The Impact of Pre-Existing Conditions on Personal Injury Cases and Settlements

Are you concerned that a pre-existing condition could compromise your ability to receive a fair settlement in a personal injury claim?

While a pre-existing condition alone doesn’t bar you from receiving financial compensation for injuries caused by another person’s recklessness or negligence, it can complicate a claim. When you have a pre-existing injury or condition, it is more difficult to prove to an insurance company or the court that the injury for which you seek compensation results from the incident.

At Khalil Law Group, we have a successful track record of helping Orange County accident victims with pre-existing conditions and personal injury cases. To schedule a free consultation, please contact us.

What Are Pre-Existing Conditions?

You often hear about pre-existing conditions when it comes time to apply for health insurance or enroll in Medicare, but pre-existing conditions are also relevant in personal injury claims.

When you claim that an incident caused you to be injured, it’s common for insurance companies and defense attorneys to investigate the matter to determine that the incident genuinely injured you. They want to ensure that you aren’t trying to collect money for something that happened in the past and is unrelated to your claim.

Being subject to this level of scrutiny can feel uncomfortable and make an already stressful and emotional situation even more difficult to tolerate.

When determining whether you have a pre-existing condition, investigators look for evidence of the following pre-existing injuries:

  • Broken bones
  • Back and neck injuries
  • Head injuries
  • Torn ligaments
  • Herniated discs
  • Arthritis
  • Post-traumatic stress disorder
  • Anxiety or depression

Personal injury attorneys will work with you to provide medical records that prove you didn’t have a pre-existing condition. Or, if you do have a prior injury that could be related to your personal injury claim, your attorney will argue that the incident aggravated or exacerbated the pre-existing condition.

Pre-Existing Injuries vs. Aggravated Injuries

Generally speaking, you cannot recover from a pre-existing injury, but you can recover if an accident worsens your condition. When you have a pre-existing condition that becomes aggravated by an incident, it is considered a “new” injury for a personal injury claim.

Determining whether a condition is purely pre-existing or has been aggravated by an incident or accident, consider the following two scenarios:

  1. Scenario 1: You have chronic back pain, and a driver rear-ends you. If you sustain an injury such as whiplash, you can receive compensation for that injury, but you will likely be unable to claim that your back pain resulted from the accident since you already had back pain.

Here, chronic back pain is a pre-existing condition, and it is unlikely that you can recover compensation for this injury as a result of the accident unless you can prove that the accident made your back pain worse.

  1. Scenario 2: Again, like Scenario 1, you have chronic back pain, and you get rear-ended. As a result of the accident, your back pain becomes much worse. Here, the incident aggravated a pre-existing injury, and you can seek compensation for the extent that being rear-ended worsened your back pain.

Even when the pre-existing condition and the new injury are related, it is still possible to recover financial compensation when it can be shown that an incident made an injury worse than it was before the incident occurred.  

Apportioning Settlements for Pre-Existing Conditions

Another complicating factor in personal injury claims with pre-existing injuries has to do with the extent that the injury was exacerbated by the incident. Claims adjusters refer to this as “apportioning fault” between new injuries and pre-existing conditions.

For example, suppose you already had back pain, and it was made worse by an accident. An insurance company might determine that 20% of your pain is related to prior injury and 80% is related to the personal injury claim incident. This can reduce your recovery amount, so it’s vital to have an experienced personal injury attorney argue these percentages when applicable.

How the Eggshell Plaintiff Rule Affects a Personal Injury Claim

To avoid writing you a settlement check, an insurance company may argue that any pre-existing condition negates liability. Their theory is that if you had been “healthy,” then you would not have been injured.

For example, if you have chronic back pain, a car accident can easily exacerbate your pain levels. However, if you had a healthy back, the accident might not have caused your back pain, and you might have walked away from the accident unscathed.

This argument does not hold water in California, which follows a legal standard called the “Eggshell Plaintiff Rule.”

This doctrine is named after the theory that if someone had a very delicate skull that had the thickness of an eggshell, any accident could lead to an injury. While someone with a “normal” skull could sustain a greater impact, the fact that someone has a thin skull does not absolve a negligent person of liability. The eggshell plaintiff rule rests on the idea that a defendant “takes the plaintiff as he finds him” and is liable for any harm resulting from his actions.

Types of Personal Injury Cases

Personal injury cases encompass a wide field of incidents, including:

  • Car accidents
  • Bicycle accidents
  • Pedestrian accidents
  • Slip and fall injuries
  • Medical malpractice
  • Animal bites
  • Workers’ compensation cases
  • Wrongful death claims

Regardless of the claim, the issue of whether an accident victim had pre-existing injuries will be relevant. Insurance companies are thorough in the claim investigation process. If they have any inkling that you are seeking compensation for a pre-existing injury unrelated to the personal injury claim, they are likely to deny the claim.

This tactic can be incredibly frustrating when dealing with the fine line between pre-existing injuries and exacerbated injuries. An experienced personal injury lawyer will be familiar with all of the tactics an insurance company employs and can argue aggressively on your behalf.

Request a Free Case Review

If someone else’s negligence has injured you, but you have a related pre-existing condition, it can be challenging to recover a fair settlement. For help with your case, contact Khalil Law Group at (714) 617-7870.

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