How Do Pre-Existing Conditions Affect a Personal Injury Case?

How Do Pre-Existing Conditions Affect a Personal Injury Case?

An insurance company may look at your old injury and see a reason to pay out less. But a pre-existing condition doesn't erase the harm caused by a new accident.

Key Takeaways

• A pre-existing condition doesn’t automatically stop you from pursuing compensation after an accident.
• Insurance companies sometimes argue that pain comes from an old injury rather than a new accident, which can reduce what they offer to pay.
• When an accident makes an existing condition worse, that aggravation can still be part of a personal injury claim.

Most adults have some kind of health history before they ever file a personal injury claim, whether it’s an old injury, a chronic condition or something they’ve managed for years. When a crash, fall or other accident happens, questions about pre-existing conditions in a personal injury case often come up, especially once the insurance company gets involved.

These conditions can complicate how your claim gets evaluated, but they don't automatically stop you from moving forward. Knowing how insurers view your medical history can help you know what to expect.

What Is a Pre-Existing Condition in a Personal Injury Case?

A pre-existing condition is any injury, illness or health issue you had before your accident happened. It might be minor or something more serious that needed ongoing treatment, but it existed separately from the accident that led to your claim.

Examples of Pre-Existing Conditions and Injuries

Common examples of pre-existing conditions include:

• A prior back injury that became more painful after the accident
• Arthritis that made the injury more serious or harder to recover from
• An old knee injury that needed new treatment after the accident
• A previous shoulder injury that caused more pain or limited movement after the incident
• A prior concussion or brain injury that made new head trauma more serious
• Diabetes or another condition that slowed healing or complicated recovery

All of these examples have one thing in common: the person already had a health problem, and a new accident made things more complicated.

Can You Pursue Damages After a Personal Injury Case With Pre-Existing Conditions?

You can still pursue compensation even if you had a health condition before your accident. An accident that makes an existing problem worse creates its own harm, and that worsening is something you can seek compensation for.

Insurance companies may point to your medical history to try to minimize your claim, but a pre-existing condition by itself doesn't disqualify you from recovering damages. What changes is the proof you may need to connect the accident to your current symptoms.

Can You Sue for a Pre-Existing Injury?

You can sue over a pre-existing injury if an accident makes it worse, even when the original injury had nothing to do with the person responsible for your accident. Many states follow a legal idea called the “eggshell skull rule,” which holds the at-fault party responsible for the actual harm caused, even if a healthier person might have fared better.

What Does It Mean To Aggravate a Pre-Existing Condition?

Aggravation happens when an accident makes an existing health problem worse for you. You may feel more pain, need more time to recover or deal with new limits on how you move.

Both personal injury and workers’ compensation cases can involve aggravation, but the legal standards aren't the same. In a personal injury case, you generally need to show that the accident, not just the natural progress of your condition, made your health problem worse.

Workers’ compensation doesn’t require you to prove fault. If a workplace incident aggravates an existing condition, you may still qualify for benefits. You still need to connect your worsened condition to your job, but that standard looks different than it does in a personal injury claim.

How Do Insurance Companies Know if You Have a Pre-Existing Condition?

Insurance companies learn about your medical history in several ways. After you file a claim, an adjuster will often ask you to sign a medical release form, letting the company request records from your doctors going back years.

They may also check databases that track prior insurance claims or review your recorded statement if you've already spoken with them. Even casual comments made during a call can prompt the company to dig deeper into your past.

Can Insurance Companies Use Your Pre-Existing Condition Against You?

Insurance companies can use a pre-existing condition to try to reduce what they offer. A common tactic involves arguing that your pain comes entirely from an old injury rather than the recent accident, so the company owes nothing for the new incident.

Having strong documentation makes that argument harder to support. Medical records, doctor’s notes, test results and treatment history can help show what symptoms you had before the accident, what changed afterward and why the new incident still matters.

What Should You Do if the Insurance Company Blames Your Pain on an Old Injury?

If an insurer tries to pin your pain on an old injury, you have options for responding. A few clear steps can help show how the accident changed your condition, even with the health issues you had beforehand.

Ask the Insurance Company To Explain Its Position in Writing

Insurance adjusters sometimes make verbal claims about your history that don't hold up once you ask for specifics. A written explanation forces the company to put its reasoning on record, which can reveal gaps in its position.

Gather Medical Records From Before and After the Accident

Medical records from before the accident show your baseline condition, while records from after show what changed. Notes about when your pain started and how your symptoms shifted afterward can also help build a clear timeline.

Ask Your Doctor Whether the Accident Aggravated Your Old Injury

Your doctor understands your medical history and your current condition. Asking directly whether the accident aggravated an old injury can give you documentation that addresses what the insurer came from a pre-existing condition.

Talk to a Personal Injury Lawyer

When an insurance company blames your pain on an old injury, a lawyer can look for weak spots in that argument, such as medical records taken out of context, symptoms that changed only after the accident or treatment you didn’t need before.

Choose a personal injury lawyer with experience handling claims involving pre-existing conditions. Your lawyer can ask your doctor more specific questions about what the accident changed, request a written opinion that explains the aggravation and push back if the insurer relies on its own medical reviewer to downplay your claim.

Talk to Sargon Law Group About How a Pre-Existing Condition Affects Your Case

Sargon Law Group represents people across Arizona, California and Colorado who are dealing with the aftermath of serious injuries. Our firm handles personal injury claims, including complex cases where an old injury or existing health issue makes recovering compensation more difficult. Because we handle your case on a contingency fee basis, you can get legal help without paying upfront attorney fees.

If a pre-existing condition is complicating your personal injury case, you don't have to fight the insurance companies alone. Contact Sargon Law Group today to schedule a free consultation with an experienced personal injury attorney who can protect your rights and help you pursue the compensation you deserve.