Florida workers’ compensation law does not give employers a free pass because you already had a sore shoulder or an old rotator cuff tear. The statute recognizes real life: people bring pre-existing conditions to their jobs. The legal question is whether the job aggravated, accelerated, or combined with your shoulder condition to produce disability or a need for treatment. That is where claims succeed or fail, and where a seasoned workers compensation attorney earns their keep.
I have handled shoulder injury cases for warehouse workers, nurses, HVAC techs, hospitality staff, and office employees whose work aggravated a prior labral tear or chronic impingement. The pattern repeats: an incident that seems small, pain that spikes, MRI findings that point in two directions, and an employer who suggests your shoulder was already bad. Florida law provides a roadmap through this push-and-pull, but the details matter.
A quick primer on Florida’s “major contributing cause”
Florida’s workers’ compensation statute uses the Major Contributing Cause standard, commonly shortened to MCC. In plain English, the work accident or occupational exposure must be more than just a piece of the puzzle. It must be the primary cause of the medical condition or the need for treatment, when compared to all other causes combined. If you had a pre-existing shoulder condition, the judge will want to know whether the work event outweighed that pre-existing problem in creating your current need for care or disability.
The MCC test can feel harsh. It did not always look this way. Earlier versions of the law were kinder to workers with pre-existing conditions. Now, insurers regularly argue that degenerative findings are the major cause, not the job. They lean on MRI words like Work accident attorney tendinosis, osteophytes, or fraying. They ask independent medical examiners hypothetical questions that emphasize age and wear-and-tear. If nobody pushes back with solid medical reasoning, the claim can slide off the rails.
Still, MCC is winnable with the right facts and a disciplined approach. The question becomes: what evidence convinces a judge that work was the major contributing cause when you already had shoulder issues?
What counts as a pre-existing shoulder condition
Shoulders are complicated. Even without symptoms, many adults have some degeneration by their forties. Radiology studies show asymptomatic rotator cuff changes and labral fraying in a meaningful share of healthy people. Florida cases commonly feature these baseline conditions:
- Chronic rotator cuff tendinosis or partial-thickness tearing Acromioclavicular joint arthritis Biceps tendonitis or SLAP lesions Adhesive capsulitis prone to flare-ups Prior dislocation or labral tear with residual laxity
Employers often latch onto the “pre-existing” label, but that label alone does not defeat compensability. If the job aggravated the condition and that aggravation is the major cause of the current treatment or disability, you are still covered. The timing of symptoms, the mechanism of injury, and the change in function carry enormous weight.
The anatomy of a believable aggravation claim
When a judge evaluates whether work aggravated your shoulder, the credibility of the story matters as much as the scans. I ask clients to walk through the day in small, concrete steps: what they lifted, how high, the angle of the arm, whether it involved overhead reach, whether the pain felt like a pop, burn, or pulling sensation, and what happened immediately after. Precision helps because shoulder pathology lines up with mechanisms. A forceful overhead pull fits a supraspinatus tear; a traction event fits biceps tendon injury; a fall onto an outstretched arm can drive labral damage.
One hospital porter I represented had intermittent right shoulder soreness for years. He managed with rest and the occasional anti-inflammatory. Then a short-staffed shift required repeated transfers of a heavy patient. He reached high to stabilize a sliding IV pole, felt a sharp pop, and lost strength within minutes. The MRI later showed a high-grade partial tear. The insurer argued the tear had been there all along. We had contemporaneous reports to his supervisor, a timeline consistent with acute injury, and a treating orthopedist who tied the mechanism to the tear. The judge accepted MCC despite the prior soreness. Details won that case.
Reporting fast, documenting well
Delay kills aggravated shoulder claims. Florida law requires timely reporting, and insurers draw a straight line from delay to doubt. If you notice a real change in pain, range of motion, or strength, report it to a supervisor the same shift or the next day at the latest. In practice, many workers wait a week, hoping the pain passes. That silence gives the carrier ammunition: perhaps you were doing yard work, perhaps it was a weekend softball game. The best workers comp attorney can still build the case around medical evidence, but it is harder.
After reporting, write down a brief account while the details are fresh. Note the date, time, task, equipment used, and any witnesses. If there was a pop, snap, or immediate weakness, not just soreness, include that. Shoulder injuries that limit active elevation or produce nighttime pain after a specific event read differently than chronic aches that accumulate over months.
Diagnostic studies and what they do and do not prove
MRIs are both vital and tricky. Radiologists often see degenerative changes, especially in older claimants. That does not settle the MCC question. Imaging needs clinical context: symptom onset, mechanism, physical exam findings like Hawkins-Kennedy impingement, lift-off test, or Speed’s test for biceps involvement, and response to targeted injections.
I have seen two MRIs of the same shoulder, six months apart, read by different radiologists with emphasis on different findings. One highlighted tendinosis, the other a high-grade partial tear. Treating surgeons also vary in how they weigh labral fraying. A workers compensation lawyer’s role is to line up the records so the doctor sees the whole picture. That means making sure the history on the intake form mentions the specific work event, not just “shoulder pain,” and that any prior shoulder treatment is disclosed so it does not surface later and look like concealment.
Electrodiagnostic studies rarely help with rotator cuff issues but can clarify cervical radiculopathy masquerading as shoulder pain. That distinction matters for MCC because an insurer may argue the neck is the real driver. When a focused subacromial injection reduces the pain dramatically, it supports the shoulder as the generator. These are the small, practical points that tend to sway independent medical examiners.
The independent medical exam you did not ask for
Carriers often schedule a compulsory independent medical exam, or IME. These doctors see many insurer referrals. That does not make their opinions invalid, but it does mean the exam will probe for alternative causes. Expect questions about hobbies, home projects, old sports injuries, and any hint of prior treatment. Telling the full truth helps. Minimizing old symptoms can backfire if records later reveal physical therapy two years ago.
An experienced workers compensation lawyer prepares clients with a simple rule: be complete and specific. If you had occasional soreness before the incident, say so. If, after the incident, you could not lift a gallon of milk without pain, say that too. Clear contrasts help the MCC analysis. Vague generalities sink it.
Temporary and permanent benefits for shoulder aggravations
Compensability opens the door to two categories of benefits. First, medical treatment at the carrier’s expense, including conservative care such as physical therapy, corticosteroid injections, and possibly arthroscopic surgery. Second, indemnity benefits when the authorized doctor takes you off work or restricts your duties and the employer cannot accommodate. Temporary Total Disability and Temporary Partial Disability benefits are common in shoulder cases where lifting and overhead work are central to the job.
Florida caps temporary benefits and tightly regulates eligibility. The treating physician’s work status note controls. Many disputes turn on whether the employer truly has light duty. I have toured “light duty” stations where a supposed filing job still involved overhead bins. If the modified assignment aggravates the shoulder, document it and ask the doctor to clarify physical restrictions.
Later, if you reach Maximum Medical Improvement, the authorized doctor may assign a Permanent Impairment Rating. For shoulder injuries, this often ranges from a few percentage points for residual loss of range of motion to higher numbers after significant rotator cuff repair. Impairment benefits are paid according to the statute’s schedule. Separate from impairment, severe injuries can generate wage loss issues or require vocational consideration, but those are less common in shoulder-only cases without complications.
The interplay with apportionment and degenerative findings
Insurers love the word apportionment. In Florida workers’ compensation, apportionment can apply to impairment benefits if the doctor can separate what portion of impairment stems from the work accident versus pre-existing disease. Apportionment does not excuse the insurer from paying for medically necessary treatment to place the injured worker back at pre-injury status for the compensable condition. The evidence must actually support apportionment; a generic nod to “degeneration” is not enough.
I once handled a case where the IME tried to apportion half of a permanent impairment to age-related degeneration. Under questioning, he admitted he could not quantify the pre-existing impairment before the work incident and had never examined the client pre-injury. The judge rejected apportionment, and the full impairment benefits were awarded. The takeaway: apportionment must be based on competent, substantial evidence, not assumptions.
When surgery becomes the battleground
Rotator cuff repairs and biceps tenodesis procedures are not rare in work shoulder claims. Insurers often approve therapy and injections but balk at surgery, arguing the tear is degenerative. Strong surgical recommendations link the mechanism to pathology and explain why conservative care failed. I ask surgeons to spell out the reasoning in letters: for instance, that the presence of retraction or edema on MRI, the acute change in function, and the tear pattern indicate an acute-on-chronic injury where the acute component is the major cause of current need for surgery.
Judges respond to clear, non-technical explanations. If your surgeon is terse, your workers comp attorney should consider a deposition to draw out the logic. I have seen cases turn on a single sentence: “While there was pre-existing fraying, the work event converted a manageable condition into a functionally disabling tear, and that conversion is the major contributing cause of surgery.”
Average weekly wage and the trap of overtime
Your compensation rate depends on your Average Weekly Wage, or AWW, typically based on the 13 weeks before the accident. Shoulder claims often involve workers who pick up overtime or shifts that fluctuate. If the carrier calculates AWW using only base hours, you can lose hundreds per week in benefits. Pay stubs, tax records, and supervisor statements can correct the number. The best workers compensation lawyer I know treats AWW as an early priority. Get it right up front, and everything downstream is cleaner.
The role of restrictions and real-world job demands
Shoulder restrictions are famous for colliding with actual work. A note that says no lifting over 10 pounds or no work above shoulder height sounds workable until you stand in a kitchen line or on a hospital floor. Employers get credit for trying to accommodate, and many do. Problems arise when an assignment looks light on paper but requires reaching, pushing, or repetitive tasks that strain the shoulder. Workers fear appearing uncooperative, so they push through pain and risk making the injury worse.
Do not guess. Ask your doctor to list specific restrictions: weight limits, reach limits, frequency of overhead activity, and push-pull limits. If the modified job violates those restrictions, say so in writing and request clarification. Documentation keeps the medical team and the employer honest, and it protects your benefits if you must step away.
Pain management without undermining your credibility
Shoulder pain can be stubborn, especially at night. Judges understand that. What they do not appreciate is a chart filled with missed therapy, inconsistent reports, or long gaps without explanation. If therapy aggravates your pain, tell the therapist and the doctor. Good providers will adjust exercises. If you cannot make an appointment because of shift changes or lack of transport, notify the adjuster and reschedule promptly. Small acts of diligence create a record that reads as credible and engaged.
Opioids are rarely central to modern shoulder care plans and tend to raise eyebrows in litigation. Non-opioid strategies, targeted injections, and active therapy carry more weight with court-appointed experts. If a carrier denies recommended injections or therapy, your workers comp lawyer can seek an expedited hearing. Do not let a denial silently stretch for months.
Settlement, or staying the course
Not every claim ends with a final hearing. Many resolve by settlement, especially when surgery is recommended and the parties disagree on MCC. A settlement closes medical and indemnity in exchange for a lump sum. The timing should match your medical trajectory. Settling too early, before you understand the full extent of permanent limits, risks underpricing future care and wage impact. Settling too late can mean missed opportunities if you deteriorate or lose leverage.
Think like a risk manager. If your authorized surgeon recommends repair, your functional job requires overhead activity, and the carrier’s IME denies causation, trial risk cuts both ways. I have advised clients to complete a round of therapy first, then revisit settlement based on response. In other cases, we pushed to trial because the MCC evidence was strong and the client wanted surgery paid. There is no one-size answer. An experienced workers compensation lawyer will walk you through probable ranges, Medicare considerations if applicable, and realistic timelines.
When to search for a workers comp attorney near me
A pre-existing shoulder complicates every stage of a claim. Add in Florida’s MCC standard and the margin for error narrows. If any of the following apply, reach out to a workers compensation attorney near me or a reputable workers comp law firm with trial experience in your county:
- The carrier denied the claim citing degeneration or pre-existing conditions. Surgery was recommended and then refused by utilization review or IME. You were offered “light duty” that violates medical restrictions. Your AWW seems low, especially if you worked overtime. The IME report feels one-sided, or you were rushed and misunderstood.
Local knowledge matters. A workers compensation law firm that appears regularly before your district’s judges knows which medical explanations resonate, how certain employers handle modified duty, and how specific carriers negotiate. Ask about their shoulder cases, not just generic experience. The best workers compensation lawyer for you has handled rotator cuff and labral disputes and can talk specifically about Hawksins tests, bursal-sided tears, and what wins an MCC argument.
Practical steps to strengthen your Florida shoulder claim
The strongest shoulder claims follow a simple rhythm. Report quickly. Document precisely. Treat consistently. Match work restrictions to reality. Keep a paper trail for every approval, denial, and appointment. When disputes arise, your workers comp attorney can convert that record into clean exhibits and clear testimony. Even in the face of a pre-existing condition, carefully built cases convince judges that work was the major contributing cause.
If you are early in the process, start a small notebook. Note daily pain levels, range of motion milestones, sleep impact, and specific tasks that trigger pain like reaching into cabinets or fastening a seatbelt. This kind of detail helps your authorized doctor set appropriate restrictions and gives your Work injury lawyer or Work accident attorney tangible data to present. It also counters the common defense theme that your complaints are vague or inconsistent.
A word on honesty and durability
Claimants sometimes worry that acknowledging prior shoulder aches will sink their case. In Florida, honesty about the baseline is not only safe, it is strategic. Judges expect some pre-existing degeneration past a certain age. What persuades them is the change in function after a defined event. I have seen honest claimants win close cases because the judge trusted them. I have also seen seemingly strong cases collapse when a prior urgent care visit for shoulder pain surfaced that had not been disclosed. Be straight with your doctors and your Workers comp attorney.
Durability matters too. If therapy helps, say so. If it helps for two hours then the pain returns at night, say that. Shoulder injuries often improve in stair-steps, not smooth lines. Your care plan should reflect those steps. When the record shows steady participation and nuanced feedback, carriers have a harder time painting you as malingering.
Finding the right advocate
Search terms like Workers compensation lawyer near me or Workers comp lawyer near me will return a long list. Narrow it with two questions. First, how often does the firm try MCC disputes involving pre-existing conditions? Second, who will handle your file day to day? Big results often come from small tasks done well: getting the AWW right, preparing you for the IME, lining up a persuasive opinion from the authorized surgeon. An Experienced workers compensation lawyer knows these are not afterthoughts. They are the case.
Ask for a clear communication plan. Will you get a call after every hearing-setting? Will someone confirm medical approvals in writing? Look for a steady hand, not just flashy verdicts. Shoulder claims move across months, sometimes a year or more. You want consistency and craftsmanship. A solid workers comp law firm invests time early to map the path and reduce surprises.
The bottom line for Florida workers with shoulder histories
Pre-existing shoulder problems are common and do not automatically bar compensation. Florida’s Major Contributing Cause standard simply raises the bar for evidence. The strongest cases tie a specific work event to a meaningful change in pain and function, backed by consistent reporting, coherent medical reasoning, and careful documentation. The insurer will point to degeneration. Your side must show how the job tipped a manageable condition into a disabling one and why that tipping point is the major cause of your current need for care.
A capable Workers compensation attorney or Work accident lawyer can help you build that bridge. If your claim has been denied, your surgery delayed, or your benefits underpaid, do not wait. Early legal guidance often turns a contested shoulder case around long before a final hearing.