Personal injury law rarely presents a clean slate. People come into accidents with histories — prior back pain, a repaired ACL, migraines, diabetes — and those histories complicate what should be a straightforward claim. As a bodily injury attorney, navigating pre-existing conditions is a weekly exercise in medicine, strategy, and persuasion. Insurers lean on those prior conditions to discount liability and slash damages. Clients worry that their past will erase the harm they’re living with now. The truth sits between those extremes: a pre-existing condition can limit some categories of recovery, but it can also strengthen a claim when a crash or fall worsens a fragile area of the body. The task is proving not only what changed, but how and by how much.
Why pre-existing conditions don’t sink a claim
The law recognizes people as they are, not as idealized versions of health. The “eggshell plaintiff” doctrine, applied in most states, holds that a negligent party takes the injured person as they find them. If a low-speed collision causes a disproportionate injury because of osteoporosis, degenerative disc disease, or a previous surgery, the at-fault driver is responsible for the aggravated harm. That doesn’t mean every symptom post-accident is compensable. It means a jury or adjuster must separate baseline problems from new or worsened problems and value the difference.
I’ve seen a warehouse worker with decade-old lumbar degeneration manage full duty for years, then after a rear-end crash, require injections and restricted duty. The insurer argued nothing had changed. Comparative MRIs and contemporaneous work restrictions — coupled with testimony from the treating physiatrist — told a different story and unlocked fair compensation for personal injury that reflected the aggravation, not the entire lifecycle of his spine.
Aggravation versus recurrence: getting the labels right
Words matter in injury negotiations. “Aggravation” signals the accident made an existing condition worse or symptomatic. “Exacerbation” often means a temporary flare. “Recurrence” suggests a return of previously resolved symptoms without a new structural change. Insurers prefer the last two. A personal injury attorney should push for precise medical language anchored in objective data: new edema on MRI, increased herniation size by millimeters, fresh tearing on ultrasound, or measurable losses in range of motion compared with pre-accident baselines.
When treating providers default to vague phrases — “could be related” or “pain since unknown time” — claims stall. A seasoned personal injury claim lawyer anticipates this and supplies the doctor with the right frame: prior history, baseline function, accident mechanics, and symptom trajectory. Clear medical narratives aren’t manufactured; they’re coached into clarity with thorough records and specific questions.
The anatomy of proof: building an aggravation case
Every solid aggravation claim rests on three pillars: baseline, delta, and causation. Baseline establishes the client’s condition before the incident. Delta measures the change. Causation ties that change to the event.
Baseline is more than a health summary. It is concrete details: medication dosages, miles walked per day, lifting limits at work, symptom frequency, and prior imaging or operative reports. I ask clients to reconstruct a typical month pre-accident. Could they vacuum a house without a break? Sit through a two-hour movie? Sleep uninterrupted? Those seemingly mundane details become gold when countering an adjuster’s favorite refrain: “no objective change.”
Delta, the change, must be documented early and consistently. Soft tissue injuries evolve. So do concussions and complex regional pain syndrome. If the first records after a fall say “mild soreness” and later notes describe debilitating pain, insurers claim embellishment. A bodily injury attorney ensures prompt evaluation, not to inflate, but to capture reality in real time.
Causation becomes the battleground. Doctors rarely write “accident caused X” in absolute terms because medicine deals in probabilities. That’s fine. Most jurisdictions accept “within reasonable medical probability” as the standard. A careful physician will explain how the accident’s forces align with the injury pattern. As counsel, you connect the dots: crash severity, vehicle damage estimates, biomechanics if needed, and medical literature that matches mechanism to injury.
Common pre-existing conditions and how claims unfold
Degenerative disc disease and bulges are the headline act of defense arguments. Many adults over 40 have some spinal degeneration on imaging; a nontrivial fraction under 40 do too. The defense points to “chronic degeneration” as if it were a shield. The key is distinguishing asymptomatic wear from symptomatic injury. Before-and-after symptom logs, new radiculopathy on EMG, and a change from conservative care to injections or surgery post-accident can show aggravation.
Knee injuries sit next in line. An old meniscal tear repaired five years earlier, a clean season of rec-league basketball, then a twist on a slick supermarket floor. A premises liability attorney must obtain operative photos, surgical reports, and therapy notes from the first injury to show healing and function. A new tear in a different zone of the meniscus or increased chondromalacia grade supports fresh harm. Gait analysis from therapy sessions can provide a measurable delta.
Shoulder pathology — impingement, rotator cuff tendinosis, partial-thickness tears — often straddles the line between chronic and acute. Radiology reports sometimes hedge. When possible, request that the interpreting radiologist quantify differences compared with prior imaging and note marrow edema or fluid that implies recent trauma. If prior imaging is unavailable, symptom onset, loss of overhead reach, and strength testing trends become crucial.
Traumatic brain injuries in the setting of pre-existing migraines or ADHD require careful handling. The overlap in symptoms gives insurers cover to deny. Neuropsychological testing at two or three months post-incident, followed by repeat testing later, can capture changes in processing speed, working memory, and executive function. Keep in mind that many clients “pass” tests but still struggle at work, especially in complex, time-sensitive tasks. Job performance metrics, supervisor notes, and accommodations documentation often carry more weight than raw test scores.
Diabetes and peripheral neuropathy add complexity. A foot fracture that heals slower or a wound that worsens due to diabetes is still an accident-related harm if the injury created the wound in the first place. Here the eggshell principle is pivotal. You cannot claim damages for diabetes, but you can claim damages for how diabetes magnifies the consequences of a negligent act.
Documentation that persuades adjusters and juries
Lawyers talk about medical records as if they were neutral artifacts. They are not. The quality of documentation often reflects whether a client felt heard and how a provider templated their notes. I’ve had strong cases undermined by copy-pasted musculoskeletal exams that never changed visit to visit. When I see that, I talk with the treating provider and ask, respectfully, for detailed, injury-specific examination findings going forward. Many clinicians respond positively if approached with professionalism and a concrete explanation of how precise notes help care coordination.
Pain scales are blunt tools. A better record includes function: standing tolerance in minutes, number of stairs tolerated, hours slept, disruptions in self-care, and timed walk tests. For work-related claims, job descriptions and ADA accommodation requests ground the functional picture in reality. If a client transitions from lifting 50 pounds frequently to a 10-pound limit, that should live in both medical and employer records.
Photos and videos hold unexpected sway. Bruising, swelling, or restricted range of motion captured at home fill genuine gaps between office visits. For concussions, spelling errors in texts and emails around the time of the incident, with sensitive redactions, can be compelling. These details humanize a file that otherwise reads like a billing ledger.
When a gap in treatment is not fatal
Life intervenes. Clients miss therapy because childcare falls through, a relative is hospitalized, or a job is at risk. Insurers pounce on gaps as proof of recovery. The remedy is context. Document the reason for the gap, and when treatment resumes, make sure the providers note continuity of symptoms. A sincere one-paragraph explanation, supported by work schedules or family medical records, can neutralize an otherwise damaging hiatus.
Telehealth plays a role here. For clients with transportation barriers or flare-ups that make travel difficult, virtual visits keep the narrative coherent. While not a substitute for physical exams or imaging, telehealth notes that record functional limitations maintain momentum and corroborate the client’s lived experience.
Settlements: valuing the aggravation, not the whole history
A fair settlement distinguishes between pre-accident baseline and post-accident reality. Two valuation lanes usually emerge. In the first, the accident creates a new injury on top of an old one. Damages include the full cost of treating the new injury and the knock-on effects on employment and daily living. In the second, the accident aggravates an existing condition. Damages include the incremental medical care and the added pain and suffering attributable to the aggravation. This division can be messy, but it is workable.
I often prepare side-by-side timelines: before and after. Before shows doctor visits per year, medications, and activity levels. After shows the escalation — frequency of care, invasive procedures, missed workdays. In negotiations, that timeline sits next to a medical summary tying each post-accident intervention to a documented change in symptoms or findings. The insurer may still argue apportionment. That’s expected. The goal is to anchor numbers to evidence: an extra 12 physical therapy visits, two injections, a week of lost wages, and permanent lifting restrictions that cost a promotion.
The best injury attorney knows when to push and when to accept reasonable apportionment. If a client had symptomatic back pain requiring quarterly injections before the crash, demanding the insurer pay for all spine care after the crash often backfires. A grounded demand recognizes the pre-existing pattern, then isolates new cost layers tied to the event.
The role of independent medical exams and how to respond
Insurers routinely request an independent medical examination, better described as a defense medical exam. Some are even-handed; others are built to minimize. Preparation changes outcomes. The client should bring a concise symptom chronology, avoid exaggeration, and answer questions directly. Counsel should ensure the examiner has complete records, not cherry-picked files that omit post-accident imaging.
When a report predictably downplays causation, a rebuttal from the treating specialist can carry more weight than an outside hired expert. Treaters have longitudinal knowledge. If the treater is too busy or reluctant, consider a records review by a neutral-leaning specialist with strong credentials. A civil injury lawyer who understands local medical communities can steer these choices wisely.
Surveillance and social media in the age of skepticism
If pre-existing conditions are the lever, surveillance is the fulcrum. Short clips of a claimant carrying groceries or attending a child’s sports game get wielded as proof of wellness. They rarely reflect the whole picture. I counsel clients from day one: live your life, but live it honestly. If you can carry in groceries with two rest breaks and pain later, that’s consistent with injury. Write those patterns in a symptom journal. Posts on social media should avoid bravado or irony that can be misread in a claims context. A single caption — “Feeling great!” — after a day managed with medication and ice has torpedoed good cases.
Practical steps for clients with pre-existing conditions
- Tell your personal injury lawyer everything about your prior injuries, even if you think they’re unrelated. Surprises kill credibility; context strengthens it. Gather pre-accident medical records early. Baseline wins negotiations, and old imaging is often archived and slow to retrieve. Be consistent in describing pain and function. If you can do an activity intermittently, say so and explain how you pay for it later. Follow medical advice, and if you deviate, document why. Cost, childcare, fear of procedures — these reasons are understandable when explained. Keep a simple weekly log of symptoms and limitations. Bullet points tied to activities help your personal injury law firm translate experience into evidence.
Workers, athletes, and older adults: distinct patterns and arguments
A laborer with chronic joint strain presents differently from a desk worker with cervical spondylosis. For laborers, wage loss and future earning capacity loom large. Objective job requirements — lifting 75 pounds, climbing ladders, overhead work — align with medical restrictions to show real economic harm. For athletes, whether competitive or recreational, the measure is function and joy. Returning to play at a lower level, with pain or time caps, is a loss even if income is unaffected. Don’t overlook that damages category in demand letters.
Older adults face the bias that degeneration equals causation. Judges and juries respond well to clear stories: walking the dog daily before, needing a cane after; gardening for hours before, ten-minute stints now. A premises liability attorney handling a fall in a store must pin down floor conditions and inspection logs, but should also highlight the client’s independence pre-fall to counter age-based assumptions.
Insurance coverage layers and personal injury protection
In no-fault states, personal injury protection attorney work begins with PIP benefits. PIP pays medical bills and, in some jurisdictions, a portion of lost wages up to set limits, regardless of fault. Pre-existing conditions do not disqualify PIP, but they can accelerate exhaustion of policy limits if care needs are higher. Proper coding matters. Providers should link visits to the accident when appropriate so PIP pays first, preserving health insurance benefits and avoiding improper denials.
When liability is disputed or damages exceed policy limits, underinsured motorist coverage fills gaps. Clients often forget these benefits. A personal injury legal representation plan should inventory all applicable coverages early: at-fault liability limits, UM/UIM, med-pay, and, in premises claims, any third-party maintenance contractors with separate policies.
The negotiations playbook with an eye on trial
Every bodily injury attorney balances risk and reward. With pre-existing conditions, that calculus sharpens. Juries can be generous when they trust the plaintiff. They can also penalize overreach. I draft two valuation scenarios before mediation: conservative apportionment and full aggravation. Both are backed by line-item medical costs, wage data, and future care projections grounded in treating physician recommendations.
Demonstratives help more than flowery arguments. Side-by-side imaging with arrows and measurements, calendars of missed work, and progression charts of medication use tell the story without rhetoric. In the rare case that goes to trial, credibility is the currency. A client who admits past problems and clearly describes what changed wins more often than a client who denies obvious history.
How to choose the right advocate when your history is complex
If you’re searching for an injury lawyer near me and you have prior injuries, focus on experience with aggravated-injury cases. Ask how the lawyer approaches baseline reconstruction, whether they have relationships with neutral medical experts, and how they handle apportionment arguments. The best injury attorney for your situation will be candid about strengths and vulnerabilities, not just optimistic about a big payout.
Look for a personal injury law firm that invests in case development. That means early record retrieval, thoughtful demand packages, and readiness to try the case if the insurer refuses to value the aggravation. Many firms offer a free consultation personal injury lawyer session — use that time to probe their plan for your specific medical history.
When settlement isn’t enough: litigation strategy
Some cases cannot settle fairly. If a defense clings to “all prior” despite clear change, filing suit is appropriate. A negligence injury lawyer will tailor discovery to the pre-existing issue: subpoenas for old imaging, depositions of treating doctors about baseline function, and requests for insurer internal notes that reveal pre-set apportionment positions. Care must be taken with broad authorizations; protect irrelevant parts of the medical past while disclosing what the law requires. Courts understand the difference between privacy and proof.
Expert selection matters. Orthopedists or neurologists with academic credentials lend authority, but the most persuasive witness can be a treating physical therapist who tracked objective gains and setbacks week by week. An injury lawsuit attorney weighs cost against benefit and builds a roster that fits the injuries and weinsteinwin.com Car Accident Lawyer the budget.
Fee structures, liens, and net recovery realities
Contingency fees align incentives, but clients care about what they take home. Pre-existing conditions can trigger Medicare conditional payments, ERISA health plan liens, or workers’ compensation subrogation. An injury settlement attorney should estimate liens early and negotiate them at the end. Evidence of apportionment can reduce lien repayment obligations, especially when a portion of care is unrelated to the accident or when recovery is limited by policy caps.
Be transparent about the numbers. I show clients a projected settlement sheet with ranges: gross recovery, attorney’s fee, case costs, medical bills, liens, and net. Too many surprises come from optimism untethered to the math. A client choosing between a settlement now and litigation later deserves a clear financial picture for both paths.
A brief case study: turning “all prior” into “fair now”
A 56-year-old delivery driver had chronic cervical spondylosis documented on a 2019 MRI, intermittent PT, and ibuprofen use. After a T-bone collision at an intersection, he developed constant neck pain with numbness down the right arm. A new MRI showed a larger C6-7 herniation with nerve root impingement. The insurer argued degeneration and offered a fraction of medical costs.
We compiled a baseline dossier: five years of work logs showing no missed days, performance reviews, and the earlier MRI. We lined it up against the post-crash arc: two epidural injections, restrictions to 20-pound lifting, missed overtime, and EMG-confirmed radiculopathy. His physiatrist provided a clear note: within reasonable medical probability, the collision aggravated the disc herniation, triggering symptomatic radiculopathy. At mediation, we used a one-page chart quantifying the delta: zero injections pre-accident, two after; zero missed overtime pre-accident, 112 hours lost after; medication escalation from NSAIDs to gabapentin and muscle relaxants. The case settled for an amount that covered past medicals, compensated wage loss, and recognized the likelihood of a future injection. Not a windfall, but fair.
Final thoughts for clients and counsel
Pre-existing conditions complicate, but they do not doom, a claim. They demand rigor: careful baseline reconstruction, disciplined documentation, and honest storytelling. A personal injury legal help strategy that owns the past makes room for the present. Whether you work with a negligence injury lawyer, a premises liability attorney, or a broader personal injury legal representation team, insist on a plan that treats your history as context, not as a cudgel against your recovery.
If you’re evaluating whether to call a personal injury attorney, do it early. Memory fades, records get archived, and first impressions in the medical chart linger. Early guidance from a bodily injury attorney or injury claim lawyer helps avoid missteps that hand ammunition to the insurer. With the right approach, an aggravated condition can be proven with clarity and valued with integrity — the essence of accountability in civil law.