Having a preexisting condition doesn’t automatically mean victims cannot recover compensation. However, it does affect how insurance companies view claims. In California, the at-fault party is still responsible for all additional harm or aggravation of existing health conditions they cause. If you’re filing a personal injury claim with a preexisting condition, it helps to know what pushback to expect.
Insurance adjusters will do a deep dive into your medical history, and they’ll most likely try to diminish your claim because ”your symptoms are only related to your condition, not the accident”. Accident victims sometimes hesitate to disclose past medical issues because they worry that it will harm their settlement. Fortunately, claimants with existing injuries are protected under California law and can still seek compensation.
What Is a Preexisting Condition in Personal Injury Claims?
A preexisting condition is any physical or mental health condition that the victim was dealing with before the accident they’re claiming for. Typical examples are broken bones, old sports injuries, arthritis, depression, bipolar disorder, herniated discs, and chronic back pain. It doesn’t matter whether the condition was healed, being managed, or dormant at the time of the accident. If your symptoms change or worsen after an accident, the at-fault party may be held responsible.
Insurance adjusters carefully review medical histories. They will look for any previous complaints that resemble your current injuries. They conduct thorough checks to shift blame away from the at-fault party and compensate you for less. For instance, say you had a minor knee sprain years ago, but the accident you’re currently claiming for caused a severe joint injury, the insurer will try to prove that it’s just an old issue flaring up. Do make a point of telling your attorney about any old injuries or diagnoses so they’re ready for the adjusters and can immediately respond when the insurer mentions them.
How Are Plaintiffs Who Have Preexisting Conditions Protected?
In California, injured victims are protected through specific legal doctrines. Under CACI No. 3928: Unusually Susceptible Plaintiff, also referred to as the eggshell plaintiff rule, defendants are fully liable for the harm they cause, even if the injured person was more fragile than average. In other words, they can’t argue, “Someone healthier wouldn’t have been hurt this badly,” and use that as an excuse to pay less.
The eggshell plaintiff rule applies to CACI No. 3927: Aggravation of Preexisting Condition or Disability, which protects victims with prior health conditions. Naturally, you can’t recover compensation for the original condition, but you can and must pursue full compensation for the impact the accident had on your condition. For example, if you had chronic back pain before the crash but now need back surgery and can’t work like you used to, you can pursue compensation for that change in your condition.
Can My Preexisting Condition Be Used Against Me in a Personal Injury Claim?
Insurance adjusters are trained to minimize payouts and protect their company’s bottom line. When an adjuster discovers your prior condition, they will request authorization to access your lifelong medical records. Be prepared for them to dig through your history and blame almost anything, even long‑forgotten aches and pains, for your current symptoms. It’s not unheard of for insurers to link minor issues like a twisted ankle from high school to serious chronic pain after an accident caused by their policyholder.
Another way that insurers shift blame to victims is by finding any gaps in treatment before or after the accident. For example, if you stopped visiting your physical therapist because you were managing your condition at home, you can expect the adjuster to claim that your condition deteriorated naturally because you weren’t going to therapy. Defense attorneys will hunt for any lack of documentation to argue that you’re either hiding something, that your symptoms are exaggerated, or that they’re completely unrelated to the accident.
Worried your medical history could impact compensation? Get experienced guidance today.
Request a Free ConsultationHow Do I Prove That My Preexisting Condition Was Aggravated by an Accident?
Proving that an accident aggravated a preexisting condition begins by demonstrating the difference between how you were doing before the crash and how you’re doing now. Getting prompt medical care after the accident is vital because it proves sudden changes in your condition. Your attorney can work with medical experts to compare your earlier records and scans with the most recent post‑accident findings.
After that first visit, follow your doctor’s treatment plan and keep your follow‑up appointments. Missed visits make it easier for the defense to argue that your symptoms aren’t serious or that you’re not doing your part to recover. It also helps to keep a simple journal. Each day, write down your pain level, what you struggled with (for example, lifting groceries, sitting at your desk, or waking in the night), and any changes to your medication, such as increased doses or new prescriptions
Ask colleagues, family members, and close friends for statements confirming the decline in your functional abilities. Building a strong case depends on thorough evidence and a timeline of your health from before the accident and throughout your recovery. We work with medical experts who can provide objective testimony about your condition and how it has changed following the accident.
What Would Happen if I Didn’t Disclose My Preexisting Condition?
Hiding a preexisting condition is one of the worst mistakes you can make in a personal injury case. Defense attorneys and insurers will uncover your full health history during their discovery. Should they find a condition you never mentioned, your credibility will tank, and it becomes almost impossible to win back the judge’s or jury’s trust. Be open and honest with your attorney from day one so they can address any past issues head-on and protect your credibility.
Filing a claim with a complex medical history requires knowledge of the legal system and assertive negotiation skills. If you focus exclusively on your bills, you ignore the profound impact on your long-term health. At HHJ Trial Attorneys we know exactly how to approach a case to secure the maximum compensation for our clients. If you’ve been injured and you have a preexisting condition, contact HHJ Trial Attorneys to speak to a personal injury expert.
