Medical malpractice cases are one of the most challenging types of personal injury cases. A primary reason for what makes it so challenging is that pre-existing conditions can complicate the process of proving negligence and causation.
Understanding how these conditions are defined and addressed under personal injury law is crucial for anyone seeking compensation. This guide aims to provide clear and comprehensive information on various aspects related to pre-existing conditions.
Understanding Pre-Existing Conditions
Pre-existing conditions refer to any health conditions or issues that existed before the occurrence of the new injury in the personal injury claim. This can include any type of health condition, such as heart disease, diabetes, or previous injuries. In personal injury claims, pre-existing conditions can influence the outcome of the case.
The insurance company or any opposing party that’s being asked to pay for the injury in the accident would likely try to attribute the injuries to the pre-existing condition rather than the new incident. Their goal is to minimize the compensation they have to pay by arguing that the current injuries aren’t a direct result of the accident but rather a continuation or exacerbation of the existing condition.
The injured person would argue that their health issues are a direct result of the accident and not a preexisting condition. This is where thorough medical documentation and expert testimony become crucial. The plaintiff would have to rely on the evidence to clearly show their state of health before and after the accident. Evidence can help establish that the accident either caused new injuries or aggravated a pre-existing condition.
Legal Considerations and Impact on Claims
In many jurisdictions, the “eggshell skull rule” applies, which states that a defendant is liable for the plaintiff’s injuries even if the plaintiff had a pre-existing condition that made them more susceptible to injury.
In other words, if you suffered a minor car accident and that resulted in your pre-existing back pain becoming worse, the defendant cannot argue that you already had back pain issues. Their negligence as a driver caused you to suffer an aggravation of the back pain, and you have the right to hold them liable for this. The law firmly holds parties responsible for aggravating pre-existing conditions.
Beyond legal principles, a key challenge in personal injury cases is to ensure you don’t allow insurance companies to use your preexisting condition against you.
Insurance adjusters could argue that our injuries stem from pre-existing conditions rather than the incident itself. This makes settlements more challenging. That’s why it’s essential to keep detailed records of all medical treatments for both your pre-existing conditions and new injuries. Without accurate documentation, your claim’s credibility could be at risk.
Claims Process
You can file a personal injury claim to seek compensation for an injury that was caused by someone else’s negligence or wrongdoing. The process involves several key steps, including gathering evidence, consulting with legal professionals, and presenting a strong case to prove your losses.
For victims with pre-existing conditions, the process can become more complex as you have to be careful in ensuring your health condition or past injuries don’t result in a reduction in your compensation or an outright denial of the claim. You want to show how the accident caused harm, whether through a new injury or by making an existing condition worse. To achieve this, you need to gather and present clear documentation and a well-prepared claim.
Your attorney will work to establish that the other party was at fault for the accident. This involves proving negligence, such as showing that the at-fault party failed to act responsibly and that their actions directly caused your injuries.
Challenges in Cases that Involve Pre-existing Conditions
A key step of the claims process is to prove new vs. aggravated injuries. This is also the most challenging aspect of such cases. There are several reasons why this is often difficult. If the injured person has a history of similar injuries or chronic conditions, it can be hard to separate the effects of the accident from pre-existing issues.
Insurance companies often try to minimize payouts. They may argue that symptoms or limitations are related to prior conditions rather than the accident, making it harder to prove the link between the injury and the incident.
Another reason this process is challenging is that some injuries, such as chronic pain or limited mobility, are subjective and harder to quantify. This can make it more difficult to show how much worse the injury became after the accident.
Proving New vs. Aggravated Injuries
When pursuing a personal injury claim, a vital part of the process is determining whether the accident caused a new injury or worsened an existing one. This distinction is important because it directly affects the validity of your claim. If you’re claiming that it’s a new injury, then you need to show evidence that no such injuries or health conditions existed before the accident.
On the other hand, if you’re claiming that the accident worsened an existing condition or injury, you need to first establish the existence of the condition and then use evidence to prove how it got worse as a result of the accident.
This often requires clear and convincing evidence to separate the effects of the accident from prior health issues. Insurance companies may challenge the link between the accident and your condition, frequently arguing that your symptoms are unrelated to the incident.

Role of Medical Records
Your medical records play a key role in cases where pre-existing conditions are a matter of dispute. These records provide a timeline of your health, including both your condition before the accident and the changes that occurred afterward.
The medical documentation you can use depends on your case. You may be able to use your historical record, such as previous diagnosis, test results, and prescription to support your claim. You may also use post-accident records, such as emergency room reports, diagnostic imaging, physical therapy records, and doctor’s notes.
Comparison reports could also be useful in such cases. Records that compare your condition before and after the accident can demonstrate how the incident worsened your pre-existing condition or caused new harm. Medical professionals may need to provide expert evaluations to support these pre-existing conditions and injury claims.
Jacobs and Jacobs Approach
For you to successfully secure compensation for your losses, you have to prove that the accident caused you harm. This could be in the form of a new injury or an aggravation of an old injury or health condition. Allow Jacobs and Jacobs Personal Injury Law to help you through this process.
Our approach to such cases begins with a thorough review of your medical history and the circumstances of your accident. We work closely with medical experts to establish a clear connection between the accident and your injuries. Based on our findings, we build a strong case that demonstrates the full extent of your losses.
Our law firm believes in delivering client-focused representation. Throughout the process, we prioritize communication and transparency. We want you to feel confident and informed every step of the way. By combining legal expertise with personalized service, we help our clients navigate the complexities of the effect of pre-existing injuries on claims and achieve justice.
Frequently Asked Questions
Will My Pre-Existing Condition Reduce the Compensation I Receive?
Having a pre-existing condition does not automatically reduce your compensation. However, the opposing party can try to use this to reduce the settlement amount. To counter this, it’s important to work with an attorney to provide clear evidence demonstrating how the accident either caused new harm or aggravated your condition.
Do Insurance Companies Have Access to My Medical Records?
Generally, insurance companies may request access to your medical records when evaluating your personal injury claim. However, they’re typically only entitled to see records directly related to the injuries caused by the accident. They do not have the legal right to access your full medical history unless it’s relevant to the case.
What If My Claim Is Denied Due to Preexisting Conditions?
If your claim is denied due to a pre-existing condition, it’s not the end of the road. You can appeal the decision by consulting a personal injury lawyer. They will help gather strong evidence, like medical records and expert opinions, to prove how the accident caused new or worsened injuries. The appeal process can involve negotiations with the insurance company. If needed, your attorney can initiate legal action to fight for your rights.
Schedule a Free Consultation with an Experienced Attorney
Do you want to learn more about how to navigate the personal injury process involving pre-existing conditions? Let us guide you through every step with clarity and unwavering support. Our team can answer your questions related to personal injury claims and previous conditions.
When you’re ready to consult with an attorney, call us to schedule a free consultation with Jacobs and Jacobs Personal Injury Law. The earlier you engage us in the process, the greater the impact we can have on the outcome of your case.