Foot and ankle injuries derail work faster than almost any other musculoskeletal problem. You can baby a sore wrist or a strained shoulder and still get through a shift. An unstable ankle or a flared-up plantar fascia stops you at the door. In Florida, workers’ compensation covers job-related injuries regardless of fault, but employees with pre-existing foot or ankle conditions often face a harder path to benefits. I have seen many good claims stumble because the injured worker did not frame the history, medical proof, and timelines correctly.
What follows is practical guidance built on litigating Florida workers’ comp claims for warehouse pickers, nurses, delivery drivers, airport ground crews, mechanics, retail staff, and hospitality workers. The law is the same statewide, yet outcomes hinge on details: how a claim is reported, the first treating note, whether diagnostic imaging was timely, how the “major contributing cause” standard is argued, and how consistent your story sounds a month later. Get these pieces right and pre-existing issues become context, not an excuse to deny you care.
How Florida Law Treats Pre-Existing Conditions
Florida’s workers’ compensation system recognizes that people come to work with medical histories. A claim is not barred simply because you had flat feet, prior ankle sprains, bunions, a midfoot fusion years ago, or long-standing plantar fasciitis. The question is whether the work accident or work exposure is the major contributing cause of the need for treatment, disability, or restrictions.
“Major contributing cause,” often shortened to MCC, means the main cause, more than 50 percent, compared to all other causes combined. For pre-existing conditions that are non-work-related, Florida law generally requires medical testimony based on reasonable medical certainty to establish that the work event outweighed your personal medical history as the driver of your current problems. When insurers dispute MCC, they tend to send you to a doctor who will say your underlying degeneration is to blame. Your case turns on evidence that the work incident changed the clinical picture in a measurable way.
The law also distinguishes aggravations. If you had an asymptomatic condition and a work accident made it symptomatic, Florida courts usually treat that as compensable, so long as the work event remains the MCC of your need for care at the relevant times. If your condition would have required the same care anyway, the carrier will argue that work did not move the needle. The cure is clear documentation, usually within days of the accident, showing new or worsened symptoms, loss of function, or new objective findings.
The Injuries That Show Up Most
Different jobs produce different patterns, but I see the same clusters again and again:
- Twisting ankle sprains from stepping off a curb with a heavy load, pushing a U-boat cart over thresholds, or pivoting on slick kitchen floors. Lisfranc injuries in the midfoot after falls from one or two steps, a common hidden injury that looks like a sprain on day one but leads to severe swelling and weight-bearing pain by day three. Achilles tendinopathy and tears in workers with long standing shifts who sprint to catch falling product or jump down from a truck bed. Plantar fasciitis flare-ups after schedule changes force back-to-back doubles or new tasks increase walking on concrete. Stress fractures of the metatarsals in warehouse or hospitality settings during peak season.
Each of these can be complicated by pre-existing issues: pes planus or cavus arches, prior sprains that never fully rehabbed, gout, diabetes with neuropathy, even a remote ankle fracture from high school sports. The carrier will try to connect your current limitations to those old problems. We counter with a structured record that shows the work incident is the new driver.
The First 72 Hours Make or Break Pre-Existing Claims
Work-related foot and ankle claims are especially sensitive to timing. Swelling, bruising, antalgic gait, and reduced range of motion can be obvious early, then fade. If you wait a week, your claim looks like a chronic complaint rather than an acute injury. I tell clients the first 72 hours are their chance to fix the narrative into place.
- Report the incident to your supervisor immediately, even if you think it is minor. Describe exactly what happened and what you felt. “Rolled right ankle stepping from pallet to floor, heard a pop, sharp lateral pain, could not put full weight.” Ask for authorized care the same day. In Florida, the employer or carrier controls medical providers. If you go to your own doctor first without authorization, expect pushback on reimbursement and questions about causation. When you see the authorized clinic or ER, use precise words. Point to the most painful spots. If your ankle was stable last week but now buckles, say so. If the dorsal midfoot hurts when you push off, say so. Vague reports sink cases. Do not minimize pre-existing issues, and do not let them overshadow the new trauma. “Yes, I had plantar fasciitis two years ago which resolved. This pain is different, sharp on the outside of the ankle after the twist, and it started at the moment I stepped down.” Photograph swelling or bruising and keep a simple pain and function log for the first two weeks.
That early clinical picture often matters more than any later MRI. The adjuster will use the first note to set their position on compensability.
What “Objective Findings” Look Like in Foot and Ankle Cases
Florida carriers love to argue there is no objective proof of injury. But with feet and ankles, subtle does not mean imaginary. Objective signs may include:
- Positive anterior drawer or talar tilt for lateral ankle instability. Point tenderness over the ATFL or CFL ligaments, or over the base of the fifth metatarsal. Midfoot squeeze test pain suggesting Lisfranc involvement. Ecchymosis along the plantar midfoot or lateral ankle. Limited dorsiflexion or eversion compared to the other side. Antalgic gait documented by the provider. Imaging correlates: x-ray showing avulsion fragments, weight-bearing films revealing widening between the first and second metatarsals, MRI with ligament edema or partial tear, ultrasound showing Achilles tendinopathy or tear.
A seasoned workers compensation attorney makes sure these findings get into the record. If the clinic visit is rushed and the exam is thin, we push for orthopedics or podiatry, and we ask for weight-bearing x-rays, not just non-weight-bearing views that miss instability.
Pre-Existing Conditions That Insurance Uses Against You
Certain histories ring the insurer’s bell. They are not fatal to your claim, but they require careful handling.
- Remote ankle sprains with lingering laxity. The carrier will argue your “rolling” ankle was bound to roll again. We show that you were stable at work for months or years and that this new event created a step-change in symptoms or function. Plantar fasciitis. If a ten-hour shift on concrete triggered heel pain last year, the adjuster may chalk today’s pain up to chronic fascia irritation. Distinguish the pain pattern and timing. Heel pain on first steps in the morning is different from lateral ankle pain after inversion. Flat feet or bunions. These are often background noise. We use this to our advantage: if you worked full duty for years with flat feet, then one misstep causes swelling and inability to bear weight, the work event is the difference-maker. Gout or diabetic neuropathy. These conditions can muddy the waters. Lab tests, uric acid levels, and exam findings help. Gout rarely causes focal ligament tenderness after a twist, and neuropathy does not create sudden bruising or mechanical instability. Prior surgery or hardware. Adjusters love to cite degeneration on imaging. We bring in comparative films, surgical records, and the timeline of asymptomatic function before the new trauma.
The Major Contributing Cause Battle, in Practice
Most denials I see come packaged as “compensable accident, but no compensable injury” or “accident accepted, but MCC is pre-existing condition.” It sounds polite, but it means no real care gets approved beyond the first visit.
You win MCC by stacking consistent facts. The accident description stays the same. The mechanism fits the injury. Symptoms begin when and how you said they did. Objective signs show up on exam. Imaging aligns with the mechanism. Work restrictions are credible and matched to findings. If you had prior issues, you can explain how this feels different or worse. A treating specialist uses clear causation language. If the carrier sends you to an independent medical examination and that doctor downplays the event, we counter with deposition questions that force the doctor to compare apples to apples: Was the ankle stable before? What changed after the inversion injury? Which findings exist only after the accident?
The law allows a shift in MCC over time. Early on, the work accident is often the major cause. Months later, once acute healing is done, residual issues may be attributed to degeneration. Insurers lean on this to cut off care. We respond by keeping the treatment path medically necessary and tied to the accident, whether that means supervised therapy, bracing, injections, or surgery if conservative care fails.
Real-world examples that mirror common outcomes
A grocery stocker with old high school sprains twists his ankle pushing a loaded U-boat through a walk-in threshold. Day-one clinic note documents lateral swelling and positive talar tilt. X-rays are clean. He works four more shifts, then returns with persistent instability. MRI shows partial ATFL tear. The carrier accepts the sprain but tries to cap care at six weeks due to “pre-existing laxity.” His orthopedist documents objective instability and failed therapy, recommends Broström repair. We secure surgery by focusing on the new tear and the fact he was sprinting up and down aisles without a brace for years before this incident.
A server with a history of plantar fasciitis starts doubles during holiday season. After a near fall on stairs, she feels midfoot pain. First clinic visit labels it “plantar fasciitis flare.” She cannot push off without sharp pain. We push for weight-bearing x-rays and an MRI. Imaging shows a subtle Lisfranc ligament injury. The diagnosis shift turns the case. She receives immobilization, protected weight-bearing, and later custom orthotics. Had the “fasciitis” label stuck, she would have been sent back to work too soon and the claim would be buried under a pre-existing diagnosis.
A delivery driver jumps from a truck bed and feels a “gunshot” in the back of his heel. He had mild Achilles soreness for years. Ultrasound confirms a partial tear. The insurer calls it chronic tendinopathy. The surgeon notes the acute mechanism, gap palpation, and new functional loss. We secure platelet-rich plasma under the authorized plan and a proper boot protocol. The difference was the immediate reporting and an exam that captured the step-off sign before swelling masked it.
Medical steps that matter in Florida claims
Florida gives the employer and carrier control of the initial doctor, which means you often start in an urgent care that churns through comp cases. Do not fight the first appointment, but do insist on specificity. If the exam is superficial, ask for a referral to orthopedics or podiatry. If you are weight-bearing through significant pain, request a boot. If midfoot pain persists and the x-ray is negative, request weight-bearing views or MRI. When therapy is ordered, attend every session or reschedule promptly. Missed appointments give the carrier ammunition.
Keep work notes clean. If you are placed on light duty and your employer offers a position within restrictions, try it if it is safe. If the assignment violates the restrictions, document what tasks were required and when pain increased. Avoid freelancing your own restrictions. Let the doctor adjust them in writing.
How benefits work for foot and ankle claims
You are entitled to authorized medical care, mileage reimbursement to and from appointments, and wage-loss checks called temporary disability benefits if the authorized doctor takes you off work or your employer cannot accommodate restrictions. The checks run at 66 2/3 percent of your average weekly wage up to a statutory cap. Overtime and concurrent employment can increase the average weekly wage if documented. For many foot and ankle claims, temporary total or temporary partial disability lasts weeks to months. If the injury becomes permanent, you may receive impairment benefits based on a rating. In some cases, vocational retraining enters the picture when standing or walking tolerance never returns to baseline.
Here workers comp law firm is where pre-existing conditions complicate things. Carriers may argue your lost time is due to your background condition, not the accident. We counter by matching each period of disability to specific medical restrictions grounded in the work injury. If you were full duty before the accident, that history carries weight.
Common traps that hurt otherwise solid cases
- Downplaying the incident at first, then ramping up symptoms later. Adjusters view that as inconsistency. Letting someone else write your mechanism of injury inaccurately on the report. Review it and correct errors in writing. Failing to mention midfoot pain early, which delays Lisfranc imaging and invites a “sprain” label that lingers. Returning to heavy activity too soon, then suffering a setback that the insurer labels a new, non-work event. Not disclosing a prior ankle or foot history, then having it surface later, which undermines credibility more than if you had been open at the start.
Credibility is currency. Consistency pays the bills.
When a Work Accident Attorney changes the trajectory
A capable work accident lawyer steps in early to shape the record, steer you to the right specialists, and keep MCC tied to the accident. We request proper diagnostics, challenge denials quickly, and schedule depositions that pin down causation. If an expert tries to dismiss your claim as degeneration, we make them articulate why the acute signs and successful prior work history do not matter. We also protect wage-loss rights, ensure your average weekly wage includes all earnings, and push for appropriate restrictions that keep you safe while maintaining income when possible.
If you are searching for help, terms like Workers comp lawyer near me or Workers compensation attorney near me will surface options, but focus on fit. Look for an experienced workers compensation lawyer who has tried foot and ankle cases, not just settled back strains. Ask how often they litigate MCC disputes. Find out whether they have relationships with orthopedic foot and ankle specialists who understand occupational injuries. A strong workers compensation law firm will explain fees clearly, handle carrier communication, and prepare you for IMEs so your history stays consistent.
Practical steps for workers with prior foot or ankle issues
- Tell the truth about your history, then draw clear lines between old and new. If you were symptom-free for months, say so. If the pain quality changed, describe it. Push for weight-bearing imaging when midfoot pain persists, and for MRI if instability or tendon pathology is suspected. Track your daily function. If swelling increases after a shift, note the time and tasks. These details anchor causation. Keep your footwear and orthotics updated. Document employer footwear policies. If steel-toe requirements or worn mats contributed, that context matters. If light duty is offered, confirm tasks in writing and report any mismatch with restrictions immediately and professionally.
Special considerations by industry
Hospitals and long-term care facilities: Nurses and CNAs with pre-existing plantar fasciitis are vulnerable when units are short-staffed. Rotating shifts, mandatory overtime, and constant pivoting while boosting patients amplify risk. Document the shift changes and staffing levels when the injury occurred. Carriers often overlook overtime that inflates average weekly wage.
Warehouses and fulfillment centers: Productivity quotas drive hurried movement and quick turns. Step-offs from dock plates, pallet edges, or tug ramps cause classic inversion injuries. Emphasize the heavy-load mechanics in your report and ensure the exam checks for midfoot instability, not just ankle swelling.
Hospitality and retail: Slippery back-of-house floors and stairways remain common hazards. Keep evidence of footwear policies and mat conditions. If you fall near a camera, request the footage immediately through your Workers compensation attorney.
Delivery and trades: Jumping down from vehicles or ladders loads the Achilles and midfoot. The “pop” and immediate weakness are powerful causation points. Do not try to walk it off. Seek care the same day and ask for ultrasound or MRI when indicated.
Airline ramp and ground crews: Irregular surfaces, equipment thresholds, and speed pressure create a perfect storm for ankle injuries. Report the specific equipment or surface that caused the misstep. Ramp incident reports matter. Ask for copies.
How settlements tend to evaluate foot and ankle cases
Settlements in Florida workers’ comp depend on unpaid benefits, future medical exposure, impairment ratings, and litigation risk. For ankle instability requiring surgery, carriers price future care for hardware removal, therapy, and possible arthritis management. For plantar fasciitis, carriers tend to undervalue because they view it as conservative-care only, unless imaging or specialist opinion elevates it. Lisfranc injuries carry higher exposure due to persistent pain, orthotic needs, and a higher chance of post-traumatic arthritis.
Pre-existing conditions factor into valuation, but so does documented pre-accident function. If time cards show you were consistently on your feet 40 to 60 hours per week without restrictions until the accident, your settlement value improves even with a complicated history. An experienced workers comp attorney can explain how Florida’s impairment ratings, which are often modest for foot and ankle, do not cap value when future medical is substantial or when MCC is strong and permanency is likely.
When surgery is on the table
Surgical decisions require measured judgment. For lateral ankle instability with an ATFL tear and failed therapy, a Broström or similar ligament reconstruction can restore stability. For Achilles tears, timely repair options vary by tear location and percentage. For Lisfranc injuries, fixation or fusion may be required to prevent progressive deformity. Carriers sometimes push for prolonged therapy to avoid surgical costs. The better path is evidence-driven: failed conservative care, persistent instability on exam, imaging that confirms pathology, and functional limits affecting safe return to duty. A Work accident lawyer keeps the focus on necessity, not price.
What to expect at an IME or peer review
If your claim includes a pre-existing condition, assume the insurer will request an IME. Prepare by reviewing your accident description, early symptoms, and what changed from your baseline. Do not exaggerate or minimize. Demonstrate what you can and cannot do. If the doctor raises your history of plantar fasciitis, explain how this pain differs. If they suggest gout, ask them to correlate that theory with your negative labs and the acute mechanism. Your Workers compensation attorney should debrief you and, if needed, set the stage for a rebuttal from your treating specialist or an independent expert retained by your workers comp law firm.
The role of footwear, orthotics, and workplace modifications
Small interventions can support both recovery and the legal record. Employer-funded orthotics after an ankle injury show ongoing medical need. Replacing worn anti-fatigue mats reduces re-injury risk and demonstrates that the employer is engaged, which can help modified duty succeed. If your job requires steel-toe or composite boots, identify models with better arch support and ankle stability. Your provider can prescribe specific features, tying gear choices to medical necessity that remains within the compensable claim.
Signs you need a lawyer now
- The adjuster accepts the accident but denies ongoing care due to your pre-existing condition. You were labeled with “plantar fasciitis” after a twist or fall and your midfoot pain is not improving. The clinic refuses to order weight-bearing x-rays or an MRI despite continued focal pain and instability. Your employer offers light duty far outside your restrictions, then threatens discipline when you cannot do it. An IME is scheduled and your story has evolved as pain patterns clarified.
Searching “Workers compensation lawyer near me” will yield pages of names. Make calls, ask about foot and ankle experience, and listen for concrete strategies, not generic promises. The best workers compensation lawyer for your case will talk specifics: mechanism, imaging, exam findings, MCC, and timing. A strong workers comp law firm will move quickly rather than letting the file drift.
Final thoughts for Florida workers with prior foot or ankle issues
Pre-existing conditions are part of life, not a scarlet letter. Florida law pays attention to what changed because of work. Your job is to report promptly, speak precisely, and follow care that’s aligned with the actual injury. A good Work injury lawyer keeps the carrier honest, secures the right specialists, and builds a record that shows the work event is the major contributing cause of your present need for treatment and any time away from work.
If you are reading this with an ice pack on your ankle and a denial letter in your inbox, you are not alone. Foot and ankle claims get denied on paper, then won with facts. Gather yours, get the right medical eyes on your injury, and put an Experienced workers compensation lawyer to work for you.