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How Pre-Existing Conditions Affect Your Personal Injury Claim
When pursuing a personal injury claim, one of the most challenging issues is dealing with pre-existing conditions. Insurance companies often try to use these conditions to minimize or deny compensation. However, a pre-existing condition doesn’t disqualify you from recovering damages for injuries caused or worsened by an accident. Understanding how personal injury claims handle pre-existing conditions and knowing how to counter insurance company tactics are crucial for protecting your rights.
What Are Pre-Existing Conditions?
A pre-existing condition refers to any medical issue or injury that existed before the accident. These conditions can include chronic illnesses like arthritis or prior injuries such as back pain or a herniated disc. In personal injury claims, the main question is whether the accident worsened or aggravated your pre-existing condition. If the accident caused new injuries or made an existing condition worse, you have the right to compensation for the additional harm.
The “Eggshell Plaintiff” Rule
The “eggshell plaintiff” rule is a legal doctrine that protects individuals with pre-existing conditions. It holds the defendant liable for all injuries caused by their negligence, even if the plaintiff’s pre-existing condition made them more vulnerable to harm. In other words, the at-fault party can’t avoid liability just because the victim was already injured or in poor health. For example, if you had a prior back injury and a car accident worsened your condition, the defendant would be responsible for the additional damage caused.
How Insurance Companies Use Pre-Existing Conditions Against You
Insurance companies are known to scrutinize claimants’ medical histories in search of pre-existing conditions they can use to reduce payouts. Their tactics may include:
- Arguing the Injury Was Pre-Existing: Adjusters may claim that your pain or limitations were present before the accident and unrelated to the incident.
- Downplaying the Aggravation: They might acknowledge the accident but argue that it only caused minimal aggravation, not warranting significant compensation.
- Blaming Delayed Treatment: If there was a gap between the accident and your medical treatment, insurers may assert that your current condition is due to the pre-existing issue, not the accident.
- Using Incomplete Records: They may cherry-pick portions of your medical history to paint a misleading picture of your condition.
These tactics aim to cast doubt on the severity of your injuries and lower the compensation you receive. Knowing how to counter these arguments is key to securing a successful claim.
Steps to Strengthen Your Claim
- Be Honest About Your Medical History: Be Honest About Your Medical History: Transparency is crucial when dealing with pre-existing conditions. Share your full medical history with your attorney, including all prior injuries or health issues. Hiding information can backfire if the insurance company discovers it later.
- Seek Immediate Medical Attention: After an accident, see a doctor as soon as possible. Getting prompt medical treatment helps establish a clear link between the accident and any aggravation of your pre-existing condition. Make sure the doctor documents all new symptoms and changes in your condition thoroughly.
- Work With Your Healthcare Provider: Your doctor’s testimony can be invaluable in proving that the accident worsened your condition. They can provide detailed explanations of how the incident impacted your health and differentiate between pre-existing issues and accident-related injuries.
- Keep Detailed Medical Records: Maintain comprehensive records of all treatments, diagnostic tests, and medical bills. These documents provide objective evidence of your condition before and after the accident.
- Consult an Experienced Attorney: An attorney who understands personal injury law and the tactics used by insurance companies can help build a strong case. They will gather evidence, work with medical experts, and counter any attempts to downplay your injuries.
Proving Aggravation of Pre-Existing Conditions
To recover compensation for the aggravation of a pre-existing condition, you must demonstrate:
- The Existence of a Pre-Existing Condition: Your medical records should confirm that the condition existed before the accident.
- The Accident Worsened the Condition: Evidence like medical opinions and imaging tests must show the accident directly caused the worsening of your condition.
- Extent of the Aggravation: Your claim should detail how much the condition worsened, including increased pain, new symptoms, or additional treatments needed.
Common Examples of Pre-Existing Conditions in Personal Injury Cases
- Back and Neck Injuries: Conditions like herniated discs or chronic back pain are often aggravated in car accidents or slip-and-fall incidents.
- Arthritis: Trauma can worsen arthritis symptoms, leading to increased stiffness, pain, or loss of mobility.
- Knee or Joint Injuries: Previous surgeries or joint issues may be exacerbated by falls or physical trauma.
- Mental Health Conditions: Anxiety, depression, or PTSD can worsen after a traumatic event, even if they predated the accident.
Real-Life Scenario: Aggravation of a Back Injury
Imagine a person with a history of back pain who is rear-ended in a car accident. Before the accident, they managed their condition with occasional physical therapy and pain medication. After the accident, their symptoms worsen significantly, requiring more intensive treatments like steroid injections or surgery. In this case, the at-fault driver would be responsible for the additional pain, medical costs, and limitations caused by the accident, even though the back injury existed beforehand.
How Compensation Is Calculated
When pre-existing conditions are involved, compensation is typically based on the aggravation caused by the accident. This can include:
- Medical Expenses: The costs of additional treatments, surgeries, or therapy required due to the aggravation.
- Lost Wages: Income lost because of an inability to work caused by the worsened condition.
- Pain and Suffering: Compensation for the increased physical and emotional distress resulting from the aggravation.
- Future Costs: Anticipated expenses for ongoing medical care or reduced earning capacity.
Your attorney will collaborate with medical experts to make sure all these factors are considered and accurately calculated.
Conclusion
A pre-existing condition doesn’t prevent you from recovering compensation in a personal injury claim. However, insurance companies often use these conditions to reduce payouts, so building a strong case is crucial. By working with an experienced attorney and gathering thorough medical evidence, you can prove the accident caused significant harm and secure the compensation you deserve.
At the Hedayati Law Group, P.C., we are committed to advocating for personal injury victims, including those with pre-existing conditions.