You are recovering from a car accident when the insurance adjuster brings up a back injury you suffered years ago. Suddenly, the conversation shifts away from the collision and the accident’s impact on your life toward your medical history, with the insurance company disputing whether the injuries and damages you are claiming resulted from the collision. If you have a preexisting condition, this tactic can complicate your personal injury claim.
Understanding these disputes can help you identify what an insurance company may dispute and why your medical history matters. You will understand what constitutes a preexisting condition and how it can affect causation and damages, as well as learn what evidence may bolster your case. Most importantly, you will see why a previous health issue does not automatically prevent you from seeking compensation for injuries caused or worsened by an accident.
What Qualifies By Law as a Preexisting Condition?
A preexisting condition is any injury, illness, or physical impairment that existed before the accident for which you are seeking compensation. It may be a workplace injury from years ago or a lingering back issue from your college football days. Maybe you had previous shoulder or knee surgeries.
The preexisting injury you currently have does not have to be serious, recent, or directly related to the incident.
A few additional examples of preexisting conditions might include:
- Arthritis
- Previous Knee Injury
- Chronic Asthma
- Diabetes
- Heart Disease
- Degenerative Changes in Your Spine
These conditions can become relevant when an insurance company argues that your current symptoms existed before the accident. For instance, you might have experienced some neck stiffness without treatment, but then after a collision, you began to experience chronic pain. Your past symptoms and current restrictions may help determine the extent of your losses. But a medical history does not automatically mean the accident caused your injuries.
The critical issue is whether the most recent incident caused new harm or worsened an existing issue.
The distinction can affect almost every aspect of your claim.
How Can a Preexisting Condition Affect a Personal Injury Claim?
Once an insurance company defending its client discovers an earlier health problem, it may review your medical records more closely and question the connection between the recent accident and your injuries. Some concerns may raise legitimate causation questions, while others may aim to reduce what the company pays.
Here are a few ways a preexisting condition can affect your case’s outcome as you move forward.
An Existing Condition May Still Be Compensable When It Gets Worse
Many state laws recognize something known as the “Eggshell Plaintiff” principle, which holds that a person who causes an injury must accept the injured party as they are found. In other words, being in good health before an accident does not preclude a valid claim.
When a collision worsens a preexisting degenerative disc disease or causes it to become a disabling condition, the at-fault party could be responsible for the extra damage done. If you are already vulnerable, that does not excuse someone else’s negligence. This matters because the same kind of accident can affect different people in different ways. A blow that only hurts a certain person a little could mean that someone with a preexisting back injury could be on treatment and rehab for months.
Your Medical History May Become a Target
Insurance adjusters may try to prove your pain, limited mobility, or other symptoms started before the accident. You might be able to use an old diagnosis or previous medical report to counter their questions.
An insurance company may cite an earlier doctor’s visit or previous prescription as proof that your condition was affecting you before the accident. But a past diagnosis does not mean your current symptoms have the same cause or severity. Consider changes in function, the nature of the accident, and the timing of symptoms.
Even small differences in your medical records may help establish how the accident changed your preexisting condition and affected your ability to manage everyday responsibilities.
Connecting Your Old Injuries to the New Accident Can Become More Difficult
If your symptoms overlap, you may need further investigations to determine whether the accident caused them or whether they stemmed from a prior medical condition. For example, if you had some preexisting and well-documented back pain before the accident, you might have to determine whether the pain has now become more frequent, more severe, or affected your ability to perform your activities of daily living after the accident.
This distinction also affects how you determine your medical costs and lost wages from the recent accident. If you used to work full-time and now have extended leave or cannot do your regular work, this may be helpful to show the impact of the new injury. Medical opinions may also help determine whether the accident caused a new injury or worsened an old existing one.
Your Compensation May Depend on What Has Changed
A personal injury lawsuit may not seek compensation for pre-existing pain, medical costs, or restrictions. The focus is now on the new injury or the additional injury the incident caused.
Proving that difference matters when your symptoms developed gradually, or your condition fluctuates over time. You may need to account for additional treatment, increased pain, reduced mobility, missed work, or activities you can no longer manage as easily as before. The clearer you can distinguish these losses from your previous circumstances, the easier it may be to evaluate the accident-related damages.
New Medical Evidence Can Help Establish What Changed
A seasoned personal injury attorney will review your medical history from before and after the accident, consult with your physicians or other qualified medical experienceds, and analyze diagnostic imaging. These details can be useful to help determine your pre-incident baseline and to help detect significant changes after the incident.
Consistent medical treatment and diagnosis can also help you know how the accident has impacted your life. Follow your doctor’s advice, attend appointments, and let your doctor know about any new or worsening symptoms. Keep records of medical costs, lost work time, and changes in daily living to measure the effects.
Inconsistencies Can Erode Your Credibility in a Case
If you do not tell your doctor and/or your attorney about past injuries, you may have unnecessary issues when it comes to filing a successful personal injury claim. If the insurance company finds information that contradicts your statement, they may question your credibility or use your omission to dispute your claim.
Be open and honest from the start. Your lawyer will be better able to handle bad news if it is not a shock. You do not have to make your own judgment on which past conditions are relevant. Your attorney can use your history to identify weaknesses, provide context, and anticipate questions the insurance company might ask.
These challenges involve more than simply proving you were injured. You must assess how the accident changed your circumstances and respond effectively when an insurer tries to shift responsibility elsewhere, potentially minimizing the compensation you deserve.
Why Do You Need an Experienced Personal Injury Attorney?
A skilled attorney can assess insurance claims, challenge medical records, and fight insurance companies for compensation when a medical condition predates the accident. Your lawyer can create a more complete picture of your medical history before and after the accident, rather than having the insurance company determine what injuries you have.
This work may involve collecting relevant records, seeking medical advice, documenting your losses, and rebutting any statements that attribute an earlier condition to the recent accident. A lawyer well-versed in personal injury law can also identify the damages you may be entitled to and develop a strategy that fits your case’s evidence.
Your attorney can also help you avoid common missteps, such as giving an insurer an incomplete account of your medical history or accepting a settlement before you recognize the extent of your injuries. Once you take a settlement and sign a release, you generally cannot later seek additional compensation for the same claim simply because your recovery takes longer than expected. Evaluating the evidence and potential future losses before resolving the case can therefore be important.
Your medical history is not a complete history of your injury. A lawyer can help you focus on what has changed, why it matters, and who is responsible for the damage you have sustained.
Call Keys Law Offices Today!
A personal injury of any kind can disrupt your life in an instant, leaving you with stress, injuries, and unanswered questions about what comes next. At Keys Law Offices, we support individuals and families facing these issues and provide advice and representation for any personal injury case. With experience and deep knowledge of how these cases are handled, our firm will work to get to the bottom of the matter, build a strong case, and seek the compensation our clients deserve.
Assistance is available, and help is only a phone call away.