One of the most common misconceptions is that suffering from pre-existing diseases and/or conditions is an automatic disqualifier from receiving accidental disability retirement benefits. Nevertheless, many applications for accidental disability retirement benefits are denied by the various pension boards due to an employee’s total and permanent disability being attributable to a pre-existing disease or condition. However, under the law, suffering from a pre-existing disease or condition is not an automatic disqualifier from receiving accidental disability retirement benefits.

Rather, the “traumatic” event from which the employee claims to have suffered from must be the essential, significant, or substantial contributing cause of the disability. In other words, the pre-existing disease or condition cannot be the essential, significant, or substantial contributing cause of the employee’s disability. This is an important distinction that New Jersey public employees must recognize.

Candidly, any individual over the age of 30 likely suffers from some type of pre-existing disease or condition, whether it be degenerative changes to our bodies, long-standing medical conditions, or some injury suffered during childhood or adolescence. Therefore, denying an employee’s application for accidental disability retirement benefits under the notion that an individual’s total and permanent disability is a result of a pre-existing disease, condition, or injury is often a convenient pretext or “easy way out” for pension boards. As such, individuals must be cognizant of the relevant law as it pertains to pre-existing diseases and conditions in the accidental disability realm.

In short, employees must establish that the work-related injury or “traumatic event” they suffered was the essential, significant, or substantial contributing cause of their disability. Therefore, both the pre-existing condition and the “traumatic event” can sometimes act in combination and still enable the employee to recover accidental disability benefits. As such, various factors such as what the pre-existing disease or conditions consists of, whether such disease or condition affected the employee’s job performance in prior years, and how the “traumatic event” occurred all become crucial considerations. Moreover, it will be imperative to present expert testimony that is able to differentiate and convey to the pension board and/or Court that an employee’s disability was substantially caused by the traumatic event as opposed to an underlying, pre-existing condition.

Quite simply, the law does not bar every worker who has a substantial or significant pre-existing medical condition and who is then severely injured at work from qualifying for accidental disability benefits. Nevertheless, if your application is denied for such a reason, it is vital that competent counsel be retained to properly assist you and help you obtain the benefits you seek.