How a Car Accident Lawyer Addresses Pre-Existing Conditions

Pre-existing conditions sit at the center of many car crash disputes. They are the soft target for insurance adjusters and defense attorneys looking to shrink payouts. If your back already hurt before the collision, they argue, why should their driver pay for your back surgery now? A good car accident lawyer knows that is the wrong question. The right question is how the collision changed your health, your function, and your life. The law allows recovery for aggravation of pre-existing conditions, but getting there requires careful strategy, disciplined documentation, and a steady hand in front of a jury.

When I first started trying these cases, I noticed a pattern. Clients with prior injuries often received skeptical looks from adjusters, even when the crash was clearly the cause of a downturn. The skepticism wasn’t always malicious. It was a habit rooted in three assumptions: pre-existing means old and unrelated, medical imaging always tells the full story, and any gaps in treatment mean the problem isn’t real. Each assumption is casually confident, and each one is flawed.

Bodies rarely fit neat timelines. A disc protrusion that sat quietly for years can destabilize after a rear-end impact and start compressing a nerve. A knee with manageable osteoarthritis can become swollen and unstable after a hard twist during a T-bone crash. Imaging is a snapshot, not a movie, and plenty of pathology that matters clinically won’t show up with clean edges on a scan. As for treatment gaps, the reasons range from lack of insurance to family obligations to the plain hope that rest will solve it. A skilled car accident lawyer rebuilds the timeline, matches symptoms to known mechanisms of injury, and shows how the collision pushed a vulnerable system past its tipping point.

Most jurisdictions follow two connected principles. First, the eggshell plaintiff rule: you take the person as you find them. If the crash victim had a fragile spine, the defendant is still responsible for the harm caused, even if a healthier person would have fared better. Second, the aggravation rule: a defendant is liable for worsening a pre-existing condition. That does not mean paying for every prior problem, only the additional harm caused by the crash.

The difficulty lies in measuring “worsening.” Lawyers translate that simple idea into evidence. We need baselines, deltas, and causation opinions. Judges and juries need clarity. Adjusters need reasons to move money. Bridging those needs requires more than citing rules. It calls for a full story, told with medical records, careful witness preparation, and a few well-chosen analogies.

Think of the case as a comparison. What did life look like before? What does it look like now? The closer and more credible the comparison, the stronger your claim for aggravation.

A thorough lawyer starts by collecting prior medical records with precision, not curiosity. We ask for a defined window that makes sense for the condition. If you had lumbar issues two years before, we want orthopedic notes, physical therapy records, pain clinic reports, and imaging during those years. We are not fishing for unrelated conditions, we are building a baseline. The aim is to show, in real terms, the difference between “manageable” and “debilitating.”

Client interviews are just as important. I ask clients to walk me through a typical month before the crash. How many days of pain were there? What activities were limited? How many hours could you stand, sit, or lift without needing a break? If golf was a weekend ritual, how many holes were you playing? If childcare involved lifting a toddler, how often did you need help? Vague adjectives do not persuade. Specifics do.

Out of the stack of records, a few typically carry unusual weight:

When someone calls after a crash and mentions a prior injury, I slow the conversation down. I want to hear what the pain felt like before and what it feels like now. Radiating versus localized. Sharp versus dull. Constant versus intermittent. What makes it worse, what eases it, and how long relief lasts. Timing helps too. If sciatica started within days of the collision and travels a classic dermatomal path down the leg, that pattern matters. If dizziness or headaches appeared for the first time after a rear-end crash with head acceleration, that timing, coupled with exam findings, supports a post-traumatic diagnosis.

I also ask about gaps. If treatment paused for three months because childcare fell apart, we will explain that. If insurance denied an MRI until conservative care failed, we will document the appeals. Gaps are not fatal if they have a human reason and the story holds together.

Overreaching kills credibility. A lawyer who tries to pin every ache and spasm on the crash invites skepticism. Good cases can turn bad when the claim balloons beyond the evidence. I have declined cases where the client’s current complaints bore no plausible relation to the mechanism of impact. A low-speed bumper tap does not explain a rotator cuff tear without a distinct bracing or outstretched arm mechanism. On the other hand, a side impact with seat belt loading can plausibly cause sternoclavicular pain. Matching mechanism to injury keeps the case grounded.

When the defense has a fair point, we concede the fair point. Yes, the degenerative changes were present. Yes, you had a prior flare last fall that required three PT visits. The key is showing that after the crash the frequency, intensity, and functional limits shifted. Jurors appreciate honesty. Adjusters do too, even if they don’t say it.

Treating physicians are often the best witnesses, but they are busy and wary of legal processes. I start with a thoughtful records request and a simple letter of inquiry. I do not ask them to advocate. I ask them to answer with their training: Did the crash more likely than not aggravate the pre-existing condition? Was additional treatment reasonable and related to the aggravation? Do the current symptoms align with the mechanism of injury and the patient’s exam?

When the treating doctor is unwilling or uncomfortable, an independent specialist can fill the gap. The best experts are not professional witnesses, they are practicing clinicians who routinely manage the condition at issue. They explain not only what the images show, but how the clinical exam and the timeline fit together. They can articulate why an annular tear that was asymptomatic can become symptomatic after a flexion-extension injury, or how cervical facet joints injured in a whiplash event can cause headaches and limited rotation long after muscles have calmed.

Imaging is a tool, not a verdict. Defense lawyers love to point at “degenerative” findings: desiccated discs, osteophytes, mild stenosis. Those words can sound clinical and damning. But a lawyer familiar with spine and joint medicine will contextualize them. A substantial slice of healthy adults has “abnormal” imaging. Studies show asymptomatic disc bulges are common in people over 30. The question is whether the crash triggered symptoms tied to the level and structures in question.

A careful presentation overlays the timeline of pain and function on the anatomy. If L5-S1 shows a new annular fissure and the client has new S1 radiculopathy signs, that alignment matters. If pre-crash films show mild osteoarthritis of the knee and post-crash films are unchanged, but the client now has mechanical catching and MRI confirms a tear in the medial meniscus, the Car accident lawyer attorneyatl.com degenerative note fades in importance. The image supports the story, it does not write it.

Adjusters read for inconsistencies. They compare your first urgent care note with your later orthopedic evaluation. If one mentions neck pain and the other does not, expect a letter raising doubts. A car accident lawyer spends time making sure your narrative is consistent across records, without manufacturing anything. If a symptom did not appear until a week later, we say so and explain why that is clinically plausible. Delayed onset for some soft tissue injuries is normal. Swelling can mask stability issues. Adrenaline in the first 24 hours can blunt pain.

We watch how forms are filled out. A single “no” checked next to “back pain” on a rushed intake can become an exhibit in deposition. Clients are encouraged to slow down and be accurate. If forms list “prior injuries,” we include relevant conditions with dates and outcomes. Transparency early reduces fireworks later.

Defense lawyers will press on every prior complaint. The goal in preparation is not scripting, it is clarity. Clients practice explaining the difference between manageable and disabling. They learn to answer in ranges, not absolutes. If you say you never had pain before, the defense will find the one chart note that mentions muscle strain from shoveling snow three years ago, and they will use it to impeach. It is better to say, “I had occasional soreness that resolved with rest. I did not miss work for it. After the crash, the pain became daily, radiated to my foot, and I needed injections to function.”

Clients should also be ready for questions about life choices after the crash. Insurance attorneys sometimes pounce on a photo of a family hike to argue that the injuries are exaggerated. We put context around those moments. A two-mile walk on flat ground with breaks is not the same as a return to pre-crash activity. Many clients push themselves to reclaim normalcy and pay for it with a pain spike that night. Living your life does not mean you are uninjured.

Valuation is part art, part arithmetic. The numbers include past medical bills, anticipated future care, lost wages, and reduced earning capacity if relevant. The art lies in connecting those numbers to the aggravation, not the entire condition. Future care matters more in these cases, because flare-ups may continue. If injections control the pain but wear off every six months, we price that out for a realistic horizon. If surgery was already advised before the crash but became unavoidable after, we parse the portion fairly attributable to the collision.

Defense teams argue that only temporary exacerbation occurred. We answer with duration of symptoms, objective findings, failed conservative care, and treating physician opinions. Where possible, we tie function to dollars: overtime lost because you can no longer lift fifty pounds, opportunities missed because neck rotation with pain makes commercial driving unsafe, or the cost of hiring help for tasks you used to perform at home.

Demand packages in aggravation cases do not try to hide the past. They lean into it. A clean, chronological narrative builds credibility. We include a short “before” section with selected prior records, followed by a “since the crash” section with clear milestones. We add selected images or illustrations showing the relevant anatomy. We explain why the new symptoms fit the new findings or, if imaging is unchanged, why clinical worsening still matters.

Numbers should have reasons. If we ask for a particular figure in general damages, we tie it to duration, intensity, and life impact, not to a multiplier formula that treats human suffering like a spreadsheet. Adjusters see too many generic letters. They pay attention when the claim reads like a real life.

Sometimes the gap between what the insurer will pay and what is fair remains wide. Trials in aggravation cases require tight, disciplined storytelling. Jurors need to understand three things by the end: what was there before, what changed, and why the change matters. We use plain language. Instead of “cervical spondylosis,” we say “age-related wear that never bothered her until the crash.” Instead of “radiculopathy,” we explain nerve irritation that causes shocks into the hand and makes typing miserable after twenty minutes.

Cross-examining the defense medical expert is often about common ground. Many will agree that imaging does not correlate perfectly with pain, that symptoms can flare after trauma even with degenerative baselines, and that patients can have objective exam findings without dramatic MRI changes. From there, we highlight the conservative progression of care, the failed attempts at relief, and the absence of similar problems before. We do not ask jurors to ignore the past. We ask them to measure the change.

Clients often ask what they can do, early on, to avoid misunderstandings. A short, practical framework helps.

These steps do not manufacture a case. They protect an honest one from easy attacks.

Some scenarios test even seasoned lawyers. One is the client who planned a surgery before the crash and had it afterward. We need the surgeon’s opinion on whether the collision accelerated the timeline or increased the complexity. Another is the long gap between crash and symptom spike. If, for instance, shoulder pain surges three months later, we examine whether altered biomechanics or delayed recognition fits the medical literature. We look for contemporaneous notes that show an evolving pattern rather than a sudden, convenient claim.

Then there are the cases where the crash is minor but the outcome is severe. Defense will argue impossibility. Experience teaches that vehicle damage does not perfectly predict injury severity, but we must be careful. We dig into occupant kinematics, seat position, pre-tensioners, and bracing reflexes. We consider whether a low delta-V clip on the bumper created a different internal motion due to angle and seat geometry. If that analysis does not support causation, we say so and pivot to a fair resolution, even if that means advising the client that trial risk is too high.

Aggravation cases carry emotional weight. People who had learned to live with a manageable condition feel betrayed by their bodies when a crash pushes them backward. They worry that jurors will judge them for not being “perfect” before. I make space to talk about that. We discuss how to testify without sounding defensive. We practice owning the past and then focusing on the present challenges. The goal is authenticity. Jurors respect people who tell the truth about their bodies and their limits.

Doctors sometimes feel pressured in these cases. I remind clients that doctors are there to treat, not to advocate. If a treating physician will not support causation, we do not try to twist arms. We seek second opinions where appropriate and let the medicine, not the desire for a claim, lead the way.

On paper, the rules about aggravation are simple. In practice, cases with pre-existing conditions are fragile. A missed record can undermine causation. A sloppy description at urgent care can haunt the claim. An expert who talks over jurors can lose them. A car accident lawyer becomes the steward of details. We build the before-and-after with care, we keep the story consistent across months of treatment, and we know when to push and when to compromise.

Most of all, we protect the core idea that the law has long recognized: vulnerability does not cancel accountability. If a negligent driver turns a manageable condition into a disabling one, the change deserves compensation. The job is to show that change with evidence and with respect for the truth.

Fairness here does not mean pretending away the past. It means paying for what the crash changed. Some clients leave with settlements that fund ongoing care and restore financial stability. Others accept modest resolutions that reflect temporary flare-ups. The throughline is careful proof. When the records align, the timeline makes sense, and the medical opinions are grounded, insurers move. When they do not, jurors can and do recognize the difference between a body that was aging and a body that was injured.

If you are navigating this path, bring every relevant record, even the ones that feel inconvenient. Be honest about prior pain. Track your present limits. Ask your providers to document functional changes. And if you work with a lawyer, choose one who can translate medical nuance into plain English and who treats your history with the respect it deserves.