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Pre-Existing Medical Conditions’ Effect on an Injury Claim

Law Offices of McCullough & Leboff, P.A.  Oct. 13, 2023

Insurance companies often employ a wide range of tactics to reduce their liability and pay claimants as little as possible when processing personal injury claims. One of the most common tactics used by insurers is arguing that the claimant is not entitled to compensation because their injury is “pre-existing.”  

What many people do not realize is that they can obtain compensation even if they have a pre-existing medical condition. However, it is fair to say that any conditions that existed before the accident can complicate your future injury claims considerably. Our personal injury attorneys at Law Offices of McCullough & Leboff, P.A., understand the tactics insurers may use to deny or devalue claims and help injured victims preserve their right to fair and full compensation.  

With an office in Davie, we serve clients in Fort Lauderdale, Florida, and the surrounding area, including Pembroke Pines, Sunrise, Hollywood, Plantation, and Weston.  

What Are Pre-Existing Medical Conditions?

The term “pre-existing condition” can be used to describe any physical, psychological, or emotional injury or illness a victim had before the accident or incident in question. Some common examples of conditions that may exist before an accident occurs include: 

  • Back pain 

  • Spinal cord injuries 

  • Previously healed broken bones and fractures 

  • Traumatic brain injuries 

  • Knee injuries 

  • Degenerative disk disease 

  • Arthritis 

  • Hernias 

  • Joint and ligament injuries 

  • Anxiety 

  • Depression 

  • Other mental health conditions 

When an insurance company is trying to use your pre-existing medical condition as grounds to deny or devalue your injury claim, you might want to contact a skilled attorney for assistance. Your attorney will help you fight for the compensation to which you are entitled if your condition was worsened or otherwise affected by the recent accident.  

Exacerbation vs. Aggravation of Pre-Existing Medical Conditions

In personal injury cases, a pre-existing medical condition can either be unaffected by the recent accident, exacerbated, or aggravated.  

  • A pre-existing condition is unaffected when the accident in question does not change the injured victim’s existing condition;  

  • Exacerbation occurs when a pre-existing condition is made worse temporarily but will return to its original condition as before the accident; and 

  • Aggravation occurs when a pre-existing condition is made worse permanently.  

Regardless of what the insurance company is trying to tell you, you may be entitled to financial compensation when your pre-existing condition requires additional medical treatment and/or results in additional expenses because of the accident for which you need to file a personal injury claim.  

Recovering Damages With a Pre-Existing Condition

Even though injured victims have a right to pursue compensation as long as their pre-existing injury was exacerbated or aggravated by the recent accident, doing so will most likely not be easy. There are often a lot of hoops to jump through to obtain the compensation you need and deserve.  

Insurance companies often use the claimant’s pre-existing condition as grounds to deny their claim. While the insurer may have legitimate grounds to deny a claim when a person is seeking compensation for an injury that existed before the accident or incident in question and was not affected by that accident/incident, the claim cannot be denied if any of the following is true:  

  1. A pre-existing condition made the new injury worse; or 

  1. The accident exacerbated or aggravated the pre-existing condition.  

Under the “eggshell skull” doctrine, injured victims can recover damages even when their pre-existing conditions make them predisposed to serious injuries. In other words, if the victim’s existing conditions make him or her more susceptible to injury, they are entitled to compensation because the defendant (the negligent party) must take the plaintiff (the injured party) as they find him/her.  

The Importance of Medical Records

Recovering damages with a pre-existing condition is more complicated because the claimant has to show the extent to which the accident or incident affected the conditions that existed before. This often requires detailed medical records. With no documentation of pre-existing injuries, you will have a hard time proving that your condition was exacerbated or aggravated by the recent accident.  

If you are not sure how to use your medical records to prove the existence and severity of your condition, seek legal guidance from an attorney. At Law Offices of McCullough & Leboff, P.A., we work with medical experts to help clients establish the exacerbation or aggravation of their prior injuries to ensure they get their rightful entitlements under the law.  

What Happens if You Were Not Aware of Your Pre-Existing Condition?

Sometimes, an injured victim may be unaware of their pre-existing condition until a medical evaluation after the accident discovers one. However, proving that you were not aware of pre-existing conditions can be tough, as the insurance company is likely to argue that you intentionally tried to conceal your condition. In the worst-case scenario, this could even result in accusations of insurance fraud. If this sounds like your case, you might want to seek legal representation from an attorney to avoid or challenge accusations of fraud and the negative consequences that come with it.  

Understand Your Rights After an Injury

If you have a pre-existing medical condition, contact Law Offices of McCullough & Leboff, P.A. for legal help. We can help you navigate the personal injury claims process and ensure that you get the insurance company’s respect and fair treatment while obtaining the compensation you are entitled to. Get in touch now to request your free consultation and discuss your rights.