Car Accident Lawyer Advice: Dealing with Pre-Existing Conditions

If you live long enough and move your body through the world, you collect a few maladies. A cranky lower back from college athletics. An old shoulder tear from a warehouse job. The headaches that show up after long days at a computer. When a crash happens, these become part of the legal conversation whether you like it or not. The defense will try to argue your pain is old news. Your job, with the right advocate, is to show what changed.

I have sat with hundreds of clients who felt blindsided by how aggressively insurers dig into their medical history. They walk in thinking the facts are simple: I was hurt by a negligent driver, my body hurts more than before, and I want help for as long as it takes to heal. Then they get a letter requesting five or ten years of records, a recorded statement asks, “You’ve had back pain before, right?”, and the tone shifts. This is where a good car accident lawyer earns their keep, by organizing your story, distinguishing prior conditions from new injuries or aggravations, and documenting the change in a way that persuades an adjuster, mediator, or jury.

The starting point is the “eggshell plaintiff” rule. In plain terms, car accident lawyer the at-fault driver takes you as they find you. If you had arthritis, a bulging disc, or an anxiety disorder, and the collision made it worse, they are responsible for the worsening. That does not give you a windfall for unrelated health issues, it simply means the law recognizes real human bodies have histories. Defense attorneys know this rule well, which is why they fight on the facts: Was there an actual aggravation, by how much, and for how long?

In practice, claims involving pre-existing conditions turn on clarity. Two files on my desk, both with similar impacts, can yield very different outcomes depending on whether the medical records tell a clear before-and-after story. If a primary care physician noted intermittent neck pain controlled with stretches before the crash, and after the crash the records show persistent radicular pain, positive Spurling test, MRI changes, and a referral to a spine specialist, it becomes hard for an insurer to deny the aggravation. But if the record is muddy, with months-long gaps and minimal detail, they will seize on that to argue nothing changed.

Back and neck issues top the list. Many adults have degenerative disc disease visible on an MRI whether they feel pain or not. Insurers call this “degeneration” like it proves their case, but degeneration is often background noise. The key question is function. Were you living normally before? Did the crash unlock symptoms that were dormant, or intensify a manageable problem?

Arthritis in knees, hips, or shoulders can be similar. If you had mild arthritis and could bowl on weekends, then after a rear-end collision you need injections and your range of motion drops, the collision likely aggravated the condition. Defense will argue “same arthritis, different day.” Your job, with your lawyer and doctors, is to track the change in activity tolerance, treatment intensity, and objective findings.

Prior concussions and migraines complicate head injury claims. A person with rare migraines who becomes light-sensitive and struggles with work after a T-bone crash presents a classic aggravation scenario. Neurology notes, vestibular therapy records, and even employer documentation of missed days help nail down the delta between pre- and post-crash function.

Psychological conditions show up more than clients expect. Anxious drivers may develop full-blown panic disorder after a highway crash. Someone with a history of depression might experience prolonged exacerbation. Juries can be receptive when the narrative is honest and consistent, and mental health records demonstrate the timing of the change.

Surgical histories are not deal-breakers. I once represented a client who had a lumbar fusion five years before her crash. She was stable and active, then a sideswipe incident caused persistent pain above the fusion level. Her surgeon documented a new adjacent segment syndrome. We resolved the case for a fair number because the records drew a straight line from collision to new symptoms and treatment.

Adjusters work from playbooks. One chapter is dedicated to “medical causation with prior conditions.” Their argument usually takes this shape: the imaging looks the same as before, treatment was conservative and similar, and complaints mirror prior notes. They back it with independent medical exams, often by doctors who perform hundreds of insurer-paid reviews each year. These reviewers lean on phrases like “age-appropriate degeneration” and “no acute changes,” hoping to sow doubt.

This is not personal, though it can feel that way. It is a cost strategy. If they can shave 30 to 50 percent off a claim by attributing pain to history, they will. That is why timing, documentation, and precision matter. It is also why recorded statements given early, before you understand your full injury picture, can backfire. “It’s just my usual back pain” becomes a refrain in their file even if, two weeks later, sciatica locks you to the couch.

You cannot change your medical history, but you can present it with discipline. The best files, the ones that settle at the high end of reasonable ranges, show a straight path from collision to symptoms to care to outcome. That does not mean over-treating or running to every specialist in town. It means accuracy, consistency, and proportional follow-up.

Start with establishing a baseline. Your car accident lawyer will often gather two to three years of pre-crash records, sometimes more if a prior injury is relevant. A single note from 18 months before the crash that says “mild intermittent low back pain, ibuprofen as needed” can be your best friend later. It proves you lived with something manageable that the collision disrupted.

Next, nail down the first 72 hours after the crash. If you feel pain, tell the ER or urgent care precisely where and how it feels. Avoid “I’m fine” if you are not. A friend of mine tried to tough it out at the scene, refused transport, and later had a disc herniation confirmed. The insurer spent a year arguing it must have happened some other time because the first record was silent on back pain. He still settled, but the gap cost him.

Then, maintain continuity. If you try conservative care, log it. Physical therapy attendance matters. Home exercises matter. If something makes you worse or better, say so. I have seen adjusters point to missed therapy visits as proof the injury was not serious. Sometimes life gets in the way. If you cancel a session because you could not get out of bed, ask the therapist to note that fact in your chart.

Lawyers talk causation, doctors talk pathophysiology. Both matter. There are a few clinical tools that help draw the distinction between old and new.

Imaging comparisons are useful, though not definitive. A new annular tear on a post-crash MRI is suggestive, but radiologists use cautious language. Even without a new tear, changes in symptom distribution can be powerful. If you never had radicular pain down the right leg before, and now you do, a treating physician can explain why that points to new nerve irritation.

Objective signs add weight. Decreased grip strength measured across visits, positive straight leg raise, spasms noted on palpation, or a documented loss in range of motion signal more than self-reported pain. When combined with consistent subjective complaints, the picture becomes hard to dismiss.

Treatment escalation tells a story too. Moving from over-the-counter meds to prescription anti-inflammatories, then to injections, and perhaps to a surgical consult reflects a real change in condition. Insurers tend to respect specialists. A spine surgeon’s note carries different gravity than a hurried urgent care script. That does not mean you must chase aggressive care, only that appropriate escalation, when warranted, builds credibility.

Presenting a case with pre-existing conditions is part art, part logistics. We build timelines that capture key milestones: the last time you felt symptom-free before the crash, the first post-crash complaint, the first specialist visit, each diagnostic, each plateau or setback. We cross-reference work records, gym check-ins, and even family calendars when that helps show function before and after. The goal is to make it easier to pay the claim than to fight it.

We also prepare you for depositions. Defense counsel will comb your history, sometimes reading off every prior mention of the word “pain.” The healthiest answer is honest and specific. “Yes, I had occasional soreness after yard work. I managed it with rest. After the crash, the pain was daily, sharp, and ran down my leg. That had not happened before.” Jurors connect with that clarity.

Good lawyering also means pushing back on invasive demands. Not every decade of your medical life is relevant. If you had shoulder surgery 12 years ago and the injury now is to your knee, we argue scope and time limits on record requests. Judges generally support reasonable boundaries.

You do not need to become a professional patient. A few practical habits carry outsized value.

Keep a simple pain and activity journal for the first two to three months. Rate your pain in a consistent way, note what activities trigger or limit you, and track sleep. Do not dramatize. Adjusters and juries appreciate ordinary details: “Could not sit through my daughter’s 90-minute school concert,” “Had to pause mowing after ten minutes,” “Slept in a recliner because turning in bed woke me.”

Tell your providers your full story every visit, not just the worst symptom. If neck pain flares with headaches and tingling in your fingers, list all three. Vague notes like “doing better” can be misread as full recovery. “Back pain reduced from 8 to 5, headaches now 3 days a week instead of daily” shows improvement while capturing ongoing issues.

Be cautious with social media. You do not need to disappear, but context can be lost. A single photo at a beach can be twisted into “you were fine” even if you sat in a chair the whole trip and paid for it later. If you post, be honest. Do not post about the case or the crash without discussing with your lawyer.

Most claims resolve before trial. Cases with pre-existing conditions tend to settle when the defense accepts the aggravation story and the parties converge on duration and degree. You can expect debate over what portion of your care is “collision-related.” For example, an adjuster might agree the first six months of treatment are covered but contest injections in month nine. That is where medical opinions and consistent recovery patterns matter.

Numbers depend on jurisdiction, policy limits, and the evidence. In moderate aggravation cases with strong documentation, I often see non-surgical settlements in the mid five figures to low six figures, though wide ranges exist. Surgical cases can climb into higher six figures. When policy limits are low, even good cases may cap out. Your lawyer should calculate all available coverages, including underinsured motorist benefits and med-pay, and investigate employer-based disability plans when time off work enters the picture.

If you go to trial, juries tend to reward clarity and modesty. Overreaching sinks cases. Claim what you can prove, and do not hide the old injury. When a plaintiff admits the prior condition with candor, then lays out the change in simple terms, the defense loses its favorite storyline.

IMEs are a reality in contested claims. Many are fair. Some are not. If your case involves pre-existing conditions, expect the IME to focus on causation and apportionment. A typical report will say a percentage of your impairment relates to degeneration versus crash. The exact percentage is often less important than the admission of some crash-related aggravation.

Prepare with your lawyer. Arrive early, bring no extra records unless instructed, and answer questions succinctly. Describe your pre-crash baseline and your current limitations without guessing at diagnoses. If the doctor pushes for prior details, be accurate and avoid argumentative tones. Afterward, jot down what was asked and how long the exam took. If the report misstates facts, your attorney can address that with your treating doctor or through a rebuttal expert.

Prior claims do not bar you from recovery. They do, however, raise the bar on documentation. If you resolved a shoulder injury two years ago, the defense will look for overlap. This is where discharge notes help. If your prior case ended with “full range of motion, pain resolved,” and now you have new imaging or new deficits, you are on solid ground. If you were mid-treatment when the crash occurred, your lawyer may need to untangle causation with the help of your providers.

One practical consideration: confidentiality provisions in prior settlements sometimes restrict disclosure. Courts generally require enough transparency to assess causation. Your attorney can negotiate protective orders to share necessary information without exposing private details beyond the case.

Older clients often get hit with the “degeneration” refrain. Age alone is not a defense. If a 72-year-old who gardened weekly now needs a cane for longer walks after a crash, the harm is real and compensable. Juries can be sympathetic when the defense leans too hard on X-ray buzzwords. The human story matters: independence lost, social routines disrupted, energy drained by chronic pain.

Medication interactions and comorbidities also require careful coordination. If you take blood thinners, for example, certain treatments change risk profiles. The defense sometimes argues that constraints on treatment mean the crash could not have caused severe harm. The better frame is necessity and prudence. Conservative care chosen because of medical realities can still reflect significant injury.

A short checklist helps in the foggy first phase.

Those first steps set the tone. They do not guarantee a smooth path, but they head off avoidable problems.

Pick clinicians who listen and document well. You do not need VIP specialists. You need providers who write clear notes, perform appropriate exams, and stay within standard-of-care guidelines. If a provider dismisses your history or rushes you through visits, switching early can prevent months of thin records. Courts and insurers read charts. A sentence like “patient attributes worsening to MVC on [date]” does more than you might think.

Stay wary of over-treatment. A stack of passive therapies for months on end, without measurable goals, can look like padding. Good physical therapy plans evolve across visits and move toward self-management. A pain specialist who tracks functional metrics alongside pain scores gives you a stronger case. Always make choices for your health first. If a recommended procedure feels wrong, seek a second opinion. Authentic decision-making aligns with credibility.

Economic damages are the straightforward part: medical bills, projected future care, lost wages, diminished earning capacity. When a pre-existing condition is present, future care projections may focus on longer recovery timelines or higher maintenance needs. A client with baseline degenerative changes who suffers a disc herniation may reasonably face more frequent flare-ups in the coming years. A life care planner or treating doctor can map out likely frequencies and costs without inflating.

Non-economic damages hinge on your daily life. Pain, discomfort, anxiety behind the wheel, disrupted sleep, the loss of hobbies, the strain on relationships. Jurors understand what it means to worry before getting on the freeway. They understand stiff mornings that turn into sluggish days. When you describe specifics instead of labels, they follow you.

A few patterns reliably undermine cases. Large gaps in treatment without explanation make adjusters skeptical. Abrupt switching between many providers, especially if referrals are unclear, looks like doctor shopping. Statements that minimize early symptoms, followed by late-stage severity claims, let the defense argue an intervening cause. Inconsistent accounts across records create fertile ground for cross-examination. None of these are fatal on their own, but they complicate a job that is already hard.

The antidote is steady transparency. If you cannot attend therapy because of childcare or a layoff, ask the provider to note it. If you tried to push through because you needed to work, say that in the record. If you had a minor incident after the crash that made symptoms flare, disclose it. Juries respect adults who deal with messy realities.

You should expect your car accident lawyer to be curious about your past, not judgmental. A good intake interview feels thorough because it needs to be. Plan to discuss prior injuries, fitness routines, job duties, and long-term goals. Bring honesty to those conversations. Surprises in litigation cost leverage. Surprises at trial cost credibility.

Your lawyer should, in turn, set expectations. Not every aggravation case brings a large settlement. Some resolve modestly if the evidence is thin or policy limits are low. Others exceed early estimates when a specialist identifies a clearer causal mechanism. You deserve candid assessments along the way, not rosy assurances.

Communication cadence matters. Monthly check-ins during active treatment help keep the file current and catch issues early. You do not need to update daily. Use email or a client portal for documents. Save questions about strategy for scheduled calls, so the team can prepare thoughtful answers instead of chasing deadlines.

Sometimes the crash truly overlaps with prior symptoms. Maybe your knee was already giving you trouble, and the collision accelerated plans for a procedure you were considering. That is not fatal. The law allows recovery for acceleration. In these cases, precise language helps. Rather than insisting nothing hurt before, focus on acceleration and loss of choice. “I expected to need surgery in two to three years. After the crash, I could not walk my route at work and had surgery within three months.” That narrative matches reality and anchors damages in the shortened timeline.

The legal process can feel adversarial, even dehumanizing. Files move between desks. Numbers get thrown around that do not look like your life at all. The work, for you and your lawyer, is to keep the claim grounded in the small, specific truths that add up to a person’s days. You do not need to be perfect before a crash to deserve fair compensation after it. You need to show what changed, why it matters, and how you are doing your part to get better.

That combination, paired with a disciplined record and steady advocacy, persuades more often than not. It will not undo the past or fix every ache, but it can get the care paid for, replace some of what you lost, and give you a path forward that feels fair.