Dealing with a personal injury claim is stressful enough, but it can feel even more complicated if you have a pre-existing medical condition. You might worry that an old injury or chronic illness will give the insurance company an excuse to deny or reduce your claim. The good news for Texans is that having a pre-existing condition does not bar you from recovery. In fact, Texas law protects accident victims even if they were already hurt or vulnerable. In this article, we’ll explain in plain language how pre-existing conditions and personal injury claims intersect, especially under Texas law. If you or a loved one in Texas has been injured and you’re concerned about your medical history affecting your case, the Adley Law Firm offers free consultations and works on a contingency fee basis, so you won’t pay a dime unless we win your case. Don’t let worry about a pre-existing condition stop you from seeking the compensation you deserve, help is available.
What Is a Pre-Existing Condition in an Injury Claim?
A pre-existing condition in the context of a personal injury claim is any health issue you had before the accident occurred. It could be a chronic illness (like arthritis or asthma), a previous injury (like an old back or knee injury), or even a prior surgery. For example, if you injured your neck in a car accident five years ago, that neck injury would be considered a pre-existing condition if you’re hurt in another crash today. Almost everyone has some medical history, and being in an accident can aggravate old problems or create new ones on top of what you already had. It’s important to understand that having a pre-existing condition is common and perfectly okay – it just means your claim may need careful handling to show what new damage the accident caused.
How Pre-Existing Conditions Can Complicate a Claim
Pre-existing conditions can introduce a few extra hurdles when you file a personal injury claim. Insurance companies and at-fault parties often seize on your medical history to try to limit their payout. Here are some common challenges you might face if you have a prior injury or condition:
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Questioning Causation (What Really Caused Your Injury?): One big challenge is proving that the accident – not your pre-existing condition – caused your current injuries. Insurers might argue that your pain or symptoms were already there before the accident. For instance, if you had back pain before a collision, they may claim the car crash didn’t cause your back problems. This makes it crucial to have clear medical evidence and doctor’s opinions showing how the accident either caused a new injury or worsened an existing one. You’ll need to connect the dots between the incident and your condition after the accident.
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Accident Aggravation vs. Old Injury: It’s very common for an accident to aggravate (flare up or worsen) a pre-existing injury. In these cases, the challenge is separating the new harm from your old problem. The insurance company might say, “Your knee was already bad, so we shouldn’t pay much.” In reality, if the accident made your condition worse, you deserve compensation for that aggravation. The tricky part is demonstrating the extent of new damage caused by the accident as opposed to the pain or limitations you already had. This often requires detailed medical records or even expert testimony to explain the difference.
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Proving Your Damages: Even after you establish that the accident made things worse, you must prove the extent of your damages (like medical bills, pain and suffering, lost work time) that are linked to the accident. When a pre-existing condition is involved, this means showing what level of health and ability you had before the accident versus after. This can be done with past and current medical records, doctor statements, and other evidence. It’s a meticulous process, but it’s essential so that you claim only the damages caused by the accident. For example, if you had some back pain before but now can’t work due to a back injury after the crash, the claim should focus on that new level of disability and its costs.
Example – Car Accident Aggravates an Old Back Injury: Imagine you’ve been living with chronic back pain from a years-old work injury. One day, you get rear-ended on a Houston highway, and afterwards your back pain goes from occasional and manageable to severe and constant. The insurance adjuster might try to argue that your pain was pre-existing and not their driver’s fault. However, with the help of a medical expert’s evaluation, you could show that the force of the car accident caused new damage to your spine or muscles, making your condition much worse. A skilled attorney would gather your prior medical records and new MRI scans or doctor reports to highlight the differences. By clearly documenting how the crash aggravated your pre-existing back injury, you put yourself in a strong position to claim the extra treatment costs, pain, and other losses caused by the accident.
Example – Slip-and-Fall Worsens a Prior Knee Issue: Consider a scenario where you have a history of knee problems (say, an old sports injury), but it’s been under control. Then, you slip and fall in a store due to a wet floor, injuring that same knee. Suddenly you need surgery that you wouldn’t have needed but for the fall. The store’s insurance might insist your knee was already bad and that they shouldn’t pay for an issue you had before. This is where detailed documentation saves the day. By comparing your medical records from before and after the fall, your lawyer can point out, for example, that before the fall you could walk and climb stairs fine, but after the fall you suffered a torn ligament or increased instability that required new medical intervention. With biomechanical analysis or an orthopedic expert’s report, you can demonstrate that the slip-and-fall accident directly caused new damage to your knee or significantly worsened it. This kind of evidence makes it much harder for the insurer to brush off your claim as “just an old injury.”
Texas Law Protects Victims with Pre-Existing Conditions (The Eggshell Skull Rule)
You might be wondering how Texas law treats situations like the examples above. Fortunately, Texas follows a principle known as the “eggshell skull” rule (or eggshell plaintiff rule). In plain terms, this rule says that a negligent person must take the victim as they find them. In other words, if someone else’s negligence injures you, they are responsible for all the harm they cause – even if you were more fragile or prone to injury because of a pre-existing condition. It doesn’t matter if a healthier person might not have been as seriously hurt; what matters is the actual outcome for you. The at-fault party cannot escape liability just because you had a prior issue that made the consequences of the accident more severe.
However, it’s important to clarify what this rule does and doesn’t mean. It doesn’t mean you get compensation for the part of your injury that existed before the accident. It does mean you can recover for the additional injury or worsened condition that the accident caused. For example, if your bad knee was at a pain level 2 before a fall and now it’s a 9 with a torn ligament, the negligent party is liable for that increase in pain and the new tear. The eggshell skull rule prevents the defense from saying “not our fault” simply because you weren’t in perfect health to begin with. Texas courts uphold this rule to protect injured people, so you have the right to pursue fair compensation even if your health history made your outcome worse than average.
How to Strengthen Your Injury Claim When You Have a Pre-Existing Condition
Facing these challenges may seem daunting, but there are several strategies to maximize your chances of success. Here are some steps you can take (with your attorney) to fortify your personal injury claim despite a pre-existing condition:
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Be Upfront About Your Medical History: Honesty is truly the best policy here. Make sure you tell your attorney about any past injuries or chronic conditions as soon as you start your case. Hiding a pre-existing condition will only hurt your claim in the long run, because the insurance company can access your medical records and will find out. When your lawyer knows your full health background, they can plan ahead to address those issues. For example, if your attorney is aware you had prior back surgery, they can gather records and possibly a letter from your doctor about your recovery before the new accident. Full disclosure allows your legal team to counter the insurance company’s arguments before they even arise.
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Gather Strong Medical Evidence: Detailed documentation is your best friend when dealing with an aggravated injury. Work with your doctors to document everything about your accident-related injury and how it differs from or worsens your pre-existing condition. This might include medical records, X-rays or MRI scans, doctor’s notes, and expert reports. If possible, get a clear statement from a medical professional about how the accident affected your pre-existing condition – for instance, a doctor noting that “the trauma from the car accident caused a herniation at a previously stable spinal disc.” Such evidence makes it much easier to prove what injuries came from the accident versus what was already there. Keeping a pain journal or therapy log can also help illustrate the change in your condition after the accident.
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Follow Your Treatment Plan: After an accident, be sure to follow all medical advice and complete your treatments or therapy. Not only is this important for your health, but it also shows a clear cause-and-effect: you were injured in the accident and needed treatment because of it. Skipping appointments or not following through can give insurers an opening to argue that your current issues aren’t due to the accident or aren’t as serious as you claim. Consistent treatment builds a timeline of care that connects the accident to the worsening of your condition.
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Consider Expert Testimony: In complicated cases, expert witnesses can make a big difference. Your attorney might work with medical experts (such as orthopedic surgeons, neurologists, or rehabilitation specialists) who can review your records and testify about how the accident impacted your health. An expert can explain, for example, that an older injury was stable or asymptomatic before, but the trauma from the incident caused new complications. They can also give an opinion on how much of your current pain is attributable to the accident. This kind of professional analysis adds credibility to your claim and can be very persuasive to insurance adjusters, judges, or juries.
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Hire an Experienced Personal Injury Attorney: Perhaps most importantly, work with a skilled personal injury lawyer who has dealt with pre-existing condition issues before. An experienced attorney will know how to counter insurance company tactics and present your case in the best light. They can navigate the legal complexities, whether it’s gathering the right evidence, applying the eggshell skull rule to your advantage, or arguing your case in court if needed. At The Adley Law Firm, for example, our Houston personal injury attorneys have helped clients all over Texas recover compensation even when the clients had prior injuries. Your lawyer can handle the heavy lifting – negotiating with insurers, consulting experts, and, if necessary, filing a lawsuit – so that you can focus on healing. And remember, when you choose a firm that works on a contingency fee, you don’t pay anything upfront or out-of-pocket – the legal fees come out of the settlement or verdict only if you win.
Contact The Adley Law Firm for Help Today
Don’t let a pre-existing condition stop you from seeking justice. If you were injured in an accident in Houston or anywhere in Texas, you have rights – and The Adley Law Firm is here to uphold them. Our dedicated team has extensive experience handling cases with pre-existing medical issues, and we know how to prove the difference between an old ailment and a new injury. We’re proud to serve clients throughout Texas, and our mission is to fight for the full compensation you deserve. Call us today for a free consultation. We will review your case at no cost, answer your questions, and explain your legal options. Because we work on a contingency fee basis, you pay nothing unless we win your case. It costs you nothing to get honest legal advice about your situation.
Your health history is part of your story, but it does not define the outcome of your personal injury claim. With the right legal help, you can turn a challenging case into a successful one. Contact The Adley Law Firm today to discuss how we can help you navigate the claims process and secure the compensation you need to move forward. Let us deal with the insurance companies and legal complexities while you focus on healing. We’re ready to stand by your side and fight for you – reach out now and take the first step toward justice and recovery.
