Pre-Existing Conditions and Your Accident Claim
Having a pre-existing medical condition doesn't prevent you from recovering damages when a car accident aggravates or worsens that condition. The "eggshell plaintiff" rule protects injury victims, but you need to understand how to handle this issue in your claim.
The law requires tortfeasors to "take their victims as they find them." If you had a pre-existing condition that made you more susceptible to injury, the at-fault driver is still responsible for the harm they caused.
The Eggshell Plaintiff Rule
What It Means
This legal doctrine states:
- Defendants must take plaintiffs as they find them
- If you're more vulnerable to injury, that's their problem
- They're liable for all harm they cause
- Even if a "normal" person wouldn't be hurt as badly
How It Applies
Example scenarios:
- Prior back injury made worse by accident
- Arthritis in neck worsened by whiplash
- Previous knee surgery re-injured
- Old fracture site refractured
- Dormant condition activated
Practical Application
What you can recover:
- Treatment to return to pre-accident state
- Treatment for aggravation
- Extended recovery time
- Permanent worsening
- New symptoms from old condition
Common Pre-Existing Conditions
Musculoskeletal
Frequently affected:
- Prior back injuries
- Neck problems (degenerative disc disease)
- Arthritis
- Previous fractures
- Shoulder/knee issues
Neurological
May be affected:
- Prior concussions
- Migraine history
- Neuropathy
- Seizure disorders
Psychological
Can be worsened:
- Anxiety
- Depression
- PTSD from prior trauma
- Chronic pain conditions
Other Conditions
Also relevant:
- Fibromyalgia
- Chronic fatigue syndrome
- Autoimmune conditions
- Cardiovascular issues
Don't hide your pre-existing conditions. Insurance will find out, and concealment destroys credibility. Instead, honestly document your pre-accident baseline and show how the accident made things worse.
What You Must Prove
Aggravation vs. Causation
Two approaches:
Aggravation:
- Had condition before
- Accident made it worse
- Entitled to recovery for worsening
Lighting Up:
- Had dormant/asymptomatic condition
- Accident activated it
- Entitled to recovery for activation
Evidence Needed
To prove aggravation:
- Pre-accident medical records (baseline)
- Post-accident medical records (worsened)
- Comparison of symptoms/function
- Medical opinion on causation
Documenting Your Baseline
Pre-Accident Status
Establish your condition before:
- Treatment you were receiving
- Medications you were taking
- Symptoms you were experiencing
- Functional level
- Work capacity
- Activity level
Why Baseline Matters
Shows the difference:
- "Before" vs. "After"
- What's attributable to accident
- How much worse it got
- What's new since accident
Gathering Evidence
Collect:
- Prior medical records
- Previous imaging studies
- Past treatment records
- Employment records
- Activity evidence (photos, gym records)
How Insurance Fights Pre-Existing Claims
Common Tactics
"It's all pre-existing"
- Claim symptoms are from old condition
- Deny accident caused anything new
- Attribute everything to prior problems
"Degenerative condition"
- Claim MRI shows age-related changes
- Would have happened anyway
- Not from accident
"Prior treatment proves it"
- You were already in treatment
- Nothing new
- Just continuing old problems
"You didn't disclose"
- You hid your history
- Not credible
- Implies fraud
Independent Medical Exam (IME)
Insurance will likely:
- Request IME
- Their doctor examines you
- Doctor often minimizes aggravation
- Attributes problems to pre-existing
Insurance company IME doctors frequently attribute symptoms to pre-existing conditions rather than the accident. Don't be surprised if their report is unfavorable - your treating physician's opinion matters too.
Countering Insurance Defenses
Medical Expert Support
Your doctor should:
- Acknowledge pre-existing condition
- Explain how accident worsened it
- Document the difference
- Opine on causation
Before/After Comparison
Show the contrast:
- Pre-accident function level
- Post-accident function level
- Change in symptoms
- Change in treatment needs
Lay Witness Testimony
Others can describe:
- How you functioned before
- Changes since accident
- Daily life differences
- Observable symptoms
Medical Evidence Strategies
Treating Physician Statement
Have doctor address:
- Pre-accident baseline
- How accident affected condition
- Need for additional treatment
- Prognosis now vs. before
Causation Language
Medical records should state:
- "Aggravated by motor vehicle accident"
- "Symptoms worsened following accident"
- "Acceleration of degenerative condition"
- Clear causal connection
Imaging Comparisons
If available:
- Pre-accident imaging
- Post-accident imaging
- Changes shown
- Expert interpretation
Valuation Considerations
Apportionment
Claims may be valued by:
- What's attributed to accident
- What's attributed to pre-existing
- Proportional recovery
Full Recovery Arguments
Arguments for full recovery:
- Eggshell plaintiff rule
- Took you as they found you
- All worsening compensable
Factors Affecting Value
| Factor | Impact |
|---|---|
| Documented stable baseline | Increases value |
| Clear aggravation | Increases value |
| Extensive prior treatment | May reduce value |
| Prior claims for same condition | May reduce credibility |
| Long symptom-free period | Increases value |
Deposition/Testimony Preparation
What to Expect
Questions about:
- Complete medical history
- Prior accidents/injuries
- Previous treatment
- Pre-accident symptoms
- Prior limitations
How to Answer
Be prepared to:
- Answer honestly
- Explain baseline condition
- Describe what's different now
- Explain aggravation clearly
Avoid Pitfalls
Don't:
- Hide prior conditions
- Exaggerate pre-accident status
- Claim perfect health before
- Be defensive about history
Work with your attorney to prepare for questions about pre-existing conditions. Honest, well-explained testimony about your baseline and how the accident changed things is much more effective than trying to minimize your history.
Special Situations
Asymptomatic Conditions
When condition existed but caused no problems:
Example: Asymptomatic disc bulge
- MRI showed bulge before accident
- No symptoms before
- Accident caused symptoms
Recovery: Full damages - you were asymptomatic before.
Dormant/Controlled Conditions
When condition was under control:
Example: Back pain managed with occasional PT
- Functioning well before
- Accident caused flare-up
- Now needs much more treatment
Recovery: Treatment to return to baseline, plus aggravation damages.
Prior Similar Claims
When you've had similar claims before:
Challenge: Credibility at issue Strategy: Distinguish this accident's impact Evidence: Medical records showing stability between incidents
Working With Your Attorney
What Attorney Does
For pre-existing cases:
- Obtains complete medical history
- Works with medical experts
- Develops causation evidence
- Counters insurance defenses
- Presents apportionment arguments
What You Do
Your role:
- Complete honesty about history
- Obtain prior records
- Describe baseline accurately
- Follow treatment consistently
- Document changes from accident
Key Takeaways
- Pre-existing conditions don't bar recovery - aggravation is compensable
- The eggshell plaintiff rule protects vulnerable injury victims
- Document your baseline condition thoroughly
- Medical records should clearly attribute worsening to the accident
- Insurance will try to attribute everything to pre-existing conditions
- IME doctors often minimize accident causation
- Treating physician causation opinions are crucial
- Before/after comparisons strengthen your case
- Complete honesty about medical history is essential
- Concealing conditions destroys credibility
- Attorney help is important for complex pre-existing condition cases