How Do Pre-Existing Conditions Affect Injury Claims?
If you've been injured at work or in an accident caused by someone else, you might wonder how a pre-existing condition could impact your personal injury claim. Many people deal with prior injuries, chronic illnesses, or other medical conditions before suffering a new injury.
However, when it comes to personal injury and workers' compensation claims, insurance companies often use pre-existing conditions to try to minimize or deny payouts. Understanding how pre-existing conditions affect personal injury claims is important for anyone seeking compensation.
That’s why it’s wise to seek guidance from Stiberth, Scarlati & Boudreau, LLC in Elgin, Illinois. We can break down key considerations, challenges you might face, and how to strengthen your case. Read on to learn more.
What Is a Pre-Existing Condition?
A pre-existing condition is any medical issue that existed before the accident or injury that led to your claim. These conditions can vary widely and include:
Chronic back pain or herniated discs
Arthritis or joint degeneration
Previous fractures or surgeries
Heart conditions or diabetes
Prior concussions or traumatic brain injuries
Asthma or other respiratory issues
Even if you were living with a pre-existing condition without much trouble, a new accident can make it worse. This is a key factor in many injury claims.
The "Eggshell Plaintiff" Rule
An important legal principle regarding pre-existing conditions is the "eggshell plaintiff" rule. This rule states that an at-fault party must take the injured person as they are. If you have a condition that makes you more susceptible to injury, the at-fault party is still responsible for the harm they cause — even if a healthier person wouldn’t have been as badly hurt.
For example, if you have a degenerative disc disease and a car accident causes a severe spinal injury, the defendant can’t argue that you wouldn’t have been as injured if your spine had been in perfect shape. They’re still liable for the harm they caused.
This rule is particularly important because it protects individuals who may have underlying health conditions from being unfairly denied compensation simply because of their medical history. Courts generally recognize that each individual’s unique health profile can influence the extent of injuries suffered in an accident.
How Insurance Companies Use Pre-Existing Conditions Against You
Insurance companies often look for ways to minimize payouts, and pre-existing conditions give them an opportunity to argue against your personal injury claim. Some tactics they may use include:
Blaming the injury on the pre-existing condition: They might argue that your pain or symptoms existed before the accident and weren’t caused by the recent injury.
Claiming the accident didn’t make the condition worse: Even if your condition has clearly worsened, they may insist that the accident had no impact.
Using medical records against you: Insurers will comb through your past medical history to find anything that could weaken your claim.
Offering a lower settlement: If they think your condition gives them leverage, they might make a lowball offer, hoping you’ll accept less than you deserve.
Delaying the claims process: Some insurers may intentionally slow down the claims process in hopes that you’ll become frustrated and accept a smaller settlement.
These tactics can make it much harder for injured individuals to get fair compensation. Insurance adjusters may try to twist medical records or use statements out of context to argue that a new injury is just a continuation of an old problem. That’s why it's crucial to present clear, thorough evidence showing how your condition has worsened as a direct result of the accident.
How to Prove Your Injury Worsened a Pre-Existing Condition
If you have a pre-existing condition, proving that your accident made it worse is key to your personal injury claim. The more evidence you have, the stronger your case will be. Here are some ways to support your claim:
Medical records showing changes: Comparing medical records from before and after the accident can demonstrate how your condition has worsened.
Doctor statements: A physician can provide expert opinions on how the accident aggravated your condition.
Diagnostic tests: MRIs, X-rays, and other tests can offer objective evidence of new or worsening injuries.
Pain journals: Keeping a record of your symptoms can help show how your condition has changed over time.
Witness statements: Testimony from family, friends, or coworkers about changes in your abilities can be valuable.
Consistent treatment history: Showing that you have followed through with medical appointments and treatment plans can support your case.
Providing thorough and well-documented evidence is critical in establishing the connection between your accident and the worsening of your condition. Insurance companies will often try to argue that your symptoms are unrelated or that your condition would have worsened naturally over time.
Workers' Compensation and Pre-Existing Conditions
Workers' compensation laws in Illinois generally cover injuries that occur on the job, but having a pre-existing condition can make things more complicated. Employers and insurers may try to deny claims by arguing that your symptoms are due to your pre-existing condition rather than a work-related injury.
What You Need to Prove in a Workers' Compensation Claim
To get workers' compensation benefits, you must show that your job duties made your condition worse. Important factors include:
A clear link between your job and the worsening condition: If repetitive motions or a workplace accident aggravated your condition, that should be documented.
Medical evidence: Your doctor should confirm that your job contributed to your increased symptoms or new injuries.
Timely reporting: Reporting your injury as soon as possible can help prevent the employer or insurer from arguing that something else caused your symptoms.
Consistent work history: If you’ve been performing the same job duties for years without issue and suddenly experience worsening symptoms, this can support your claim.
Illinois law generally favors workers when it comes to pre-existing conditions. If your job worsens a condition — even if you had that condition before — you may still be entitled to benefits.
Pre-Existing Conditions in Personal Injury Claims
Personal injury claims, such as those from car accidents, slip-and-fall incidents, or medical malpractice, often involve disputes over pre-existing conditions. Defendants and insurers may try to shift blame to your prior health issues instead of taking responsibility for your current injuries.
What You Can Do to Strengthen Your Personal Injury Claim
If you’re filing a personal injury claim and have a pre-existing condition, taking the right steps can make a difference. Consider the following:
Be honest about your medical history: Trying to hide a pre-existing condition can hurt your credibility if it comes out later.
Follow all medical advice: Showing that you’re actively treating your injury can reinforce your claim.
Work with a knowledgeable attorney: Legal guidance can help counter insurance company tactics and build a strong case.
Keep detailed records: Documenting your medical appointments, treatments, and symptoms can be crucial to proving your case.
Taking these steps not only helps strengthen your claim but also prevents insurance companies from using gaps or inconsistencies against you. The more organized and thorough you are in presenting your case, the harder it will be for insurers to dispute your injuries.
Contact Us Today
Pre-existing conditions can make injury claims more difficult, but they don’t automatically prevent you from getting compensation. If you’re dealing with a personal injury claim, proving that your accident worsened your condition is key. Our firm serves Chicago, Illinois, and throughout Cook and the Collar counties. If you have questions about your case, speak with an experienced attorney at Stiberth, Scarlati & Boudreau, LLC.