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Legal Insights | | 6 min

How A Pre-existing Condition Can Affect Personal Injury Claims

By Ross Cellino

In the world of personal injury law, the presence of pre-existing conditions can significantly influence the outcome of a claim. Whether you’ve been in a car accident, suffered a slip and fall, or experienced any other form of personal injury, the existence of a prior medical condition can complicate the process of securing compensation for your injuries. 

When filing a claim for a personal injury, it’s important to understand how your already existing medical conditions can affect your road to financial recovery. However, the existence of these conditions doesn’t mean that you can’t still build a solid personal injury case – especially when you enlist the help of a skilled personal injury attorney

Woman suffers back pain

What is a Pre-Existing Condition?

A pre-existing condition refers to any medical condition or injury that existed prior to the current accident occurring. These conditions can run the spectrum from chronic illnesses to past injuries. 

In the context of personal injury claims, the central issue revolves around determining how much of your current medical condition is attributable to the most recent accident versus your prior injury or illness. 

Common Types of Pre-existing Conditions and Injuries

There are a number of pre-existing conditions that can affect a personal injury claim. Some common pre-existing injuries and illnesses include:

  • Chronic neck and back pains
  • Previously broken bones
  • Previous sprains or strains
  • A history of concussions or other TBIs
  • Joint pains or arthritis
  • A history of mental health conditions like anxiety or depression

In addition to making specific injuries or illnesses worse, an accident can complicate these conditions. 

How Pre-existing Conditions Can Affect Your Personal Injury Claim

After a personal injury, the insurance company will look for any reason they can to devalue your claim. This includes the existence of conditions that could have been impacted by your accident. 

In New York, you are not entitled to recover compensation for health or medical issues that you experienced prior to your most current accident. However, it is possible for your current accident to have aggravated 

Disclosing Pre-existing Conditions

It’s possible to successfully recover personal injury damages from the insurance company with a pre-existing condition if you’re honest with your doctor, attorney, and insurance provider. 

  • At the doctor’s office: Informing the treating physician of any pre-existing conditions after an accident is important, as this can help the physician accurately update medical records and provide an adequate treatment plan. 
  • With your attorney: Disclosing a pre-existing injury to your attorney is important because it enables them to build a strong case by accurately assessing the impact of the incident on your health and addressing potential challenges from the opposing party.
  • With the insurance company: Disclosing a pre-existing injury to your insurance company is important because it ensures an accurate evaluation of your claim and prevents potential denial or reduction of your benefits due to perceived dishonesty or incomplete information.

There’s a stigma that having a pre-existing medical condition can affect your claim, but the law will typically recognize any new injury, even if it is amplified by a pre-existing condition. Being open about these conditions from the beginning can prevent any party from accusing you of attempting to conceal the truth or that you’re dramatizing your pain.

What Will Happen If You Don’t Disclose Pre-existing Conditions?

Failure to disclose any pre-existing conditions in a personal injury claim can have serious implications in both your healing process and when it comes to recovering compensation for your injuries. 

Besides the fact that you may not receive the proper medical treatment and recovery plan you need, failing to alert the appropriate parties of your condition could damage your credibility. 

The “Eggshell Plaintiff” Rule

In personal injury law, the “eggshell plaintiff” rule is often referenced. This rule establishes that a defendant is liable for the plaintiff’s injuries even if the plaintiff’s existing health condition made them more susceptible to injury. In essence, the defendant must take the plaintiff as they find them. 

For example: Two people are involved in a rear-end car accident. One person has previously suffered from a back injury, while the other person has no prior injuries. After the accident, the person who did not have a prior injury is sore, but will have no serious long-term injuries. The person who had previously suffered from a back injury, however, is more severely injured than their counterpart. 

If a pre-existing health condition is exacerbated by an accident or incident that would otherwise result in a minor injury, both parties may agree to seek the help of medical professionals. These professionals can determine what percent of the injury can be attributed to the accident or incident.

Do You Need A Personal Injury Lawyer To File A Claim With A Pre-existing Condition?

Personal injury claims that involve a pre-existing condition can be more complex than cases where the injured party was in good health before the accident happened. While it is possible to file a claim without legal representation, having a lawyer can significantly enhance your chances of receiving fair compensation, especially when a pre-existing condition is involved.

Here’s how a personal injury attorney can be an asset to your claim: 

  • Understanding How Pre-Existing Conditions Affect Your Claim: Working with an attorney who has first-hand experience working with injury victims who have pre-existing conditions can be a benefit to your claim. Your attorney will work to gather medical records, demonstrate how the accident aggravated your condition, and may hire medical experts to corroborate your claim. 
  • Navigate Insurance Company Challenges: Insurance companies often use pre-existing conditions to deny or minimize claims. A personal injury lawyer can negotiate with insurers, ensuring you receive fair compensation by presenting a strong case that highlights how the accident exacerbated your existing condition. In instances where a fair settlement cannot be reached, they will represent you in court. 
  • Knowledge Of Pertinent Laws: Your attorney should understand the laws and regulations relevant to your case. They can navigate the legal system efficiently, ensuring all paperwork is correctly filed and deadlines are met, which can be particularly challenging if you are dealing with a complex medical history.
  • Maximizing Compensation: A lawyer can help calculate the full extent of your damages, including medical expenses, lost wages, and pain and suffering, ensuring you receive the maximum compensation possible.

While you can certainly file a claim without the help of a personal injury lawyer, having one on your side can help to significantly improve your chances of a successful outcome. 

Need Help With A Pre-Existing Condition Claim? Call Cellino. 

If you have a pre-existing condition and have been involved in a car crash, slip and fall, work accident, or anything else, call the professionals at Cellino Law. Our team of attorneys have the experience to handle these particularly complex cases to help you achieve a favorable outcome. For a free consultation with a member of our legal team, call us at 888-888-8888. You don’t have to navigate the legal process on your own. Let us fight to get you the compensation you deserve.

Content checked by the personal injury attorney Ross Cellino

Ross Cellino

As a family man and a trial attorney, I pride myself on winning cases and serving the community. With over 35 years of experience, I understand the function of a jury, how juries arrive at conclusions, and the role that the jury plays in administering justice. I know how to win cases. You can find us in ManhattanBuffaloMelvilleRochesterBrooklynThe BronxQueens and other locations throughout New York.

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