Imagine stopping at a red light, and another car rear-ends your car. Your neck snaps forward and back, and in the days that follow, the pain isn’t just a stiff neck; it’s a radiating fire down your spine that feels near-paralyzed. You panic and think that the insurance company will see your medical records and link your pain and suffering to an old injury.
In any such scenario, the question that arises then is, “Can I sue for an injury if I have a pre-existing condition?” The short answer is yes. New York law doesn’t allow insurance companies to dismiss your claim simply because you weren’t in perfect health before an accident. According to NY personal injury laws, you may still deserve compensation if an accident leads to the aggravation of a pre-existing condition.
What Are Pre-Existing Conditions in Personal Injury Claims?
Many people live perfectly normal lives with pre-existing conditions, until an accident suddenly makes things worse. For example, while you had a manageable back problem in the past, you now struggle to sit, sleep, or work without pain because of an accident. A pre-existing condition can be any medical issue you had, such as:
- A back or neck injury from a prior accident.
- A sports injury to the knee or shoulder.
- Chronic conditions like arthritis or degenerative disc disease.
- Past slip and fall injuries.
- Prior traumatic brain injuries.
- Congenital physical issues.
New York “Eggshell Skull Rule” Explained For Injury Victims
The eggshell skull rule serves as the backbone of many personal injury claims in NY involving prior injuries, and it implies that defendants must take victims as they find them.
Based on this rule, a negligent party cannot avoid liability just because a victim had a prior weakness or medical issue. The law holds them responsible for all the additional harm they cause, even if the victim was predisposed to be injured more severely. The focus, in such cases, is on how an accident aggravated a condition, not the condition itself.
Consider this example. Two people get rear-ended in identical car accidents. While one has a perfectly healthy spine before the crash and suffers from mild soreness after, the other has a history of herniated discs and chronic back pain, and the accident leads to severe nerve pain and the need for surgery. The drivers who caused the accidents are responsible for both victims’ injuries, even if the second person’s condition worsened because of an existing vulnerability.
Simply put, even if a minor accident results in major injuries because of a pre-existing condition, the negligent party still owes compensation for the full extent of the damage.
What If You Were Receiving Treatment Before the Accident?
That’s completely okay. After all, many people get ongoing treatment, be it in the form of pain medication, injections, or chiropractic visits. The key question is whether your need for treatment increased after the accident. This can be the case if your life moves from:
- Minimal pain to severe pain that affects normal functioning.
- Occasional chiropractic visits to surgery, injections, and regular therapy.
- No work restrictions to an inability to work or requiring special considerations.
How Pre-Existing Injury Compensation in NY Works
A past injury doesn’t necessarily reduce the value of your claim, and you may recover damages for the new problems caused by someone else’s negligence. What matters most is proving the exacerbation of a pre-existing injury. You can do this by showing:
- Your condition worsened because of the accident.
- You need additional medical treatment.
- Your quality of life has changed since the incident.
By proving an aggravated pre-existing injury in a New York accident claim, you may receive compensation for:
- Medical treatment (past and future).
- Pain and suffering, especially if you face new limitations.
- Loss of earnings.
- Caregiving costs.
- Reduced enjoyment of life.
Distinguishing Between Latent and Symptomatic
When evaluating a personal injury settlement with degenerative disc disease or any other pre-existing condition, it’s crucial to look at whether the condition was active or quiet before the accident.
Latent (Asymptomatic) Conditions
This is the most common scenario. For instance, you might have had wear and tear in your spine (spondylosis), as seen on an MRI, but you were living your life pain-free; going to the gym, playing with your kids, and working without any problem. The argument in this case would be that the accident exacerbated your condition and is the cause of your current pain.
Symptomatic Conditions
An example in this case is that you were already seeing a chiropractor once a month for lower back pain. However, as a result of the accident, you need spinal fusion surgery. This is an aggravation of injury, and while you’re not suggesting that the accident caused the back pain initially, you are claiming it took you from “level 3” tolerable pain to “level 7” intense pain that restricts you from carrying out normal activities.
Keep in mind that even if tests show age-related degeneration, you can still receive compensation if an accident made your condition symptomatic.
Common Injury Types Affected by Pre-Existing Conditions
Several personal injury claims in New York involve victims suffering from pre-existing conditions, and the most common ones include:
- Spinal injuries. These can come in the form of degenerative disc disease, herniated or bulging discs, or chronic lower back pain.
- Knee and joint injuries. A collision or fall can dramatically worsen anterior cruciate ligament (ACL) and meniscus injuries.
- Neck and whiplash-related issues. Existing cervical spine problems are highly susceptible to aggravation in rear-end crashes.
- Osteoarthritis. Mild arthritis can become more intense after trauma.
Protecting Your Rights When You Have a Prior Injury
When it comes to pre-existing conditions in personal injury claims, victims have the right to receive compensation for the difference between their life before and after an accident.
Consider these examples. Someone with a perfect back gets hit and suffers a herniated disc. He recovers $100,000 for pain and suffering. On the other hand, an individual with a stiff back (pain level 2/10) gets involved in an accident, which makes the pain unbearable (level 8/10) and requires surgery.
In the second example, the defense might argue they shouldn’t pay the full $100,000 because the victim had a pre-existing condition. However, New York’s Pattern Jury Instructions (PJI) 2:283 instructs juries to award damages for the aggravation. If the aggravation destroyed your quality of life, the settlement value can sometimes be higher than in the first example, because the consequences for you are more severe.
The Crumbling Skull Defense
While the eggshell rule is in place to help victims, New York courts also recognize the crumbling skull rule. This is when a defense argues that a victim already had a medical condition that was actively deteriorating before the accident, and would have continued to worsen regardless of the defendant’s negligence. In this scenario, a court might hold a defendant liable only for the acceleration of the timeline, and they don’t have to pay for an inevitable disability.
Tactics Insurance Company Use
If you plan to seek pre-existing injury compensation in NY, the insurance company you’re up against might argue that your symptoms are old and not related to the accident, claim that you’re exaggerating your pain, demand years of medical records, or downplay the difference between before vs. after the accident.
Remember that insurance companies do their best to dig deep, and this is what you may expect.
- The medical fishing expedition. Insurance adjusters might ask you to sign a HIPAA authorization, and if you do, they can pull records from 20 years ago, looking for anything to discredit your case.
- Social media stalking. If you claim your old back injury was aggravated, and you can’t move, but you post a photo of yourself jet-skiing on social media, your case is dead.
- The gap in treatment trap. If you wait two weeks to see a doctor after an accident, an insurance adjuster might insinuate that the gap means you are faking.
Tips For Dealing With Adjusters Who Dispute Pre-Existing Injuries
What happens if the insurance company blames your injury on a pre-existing condition? The answer depends on what you do, and you may safeguard your rights by following a few simple steps.
- Be honest and specific with your doctors. When you see your doctor after an accident, tell them about your history and highlight how you feel different from before. This creates a medical record that proves aggravation of an old injury.
- Do not sign blanket medical authorizations. If an insurance adjuster asks you to sign a HIPAA authorization or any other medical authorization form, it’s best to let your attorney handle the release of records.
- Gather witness testimony. While medical records are great, lay witness testimony can work better in showing the human impact. For example, testimony from friends, family, and coworkers can likely prove the exacerbation of a pre-existing injury better than an MRI.
- Hire an attorney. Dealing with pre-existing condition insurance disputes requires knowledge of all applicable laws, which is why you should consider hiring an attorney. Besides, your attorney can collaborate with expert witnesses to further strengthen your case.
Conclusion
Now that you know how pre-existing conditions affect personal injury claims, remember that if an accident causes your condition to worsen, you might be in a position to seek compensation for the same. After all, the law in New York is clear; if someone breaks you, they pay for the damage, even if you were fragile to begin with.
Seeking legal assistance makes sense on multiple counts because a skilled personal injury attorney can help gather all the required medical proof, push back against insurance company tactics, and work on maximizing your compensation.