Why Your Pre-Existing Condition Doesn’t Disqualify Your Claim

The phone call comes when you’re still recovering from the accident. An insurance adjuster informs you that because you had back pain before the collision, they’re denying coverage for your current back injury. Or perhaps they’ve discovered you were treated for anxiety years ago and are now claiming your post-accident emotional distress isn’t compensable. These tactics are common, but they’re often wrong. Having a pre-existing condition does not automatically disqualify your personal injury claim.

Understanding Pre-Existing Conditions in Personal Injury Law

A pre-existing condition is any injury, illness, or medical condition that existed before your accident. This could include chronic back pain, arthritis, previous injuries, diabetes, heart disease, or mental health conditions. Insurance companies love to discover pre-existing conditions because they provide an opportunity to reduce or deny claims and claim that someone who was healthy would not have received the occurred injuries.

However, the law recognizes something insurance adjusters often ignore: an accident can aggravate, worsen, or exacerbate a pre-existing condition. When this happens, the at-fault party is still responsible for the additional harm they’ve caused. You don’t need to be in perfect health for someone else’s negligence to injure you. And even those who are lucky enough to be in “perfect” condition, could still have sustained those injuries.

The Eggshell Plaintiff Rule

Personal injury law includes a principle known as the “eggshell plaintiff” or “eggshell skull” rule. This doctrine states that a defendant must take their victim as they find them. If someone with a pre-existing vulnerability is injured more severely than a healthier person would have been in the same accident, the defendant is still liable for the full extent of the injuries.

Consider someone with degenerative disc disease who is rear-ended at a stoplight. The impact might cause minimal injury to someone with a healthy spine, but for this person, it triggers severe pain, nerve damage, and the need for surgery. The at-fault driver doesn’t get a reduced liability simply because their victim had a pre-existing vulnerability. They’re responsible for the actual harm caused, even if that harm was more severe because of the victim’s existing condition.

This rule exists because holding defendants liable only for injuries to perfectly healthy people would be both impractical and unjust. Everyone has some vulnerability, whether known or unknown. The law protects your right to compensation regardless of your health status before the accident.

Aggravation vs. Pre-Existing Conditions

The key distinction in these cases is between your baseline condition BEFORE the accident and your condition AFTERWARD. If you had manageable back pain that flared up occasionally but the accident left you unable to work or perform daily activities, that’s a compensable aggravation. If you were treating anxiety with therapy but now require medication and intensive treatment following a traumatic accident, that worsening is compensable.

Documentation becomes crucial in these situations. Medical records showing your condition and treatment level before the accident establish your baseline. Records after the accident demonstrate how your condition changed. The difference between these two states represents the harm caused by the accident, which is harm you’re entitled to recover.

Your physician’s opinions matter significantly. A doctor who has treated you both before and after an accident can provide powerful testimony about how the incident changed your condition. They can explain which symptoms are new, which pre-existing symptoms have worsened, and how your prognosis has changed as a result of the accident. If you’re using a company doctor, then you should look for these warning signs that they cannot be trusted.

How Insurance Companies Exploit Pre-Existing Conditions

Insurance adjusters are trained to minimize payouts, and pre-existing conditions provide a convenient tool. They may argue that all your current symptoms stem from your pre-existing condition rather than the accident. They might claim you would have required the same treatment eventually, so the accident didn’t actually cause additional harm. Some adjusters cherry-pick medical records, highlighting previous complaints while ignoring clear evidence of aggravation.

These tactics rely on victims not understanding their legal rights. An adjuster might make statements that sound authoritative but are legally incorrect. They may pressure you to settle quickly before you’ve fully understood the extent of your injuries or consulted with an attorney. They count on people accepting their characterization of the law rather than seeking proper legal guidance.

Proving Your Claim with a Pre-Existing Condition

Successfully pursuing a claim involving a pre-existing condition requires thorough documentation and strategic presentation. You’ll need complete medical records from before and after the accident. Expert medical testimony often becomes necessary to explain the connection between the accident and your worsened condition. This might include testimony from treating physicians, independent medical examiners, or specialists in your particular condition.

Testimony about your daily life before and after the accident provides important context. If you were managing your condition and living normally before the accident but now struggle with basic activities, that transformation demonstrates real harm. Friends, family members, and coworkers can verify how the accident changed your abilities and quality of life.

Comparing your treatment patterns before and after the accident also builds your case. If you required occasional physical therapy before but now need ongoing pain management and invasive procedures, that escalation evidences accident-related harm. If you were stable on medication before but now require increased dosages or additional medications, those changes support your claim.

The Importance of Legal Representation

Cases involving pre-existing conditions are more complex than straightforward injury claims. Insurance companies fight much harder to reduce settlements when pre-existing conditions are involved.

The Floyd Law Firm knows how to counter these tactics. We gather the right evidence, retain medical experts, and clearly demonstrate how the accident worsened your condition instead of your pre-existing health issues.

Your pre-existing condition doesn’t diminish your right to compensation. If an insurance company has denied or undervalued your claim, contact The Floyd Law Firm today for a free case consultation.