Filing a personal injury claim with a pre-existing condition can feel like a gray area of the law. At the very mention of the buzzword “pre-existing condition”, you may immediately think of complications in insurance policies. Unfortunately, you’re not wrong.
Your goal in a personal injury case is to earn compensation for medical bills, lost wages, and all other damages attributed to the accident. Regardless of the circumstances, your settlement might be compromised in a personal injury claim with a pre-existing condition.
The good news is the law may be on your side. There are certain doctrines in place to protect people in this situation. Partnering with an experienced personal injury attorney will be instrumental in earning the compensation you deserve.
In this post, we want to discuss how pre-existing conditions affect personal injury claims – and what your options are.
Let’s dive in.
What Are Pre-Existing Conditions?
Concerning personal injury law, pre-existing conditions are medical or health issues you had before the accident in question occurred.
For example, say you have chronic back pain from a past injury. If you get rear-ended in traffic and suffer a new back/neck injury, the insurance companies would likely classify the chronic back pain as a pre-existing condition.
Some of the most common pre-existing conditions we see in personal injury cases include (but are not limited to):
- Degenerative disc disease
- Back-related injuries
- Neck-related injuries
- Sprains and Strains
Insurance companies will do everything possible to avoid paying out expenses related to personal injury cases. They will label every single option as pre-existing.
The “Eggshell Skull” Rule
The Eggshell Skull Rule exists to help victims of personal injury cases with pre-existing conditions. The doctrine makes the defendant liable for the unforeseeable and uncommon reactions of the plaintiff due to the defendant’s negligence. Further, it states that the victim’s weakness, frailty, or sensitivity cannot be used against them.
Under the Eggshell Skull Rule, the at-fault party may still be liable for the victim’s new injuries. This is because the pre-existing conditions made them susceptible to the current injuries suffered from the accident.
Insurance companies commonly argue that the accident might not have happened if the victim did not have pre-existing conditions. This rule helps to shield victims from this speculation.
How Do Pre-Existing Conditions Affect Personal Injury Claims?
Pre-existing conditions are usually the first place insurance companies turn to minimize the payout. This is because a huge portion of Americans have them. According to the Department of Health and Human Services, up to 129 million non-elderly Americans have some type of health condition.
Your personal injury claim with a pre-existing condition may be more or less valuable depending on how previous injuries relate to the new ones. In some cases, the Eggshell Skull Rule can actually increase the value of your claim.
On the flip side, your claim could potentially be devalued based on the treatment plan. For instance, let’s say you have been on a pain medication regimen for chronic Cervicalgia and routinely see a chiropractor. Then, you suffer whiplash from a pedestrian accident – but continue the same regimen. The insurance company will likely try to argue that your symptoms were not made worse by the accident.
As the common theme in this article – insurance companies are never on your side. To them, their bottom line is much more important than making sure you get the treatment you need. You are a number in their books, nothing more.
Their goal is to lower your damages by any means necessary. They may dig through your medical records and claim that some (or most) of your treatment following the accident is unreasonable. A skilled personal injury attorney is trained to negotiate with insurance companies and make sure you receive all the compensation you deserve for damages.
What About Workers’ Comp and a Pre-Existing Condition?
A personal injury claim with a pre-existing condition does not change with workers’ compensation. If you are injured on the job, you have the right to seek fair compensation – regardless of your previous health issues. Additionally, pre-existing conditions made worse by job activities may also equate to benefits.
But unfortunately, insurance companies commonly deny claims for pre-existing injury workers’ compensation. This can reduce the payout and the company’s liability. Generally, there are three scenarios in which pre-existing conditions come into play:
Pre-existing injuries related to the claim
This scenario would involve a workplace injury to the same body part that was injured in a previous workplace injury. If a worker broke their right arm on the job, then re-broke the same arm in another accident on the job, the employer will be held accountable. They may be liable for medical bills and temporary disability benefits. However, the compensation may be reduced.
Pre-existing injuries NOT related to the claim
This scenario would involve pre-existing conditions that did not stem from a workplace accident – but were worsened by the job environment. In this case, the employer may be liable for medical bills and treatment.
Pre-existing unrelated condition
The last scenario refers to a pre-existing condition that has no relation to the workers’ compensation claim whatsoever. This will not likely play a factor in the workers’ compensation benefits for the victim, but they may need to seek treatment from different medical providers.
What Damages Can You Collect in a Personal Injury Claim?
Victims of a personal injury may be eligible to collect a number of damages following the accident – even if they have a pre-existing condition. Damages in personal injury cases are typically grouped into two categories.
- Economic Damages
- Non-Economic Damages
Economic damages refer to recoupable costs that have tangible values, including (but not limited to):
- Medical and hospital bills
- Future medical treatment
- Lost wages
- Lost earning potential
- Property damage
Non-economic damages involve personal struggles that do not have a clear price tag. These would include (but are not limited to):
- Pain and suffering
- Lost companionship
- Decreased quality of life
Your personal injury attorney will help you place a value on all the damages you suffered in building your claim.
How to Maximize Your Personal Injury Claim
The value of your personal injury claim with a pre-existing condition depends on the evidence you have in place. The best thing you can do to help yourself and your attorney is to gather as much information about the accident as you can. This includes (but is not limited to):
- Documentation of the accident
- Pictures of the accident/surrounding area
- The police report
- Witness contact information
- All medical records of your pre-existing condition
- Medical expenses incurred from the new accident
Detailed records of your medical history and treatment are going to be the most valuable pieces of evidence in your claim. In a personal injury claim with a pre-existing condition, this documentation is crucial. You will need to show the details of the accident and the impact it had on your condition.
Hire an Experienced Personal Injury Attorney
Managing a personal injury claim with a pre-existing condition can get complicated. The toughest obstacle will be negotiating with insurance companies for a fair settlement. Personal injury attorneys are trained to manage these negotiations and earn you the maximum compensation.
Now, many victims are hesitant to hire a personal injury attorney because they are worried about expensive fees. Lawyers in this field work on a contingency fee agreement. This means they make a percentage of the settlement AFTER they win the case – and won’t charge clients anything out-of-pocket. In other words, anyone can afford to hire a personal injury attorney.
At Midwest Injury Lawyers, we specialize in helping victims manage their personal injury claim with a pre-existing condition. We’re ready to help you get the ball rolling in earning justice following an accident. Even if you’re not sure if you have a valid claim, our team is happy to answer your questions and point you in the right direction.