The Impact of Pre-Existing Conditions on Personal Injury Claims

Published March 18, 2025 by Harker Injury Law

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If you’ve been in an accident, you deserve fair treatment and full compensation when someone else’s negligence has caused you harm. Unfortunately, having a pre-existing health condition can make seeking compensation for an accident challenging.

Unfair as it is, insurance companies often use prior health issues to diminish a personal injury claim. They may argue that your current pain comes from pre-existing problems rather than from your recent accident.

However, it is good to note that the law is on your side. According to the Affordable Care Act, insurers cannot deny coverage or charge higher rates for pre-existing conditions. In this article, we will discuss how having a pre-existing condition can affect your case.

What Are Pre-Existing Health Conditions?

Pre-existing conditions are any health issues or medical conditions that you had before your personal injury accident. These conditions are usually documented in your medical history.

Some examples of common pre-existing conditions include:

Degenerative disc disease and other spinal conditions
Arthritis in various joints
Fractures from a previous accident
Chronic pain conditions
Diabetes, which can affect healing rates
Heart conditions that might be worsened by physical stress
Mental health conditions like depression or anxiety

The Basics of a Personal Injury Claim

It is not right for someone else’s carelessness to disrupt your life. The negligent person or company should be held responsible for the resulting damages.

Thus, a personal injury claim enables you to seek compensation for your losses after an accident. If your injuries were caused by someone’s negligence, injured victims can file a claim.

Examples of personal injury cases

Personal injury cases cover many situations. Here are some incident cases we handle at Harker Injury Law:

Statute of limitations for filing a personal injury claim

Every state sets strict deadlines for filing personal injury lawsuits. These deadlines are called the statute of limitations. This period is generally2 years from the date of the injury, though certain exceptions may apply. Several factors can affect these filing deadlines.

These factors include:

The type of claim being filed
The state where the injury occurred
Whether the injured person is a minor
Whether the injury wasn’t immediately discoverable
Whether the injured person was mentally incapacitated

If you miss the statute of limitations, you may miss out on the chance for compensation. Acting quickly after an injury helps ensure your rights are protected. All necessary legal steps need to be handled within the set legal timeframe.

Proving negligence in a personal injury case

After an accident, the other party may deny fault and try to avoid a payout. In this case, how can you prove that they did cause your injuries?

To successfully pursue a personal injury claim, you need to prove these four key elements:

Duty of care: The at-fault party had a legal responsibility to act with reasonable care
Breach of duty: The at-fault party failed to meet that standard of care
Causation: Their failure directly caused your injuries
Damages: You suffered actual losses like medical bills or pain and suffering

What You Can Claim If You Have a Pre-Existing Condition

With pre-existing conditions, you can claim compensation for all accident-related damages. You cannot claim damages for the pre-existing condition itself. You are only entitled to fair compensation for any worsening harm caused by the accident.

Recoverable damages may include:

Extra medical costs to deal with your worsened pre-existing condition
Lost wages if you had to miss work due to injuries
Future medical expenses for ongoing treatment
Rehabilitation expenses
Home modifications costs
Increased pain and suffering
Mental anguish caused by the worsened condition
Loss of enjoyment of life
Reduced quality of life
Increased disability

How Insurers Might Approach a Pre-Existing Condition Case

Insurance companies use various tactics when dealing with claims involving pre-existing conditions. These tactics are designed to cut their financial liability. Understanding how they might trick you can help you prepare yourself.

A couple of common insurance company tactics include:

Asking for extensive medical records going back years or even decades
Using surveillance to document activities that appear inconsistent with your claimed injuries
Pressuring you to accept quick, low settlements before you fully understand your condition
Misrepresenting the law on pre-existing conditions to reduce your compensation

As an injured victim, you probably put your trust in the insurance company to do the right thing. Sadly, insurance companies care more about their financial gain than your pain. However, having personal injury lawyers who are dedicated to your recovery helps level the playing field. Legal assistance ensures your rights are protected.

Common Challenges in Personal Injury Cases

Personal injury law can be complex to navigate. They can be especially challenging when you have a pre-existing medical condition. It’s not always easy to prove that the other party’s actions made your pre-existing condition worse or caused new injuries.

Some other challenges with these types of claims include:

Telling apart new injuries from pre-existing ones
Proving how much the accident made your pre-existing condition worse
Lacking enough detailed medical records for your pre-existing condition
Proving to adjusters or juries how the accident affected your health

Each of these challenges requires specific strategies and evidence to overcome. That’s why legal help is not just valuable but vital to personal injury cases with pre-existing conditions.

Proving the Impact of an Injury on a Pre-Existing Condition

Medical evidence is valuable to any personal injury claim involving pre-existing conditions. Detailed documents help insurance adjusters see a connection between your pre-existing condition and the recent accident.

Consider gathering these medical documents to strengthen your case:

X-rays, MRIs, and CT scans from before and after the accident
Treatment notes from your doctors detailing changes in your pre-existing condition
Physical therapy evaluations that show decreased functionality after the incident
Pain management records that show increased pain levels following the accident
Prescription records showing new or increased medications needed after the injury

An experienced personal injury attorney can help you gather this evidence for your case. It is extremely vital to ensure you get the justice you deserve. Without this documentation, proving that the accident has worsened your condition can be challenging.

Consequences of Withholding Information About Pre-Existing Conditions

Hiding or lying about your medical condition can severely damage your personal injury claim. Insurance companies invest a lot in investigating claims. They usually request extensive medical records that will reveal any pre-existing conditions. The investigations can be conducted even if you disclose your pre-existing injuries.

The consequences of dishonesty about pre-existing conditions can include:

Complete dismissal of your case
Significant reduction in compensation
Damage to your credibility with the judge and jury
Potential charges of insurance fraud in extreme cases

Beyond the legal consequences, hiding pre-existing conditions works against your case. Not providing an accurate medical history can make it hard for your personal injury attorney to defend your case. It can also affect your future need for legal representation. Other lawyers may not want to represent you if you’re dishonest about evidence.

Why You Should Hire a Lawyer to Handle Your Claim

Personal injury lawyers often have years of experience in navigating the legal system. They are equipped with the skills and resources to build a strong compensation case on your behalf.

A skilled attorney can help you:

Gather and organize medical evidence
Find and work with the right medical experts
Predict and fight insurance company arguments
Properly value your claim
Navigate the complex legal processes and deadlines

Working with a personal injury lawyer can give you peace of mind during the legal process. Your lawyer can work on the complicated details of the case, allowing you to focus on recovery.

Contact an Experienced Personal Injury Attorney

Don’t let pre-existing conditions prevent you from seeking justice. Are you worried that a pre-existing condition will negatively affect your claim? You are not alone. Many injury victims with pre-existing conditions hesitate to pursue legal action. They are worried that their prior health issues will undermine their claim.

However, Harker Injury Law is here to help. The personal injury lawyers at our law firm have extensive experience in handling personal injury claims. We are ready to file your personal injury claim and get the justice you deserve. Our goal is to develop effective strategies to secure fair compensation for you.

Need to discuss your case involving a pre-existing condition? Contact us today for a free consultation. We are ready to help you navigate this complex legal process while you focus on your recovery. Remember, every case is important to us — no matter how small — and you deserve compassionate legal representatives who put your needs first.