How Pre-Existing Conditions Affect Your Personal Injury Claim in PA
When you get hurt in an accident, your past medical history can play a big part in your legal case. Many people in Pennsylvania already deal with health conditions like back problems or old injuries. This doesn’t mean you can’t be compensated if someone else’s negligence causes new harm. It’s essential to understand how pre-existing conditions can affect your claim and what steps you need to take to maximize the compensation you receive despite your previous injuries.
Common pre-existing conditions at issue
Insurance companies often try to deny claims by bringing up pre-existing conditions. Knowing how these conditions could play a role in your injury case is essential. If an accident or incident worsens a pre-existing condition, you still have the right to fair compensation. Here’s a look at common conditions that come up.
Back/spine problems
Many people have diagnoses like degenerative disc disease, past herniated discs, spinal stenosis, or an old back strain. Insurers will often argue that your pain was there all along and any pain you’re currently experiencing is simply a pre-existing condition and has nothing to do with the accident.
Shoulder/knee issues
Shoulder and knee cases often involve old rotator cuff tears, past meniscus injuries, or signs of arthritis left over from sports. You may also have suffered a sprain in the past. These are common areas of the body injured in personal injury accidents, and insurance companies pay close attention to your medical records related to prior concerns.
Head injuries
Issues such as an old concussion or frequent migraines can be significantly worsened by a new accident. The symptoms can intensify, and triggers can become more frequent, but an insurance company will likely try to say it’s unrelated to the incident.
Mental health concerns
Anxiety, depression, or trauma-related stress can get worse after an accident. Even if you managed stress or mental health issues before, new events can set you back and deserve fair consideration, regardless of what the insurance adjuster tries to argue.
Aggravation is compensable—eggshell plaintiff rule
If you suffer a physical injury because of someone else’s behavior, you’ll probably hear your lawyer talk about “aggravation” of pre-existing injuries. This simply means the accident made a prior or dormant condition worse—or activated symptoms you didn’t have before the event. The law supports your right to seek compensation, even if your health was already fragile.
The Eggshell skull rule
This notion is referred to as the eggshell skull rule, which means you take your victim as you find them. In other words, a defendant is responsible for all aggravation caused by the accident but not for the natural progression the condition would have had regardless of the incident.
Taken literally, even if someone had a skull as delicate as an eggshell, the responsible party doesn’t escape or get to pay less just because another, healthier person might not have gotten hurt in the same way. Finding yourself weaker or more susceptible doesn’t undercut the case.
Why insurers target pre-existing conditions
When someone files an insurance claim after an accident, one subject that usually pops up is the person’s previous health. This can catch many claimants off guard, and it helps to know why insurers do this and how it plays out during the claim process.
The primary reason they do this is to reduce the size of payouts. Insurance companies are focused on paying out as little as possible. If they find any information suggesting a person had a health issue before the accident, they use this to argue that some or all of their discomfort was already there.
For example, if your lower back hurt a year before the car crash, they may argue your current back pain would have happened regardless of the new injury. Insurers want to save money, and showing that part of the condition came from before the accident can lower the amount they pay.
How your personal injury attorney proves aggravation and causation
When you’re hurt in an accident, your case depends on evidence. Your personal injury attorney needs to gather and present proof that not only shows how you were injured, but also that someone else is legally responsible for your worsened condition. Here’s how attorneys work to establish aggravation and causation.
Medical records and diagnostic imaging
To prove your injury was made worse by the accident, your lawyer will request your complete medical records. This will include doctors’ notes before and after the accident. Your lawyer will also have access to any diagnostic imaging from before and after the accident, like X-rays, CT scans, and MRI results, which can show changes over time. Comparing images does a lot to demonstrate that your condition has worsened after the incident in question.
Expert testimony
Doctors or specialists review your records and explain how your condition has changed. They can write detailed reports explaining that symptoms only began or worsened after your accident. Your lawyer can get experts to testify on your behalf in court if needed as well.
Witness statements
Family members, friends, or coworkers likely noticed changes in your health before and after the accident.
Your attorney can use their statements about what you were like before the accident and what you’re like now to show what has changed.
With the right documents and information, your lawyer can prove that your injuries got worse and aren’t just the result of pre-existing medical conditions.
Mistakes to avoid after an injury
When you’ve been injured and are trying to build a personal injury case, many people don’t realize how easy it is to make simple mistakes that seriously damage their claim. Ensure you avoid the following to give yourself the best chance of success.
Hiding prior issues
If you try to hide prior injuries or old medical conditions, the insurance company or defense attorney will likely find out anyway, and you’ll just end up hurting your credibility. Always be upfront with your attorney so they know how to protect you.
Over or under-stating your symptoms
Some people play down their pain, hoping not to come off as a complainer. Others exaggerate, thinking it will help the case. Both strategies hurt you. Accurate and consistent descriptions of your pain and symptoms keep your story reliable.
Incriminating posts on social media
Even something as simple as saying, “I’m fine,” or sharing pictures of you hiking, can be twisted to mean you aren’t really injured. Insurers search your social media for ammo. Limit your activity and change privacy settings, but do not delete or alter any existing content. Also, never post about your injury case online.
Signing blanket releases for the other insurer
When the other insurance company asks you to sign a medical release form, you should always speak with your lawyer first. These forms may allow them access to your entire medical history, not just the treatments related to this accident.
If you’ve aggravated an old injury or have a complicated medical history, don’t assume that means you don’t have a case. What matters is having skilled advocates who have handled thousands of claims like yours. Our Pittsburgh firm has recovered tens of millions for injured clients, many with pre-existing conditions. While prior recoveries don’t guarantee future results, they do illustrate our dedication to our clients. When you contact us, we can explain your rights and how to prove you’ve suffered additional injuries. Call Carmody and Ging Injury & Accident Lawyers to schedule a free consultation.