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Are Pre-existing Conditions Covered in a Personal Injury Claim?

By DiBella Law Offices on December 7, 2020

One of the most hotly debated issues when it comes to personal injury claims is pre-existing conditions, especially for older accident victims. A serious car wreck or slip-and-fall and cause catastrophic injuries to the elderly, as well as to younger victims, and it is not uncommon for an accident to exasperate an older injury. In fact, insurance companies will often try to deny coverage if a plaintiff has a pre-existing condition. However, a pre-existing condition does not completely bar you from receiving payment on a claim, and there are several legal doctrines that a skilled attorney can use to protect your right to compensation.

Types of Pre-existing Conditions

Over the years, we all suffer from a variety of wear-and-tear that takes a great toll on our bodies. While some bumps and breaks heal, others remain with us for years to come. Arthritis, back pain, limps, and other mobility issues can be exasperated after an accident. This may make it harder for the original problem to heal, or increase the overall pain you are dealing with afterward.

While you might assume that the term “pre-existing condition” only includes physical injuries, that is not always the case. Mental illnesses such as PTSD, depression, and anxiety can also be considered pre-existing conditions, especially if they were treated with therapy or medication. Also, serious physical injuries, such as paralysis brought on by a spinal cord injury, can cause an existing neurological injury to worsen. This is especially true after auto accidents, which on their own can cause PTSD, especially if the victim suffers a brain injury.

Following a serious accident, it is important to speak to your doctors about any pre-existing conditions you are dealing with. They can work with you to develop a treatment plan that helps you heal from both your accident-related injuries and pre-existing conditions. Your medical records can also show how the accident caused a condition to worsen, which is extremely important when filing a claim. While the at-fault party’s insurance company will try to minimize the amount of money it pays to you, if the accident caused your condition to worsen, then you may be able to include any treatment costs in your claim.

The Eggshell Doctrine and Pre-existing Conditions

One of the most important legal arguments a personal injury attorney can use is called the Eggshell Skull Doctrine. This legal argument states that the person responsible for an accident is liable for any injuries a victim suffers, even if that victim was more likely to suffer a serious injury when compared to the average person.

The common example used in this argument is a victim with an eggshell-thin skull. Imagine an average person getting struck in the head with a baseball. Depending on the speed of the baseball, he may only suffer a bruise and minor concussion. However, if the victim had an eggshell-thin skull, the victim would probably suffer a fractured skull and a catastrophic brain injury.

Under the Eggshell Skull Doctrine, both victims deserve to have their injuries treated as appropriate and to receive proper compensation from the person who hit them. Essentially, the at-fault party does not get to pick the type of victim he injured; rather, he must provide compensation for all injuries he caused, no matter how extensive.

When applied to pre-existing conditions, this means that the at-fault insurance company must provide compensation for pre-existing conditions if they were worsened in an accident caused by the company’s client. If your back pain, arthritis, or mental health worsened after an accident, then you can receive compensation for those injuries.

But recovering compensation for a pre-existing condition is not as simple as citing the Eggshell Skull Doctrine. You will need to collect evidence of negligence to show that the at-fault party is liable for your injuries, and prove that your medical condition worsened due to the at-fault party’s actions. All of this requires extensive research and an in-depth medical review, which is next to impossible for the average person. If you try to file a claim on your own, the at-fault insurance company will likely deny your claim.

Your best option is to speak to a Burlington personal injury attorney at DiBella Law Offices, P.C. Our lead attorney has more than 15 years of experience and knows the claims process inside and out. He can work with your doctors to show how a pre-existing condition was exasperated after an accident and defend your right to compensation in insurance negotiations or a jury trial. To get started on your claim, schedule a free consultation by calling our office at (781) 262-3338.

Posted in: Personal Injuries