Pre-existing conditions can pose notable hurdles and barriers to obtaining fair compensation and claim resolutions. Insurers will almost always leverage pre-accident health issues to dispute injury causation, apportion percentages of responsibility, undermine financial demands, and generally avoid or minimize payouts.
As the injured victim, you need to utilize proactive legal strategies and advocacy to overcome these anticipated challenges.
What Exactly Constitutes a Pre-Existing Condition?
Essentially any injury, disease, disorder, disability, or health complication that predates your car accident by any length of time can fall under the definition of a “pre-existing condition” when it comes to filing an injury claim later. Even old healed fractures you sustained years ago would still be pre-existing if they become symptomatic again.
The simplest test is whether the condition was documented at any point in your medical records prior to the accident occurring. If so, consider it pre-existing even if you had no symptoms for years. The defense will still leverage it to undermine your demands.
How Pre-Existing Conditions Negatively Impact Accident Claims
Now that you understand exactly what constitutes a pre-existing condition, how do they actually impact your car accident injury claim once you file? There are a few very specific ways pre-existing health issues can negatively affect your ability to obtain a typical car accident settlement:
Apportionment of Liability and Damages
The legal concept of “apportionment” basically refers to determining what percentage of your injuries, disabilities, medical treatment, and financial damages were directly caused by the car accident itself versus what proportion relates to your pre-existing conditions instead.
The at-fault driver’s insurance carrier will almost always argue that some or possibly all of your claimed injuries, pain, medical care, lost wages, etc. are attributable to symptoms and conditions you already had. By making this case, they can attempt to apportion fault which limits their overall percentage of responsibility. This directly lowers what they have to cover and pay out.
For example, if you had existing chronic back pain and are now claiming a herniated disc, the insurer will contend part or even all of your back problems are due to the pre-existing spinal issues. This translates into trying to apportion only a small fraction of causation and damages to the actual accident.
Disputes Over What Medical Treatment is “Reasonable and Necessary”
Another common debate involves whether the treatment you obtained post-accident was medically necessary specifically due to new injuries sustained…or alternatively related to pre-existing health complications instead.
Insurers love to claim follow-up care was not essential for accident-caused conditions. Especially with diagnoses prone to chronic discomfort like arthritis, fibromyalgia, and degenerative disc disease, carriers perpetually argue treatment is linked to the pre-existing diseases versus new traumatic harm from crashes.
By taking this stance, insurers try to avoid covering large medical bills they can blame on old conditions while absolving themselves of financial liability. This forces victims to pay their own medical expenses despite having clearly actionable accident claims.
Debates Over New Injuries vs Mere “Aggravation”
A prime tactic insurance companies use is attempting to classify any injuries in body areas you had prior documented conditions in as mere temporary “aggravations” of those old problems rather than recognizing wholly new damage caused by the collision.
They will vehemently argue crash forces cannot structurally worsen pre-existing defects like arthritis and degenerative changes. Instead, they claim any post-accident symptoms are just short-term inflammation flare-ups of old issues. By framing new hip, spine, and shoulder injuries as mere aggravation, it severely limits financial accountability.
Proving new bodily damage directly caused by the crash itself is vital yet endlessly debated when corresponding to the same anatomical zones as your pre-accident health defects. Having an expert explain the structural worsening and permanence of collision-induced harm is key to overcoming the endless arguments over “aggravation” vs real further injury.
ADA Antagonism Over Disability Accommodations
Finally, insurers are notoriously reluctant to provide disability accommodations and loss of enjoyment of life damages if they can tie restrictions and lifestyle limitations to pre-existing impediments. ADL assistance, modified vehicles, and extended earnings losses become disputed if they already existed pre-crash. Victims must financially endure their own disability needs rather than receive rightful aid.
As you can see, pre-existing conditions open the door for relentless debates over medical causation, reasonable treatment, apportionment of harms, and accident vs illness attribution – all diverting responsibility back onto the injured party.
Smart Strategies for Overcoming Pre-Existing Condition Issues
Now that you understand all the ways pre-existing health defects can undermine injury claims, what proactive legal strategies can help overcome these challenges?
Establish Extensive Pre-Accident Medical History
The single most vital strategy is to extensively document the status of your pre-existing condition well BEFORE the accident occurred. Large gaps in medical treatment prior to crashes significantly undermine arguments later. You want abundant records confirming your typical symptom rates and baselines.
Suppose an old body area flares up post-crash. In that case, you need physician notes substantiating how controlled or dormant it was recently to contrast with suddenly renewed trauma and dysfunction directly attributable to accident forces.
Report Aggravated Issues to Responders
Even if prior defects feel temporarily re-aggravated or inflamed by accident stresses, be sure to report this to first responders, ER staff, and initial treatment providers. Reporting the slightest renewal of old pain clearly traces causation to the crash when debated later.
Tell all subsequent specialists these complaint areas were dormant until the collision date. Saying so on-record links aggravations directly to crash forces rather than the natural variability of old diagnoses.
Obtain Expert Medical Opinions
Retaining reputable medical experts in fields like orthopedics, neurology, biomechanics, rehabilitation, and chronic pain can provide immense weight. Securing specialized opinions directly attributing transformed function and disability status to traumatic forces inflicted on vulnerable tissues by the collision itself helps overcome causation disputes.
Saying new crash-induced structural changes exacerbate old conditions better substantiates renewed symptoms stem from additional anatomical defects…not pre-existing variability.
Undergo Independent Medical Examinations
Submitting to an Independent Medical Exam by third-party specialists gives objective insight into how crash dynamics specifically affected your unique health defects. Having an IME confirm the precise musculoskeletal or neurological basis for collision stresses to new symptoms or aggravation that remained absent for years prior strongly supports accident attribution.
Document the IME emphasizing dormancy followed by structural reinjury proving the accident substantially changed an otherwise static disease state.
Meticulously Track Special Damages
Carefully logging every single medical bill, missed wages instance, medication cost, modified living aid purchase, hired home help, transportation fee, and so on that you directly incur post-accident due to new restrictions establishes essential financial accountability.
If insurers argue lifestyle limitations pre-dated crashes, you refute showing recent independence followed by purchases and economic impact strictly traceable back to the collision dates.
How Various Specific Conditions Affect Claims
Beyond blanket strategies, it also helps to recognize how different types of common pre-existing conditions tend to affect accident claims differently:
Minor Pre-Existing Conditions
Small aggravations of old minor conditions like small scars, long-healed fractures, removed hardware, kidney stones, etc. typically have little to no impact on accident claims unless also recurred by crash trauma.
Insurers cannot reasonably dispute serious new neck and back disc conditions based on a decade-old finger fracture. Minor pre-existing history is generally inconsequential unless clearly anatomically related to claimed crash injuries.
Serious But Medically-Controlled Pre-Existing Conditions
Diagnoses like diabetes, hypertension, thyroid disorders, autoimmune diseases, etc. are quite serious innately but when well-controlled medically have less impact on claims.
Insurers may leverage consequences like slowed healing from diabetes to debate the causation of specific infections or complications. Overall though, an expert can refute any major dispute of collision-induced harm by showing the condition was controlled and non-variable for years until additional crash trauma stressed systems.
Well-managed serious disease typically affects claims modestly but still requires an expert to separate pre versus post-crash symptoms and disabilities.
Symptomatic Pre-Existing Conditions
Symptomatic diagnoses causing chronic widespread pain like arthritis, fibromyalgia, migraine, and degenerative disc disease almost always heavily affect claims. Insurers argue these conditions inherently involve flare-ups masking any effects from crashes based on natural variability.
Since these diseases independently cause intermittent pain, insurers argue spine and joint injury claims relate to typical ongoing agony variation rather than collisions themselves. Massive treatment and apportionment debates result.
Heavy clear documentation of extended stable symptom phases pre-crash followed by dramatic worsening post-collision cases helps overcome arguments that new complaints involve ordinary disease ups and downs.
Previous Body Area Injuries
Without question, claiming new injuries in body zones you already injured previously, like old shoulder dislocations and new labral tears or old spine fractures and new disc herniations, massively reduces claim potential.
Insurers argue previous fragile areas cannot sustain incremental damage, or that ordinary disease progression explains acute renewed symptoms better than delayed traumatic changes.
Overcoming these arguments requires extensive pre-accident records confirming complete healing and stability for years until the crash destabilized tissues. You also need an expert to detail the precise anatomical worsening showing objectively new damage.
These factors maximize arguments for additional injury instead of pre-existing natural histories explaining acute renewed complaints after crashes. But extensive debate should be expected.
The exact type and history of your pre-existing condition can negatively impact your car accident claim. Depending on the nature of the condition and its relation to claimed injuries, you can even lose your right to compensation. And so, it is always advisable to hire an experienced lawyer to help you navigate claims involving pre-existing conditions. However, it is important to keep in mind that not every attorney will be ideal for you. You need to go for someone who is experienced, skilled and has a history of winning car accident claims. Also, making sure that they are located near you is important, For example, if you live in West Houston, going for a car accident lawyer in West Houston is advisable.
How Pre-Existing Conditions Negatively Impact Settlements
Beyond general claim disputes, pre-existing medical conditions also demonstrably reduce the potential value of car accident injury settlements by:
Diminishing General Case Value
The overall highest possible settlement value diminishes in proportion to the percentage of injury causation and apportionment insurers can plausibly tie to pre-existing conditions based on documentation histories and expert support.
Aggressive insurance carriers leverage arguable apportionment rates of 50% or more to slash top settlement ranges confidently. This automatically cuts potential claim value in half or worse right out of the gate.
Delaying or Obstructing Any Settlement whatsoever
Lengthy disputes over pre-existing factors often deliberately extend claim timelines for years. This taxes victims who have to fund their own medical care and recovery needs while fighting to prove degrees of causation before securing compensation.
Insurers exploit costly delays by refusing settlement until every expert argument over minutiae is exhausted. Many victims ultimately accept reduced legal settlements just to gain relief from the perpetual debate and financial drain.
Forcing Smaller Incremental Settlements
Insurers often divide claims into multiple isolated settlements over time instead of summing a total unified amount. They may offer token sums for expenses clearly tied to the crash itself while requiring extensive further debate before resolving everything else piecemeal.
This incremental approach denies victims complete closure and adequate means early on while still requiring continual medical costs and legal expenses from their own pockets. Cases linger endlessly.
Potentially No Settlement Ever in Severe Cases
In the worst scenarios with substantial pre-accident histories and unclear new damage, insurers may escape settling anything. If apportionment arguments are strong enough with experts adamantly supporting pre-existing causation, companies can defeat claims overall since less than 51% relation to the crash itself is too feeble to warrant payments.
Victims still endure major lifestyle costs, medical bills, and lost income from disabilities while having minimal recourse without strong evidence definitively proving new injuries despite complicated backgrounds. Cases founder entirely if pre-accident findings can possibly explain symptoms better.
Proactive Steps to Take
If you currently have any documented pre-existing health conditions and end up injured in an automobile accident, some of the most proactive steps to take immediately include:
Carefully Report All Medical Issues
Any renewed symptoms and complaints potentially related to old history need to be clearly reported to all initial medical providers even in police reports to firmly link later consequences back to the collision events. Vague descriptions fail to establish causation.
Maintain Consistent Ongoing Treatment
Staying compliant with treatments while carefully documenting all lifestyle limitations, special costs from disabilities, and medication needs cement arguments that stem from crash-caused harms, not pre-existing struggles.
Consult an Attorney ASAP
Speaking with legal counsel knowledgeable regarding pre-existing conditions gives a valuable perspective on documenting special needs to ascribe impaired function to collision trauma despite complicated histories. An attorney also assists in managing insurance company challenges.
Utilize Specialist Experts
Orthopedic, neurological, biomechanical, vocational analysis, chronic pain, and rehabilitation medical experts help delineate pre versus post-collision status changes attributable to trauma despite complicated backgrounds.
Log All Financial Costs
Meticulously recording every single medical bill, assistive purchase, hired help, missed work day, transportation cost, medication, and liability stemming from new restrictions post-crash is imperative to prove economic damages since insurers refute these as pre-existing otherwise.
Document everything attributable to increased symptoms and impairment surges only arising after collisions and never before. Doing so frames expenses as related to accidents.
Final Thoughts
In conclusion, pre-existing medical conditions substantially affect almost all aspects of car accident injury claims from causation disputes to reasonable necessity of treatments, to vicious debates over new immediate traumas versus transient flares of old injuries.
Insurers leverage complicated health histories to undermine financial accountability by attributing medical needs and life limitations to pre-existing diagnoses no matter how much evidence supports renewed symptoms only arising post-collision.
Car accident victims with problematic histories must utilize extensive documentation, unbiased expert opinions, specialist exams, financial logging, and attorney guidance to help overcome these significant yet expected disputes over pre-versus-post-crash clinical changes.
Despite genuine new harm from collisions, victims still unfairly endure the bulk of costs, care needs, and losses from their own pockets while having to fight relentlessly against insurance company arguments blaming pre-existing conditions instead. Proactive concerted legal advocacy from the earliest stages onward helps substantially overcome these otherwise destructive defense tactics.
With smart leveraging of evidence, most individuals still can successfully resolve car accident injury claims related to pre-existing conditions given patience, financial endurance, and persistence in holding negligent parties properly accountable. Though massively challenging, justice remains achievable.