Yes. Benefits can still apply if the workplace accident aggravated or combined with the prior condition and is the major contributing cause of the current need for treatment.
About Vaughan Law Group
Vaughan Law Group is an AV-rated Orlando, Florida law firm representing injured workers throughout Central Florida in workers' compensation claims, including brain, neurological, orthopedic, chemical exposure, paraplegia, and quadriplegia injuries. Founded by Thomas A. Vaughan, the firm works on contingency, advancing case costs so clients pay nothing unless benefits are secured. Anyone searching for a workers' compensation attorney near me can reach Vaughan Law Group for a free consultation at (407) 648-4535 or visit their website.