Can You File a Personal Injury Claim if You Had a Pre-Existing Condition?

Before the car accident, you experienced occasional back pain. Now, the pain occurs more often, you need physical therapy, and you’ve missed work. Can you file a personal injury claim if you already had a medical condition?

In California, a claim is not automatically barred by a pre-existing condition. Typically, you will not receive compensation for the condition as it existed before the accident. However, if the condition was worsened by the wrongful actions of another party, you may be entitled to claim damages for the additional harm.

This distinction appears in California Civil Jury Instruction 3927. The issue is “What changed due to the new incident?” It’s important to consider your health, treatment, and activities before and after your accident when answering that question.

What Is a Pre-Existing Condition?

A pre-existing condition is a physical or mental condition that existed before the incident for which you’re making a claim. This may be a previous injury, recurring headaches or a medical condition for which you were already receiving treatment. Pre-existing conditions can affect people in different ways.

A person can have an ongoing condition that requires regular care. Another might have had an old injury that rarely caused pain but became a problem after the new accident. A diagnosis alone does not show how a condition affected your daily life.

You may have been working, exercising, and doing normal activities prior to the incident, though you might have experienced symptoms at times. If those activities became more difficult after the incident, the change should be documented.

Does an Old Injury Disqualify You From Making a Claim?

No. A previous injury will not automatically exclude you from making a claim. The question is whether the new incident caused an additional injury or aggravated an existing condition. Suppose, for example, that someone hurt their shoulder a few years ago.

Before the crash, they could carry groceries and run errands without frequent pain. After the crash, they may have trouble moving and need more treatment. Their medical history matters, but it does not show how the crash affected them.

California Civil Jury Instruction 3927 says that someone cannot receive compensation for a physical or emotional condition they already had before the defendant’s actions. If the defendant’s actions made that condition worse, they may receive compensation for the additional harm. The claim, therefore, requires proof that the condition got worse because of those actions. You do not need to prove that you had never been injured before.

What Does It Mean to Aggravate a Pre-Existing Condition?

Aggravation: a condition, which became worse because of an incident. This worsening can mean symptoms that happen more often or more intensely, the need for greater treatment or new limitations on activities. Individuals with an history of occasional low back pain may develop daily low back pain following an injury.

Someone with a previous injury may also need to return for treatment after an accident. The above are examples, but not all incident symptoms will be caused by them. Changes may need to be evaluated by a medical professional to determine if the changes are related to the accident. The facts are important in each case.

What if You Were More Vulnerable to Injury?

Some people may be more likely to be seriously hurt because of a pre-existing condition. An accident that causes only a minor injury to one person could cause a more serious injury to someone with an existing spine or joint condition. California’s civil jury instructions also address claims involving people who are more likely to be hurt.

The fact that someone else might have suffered less harm does not automatically excuse the person responsible for the injury. The cause and extent of the injury still need to be determined. courts.ca.gov. You’re not required to have been healthy at all times.

Why is Your Medical History Important?

When you have a pre-existing condition, medical records can help establish a starting point. They could show the symptoms you described, the treatment you received and the frequency of care prior to the accident. Records made after an incident may then demonstrate any change in your ability to function, treatment or symptoms.

For instance, they could record a new complaint, a referral for physical therapy, or a change in what activities you are able to perform. Earlier records do not necessarily support only one side of a claim. They can demonstrate that you had been treated regularly prior to the accident or that you had not needed treatment for a while. Regardless, a detailed and accurate history helps give your healthcare providers and attorney a better picture.

Do You Need to Mention the Previous Injury To Your Doctor?

Yes. Let your healthcare provider know if you have any relevant previous injuries, symptoms, or treatment. Describe the differences between the period before the accident and the period since.

You might explain that you used to have mild pain twice a month but now experience it every day. Or you may explain that you had an old injury that wasn’t bothering you until now. Be specific, but don’t guess at the medical cause of your symptoms. Explain what happened and what you are feeling.

A healthcare professional can evaluate your condition and recommend appropriate treatment. Accurate information also helps prevent confusion later. You may have both an old condition and a new aggravation of that condition.

How Can You Document What Changed?

A simple timeline can help you track the period before and after the incident. There is no need for cumbersome paperwork to start. Write down the date of the accident, the date you first noticed the symptoms, and how they affected your routine. The following information may be helpful:

• Medical records prior to the accident: Diagnoses, appointments, treatment plans and previous symptoms
• Medical records following the accident: Examinations, referrals, treatments, follow-up care.
• Work records: Missed shifts, reduced hours, or changed duties
• Expenses: Bills and receipts for treatment related to the alleged worsening
• Daily activity notes: Specific tasks that you used to be able to do, but can’t or don’t do anymore.

Keep your descriptions factual. “I could carry my groceries upstairs before the accident, but now I need help” is more useful than a broad statement that you can no longer do anything.

If you are unsure which records matter, a San Diego personal injury lawyer can help review them.

What if Your Symptoms Did NOT Worsen Immediately?

Some people do not realize the full impact of an accident at the scene. Symptoms can become more apparent when they get back to work or return to their normal routine.

If you notice a change, seek appropriate medical care and let the doctor know when symptoms first started. Inform your provider of the incident as well as the previous condition. If you provide an accurate account promptly, they can get a clearer picture of your health and record your symptoms.

A delay alone does not determine whether an accident caused your symptoms. It can, however, raise additional questions about the timeline. This is another reason to document changes as accurately as possible.

If the Insurance Company Claims your Preexisting Injury, What Happens?

An insurance company may argue that your current symptoms are caused by the previous condition, not the accident. It may also ask whether you would have needed the same treatment without the accident. The answer will be based on evidence.

Your records may indicate that your symptoms got worse after the incident and became more severe than before. This may show up as an increase in treatment or new difficulty working. Other times, the medical history might not be as clear and will need to be examined more carefully. Don’t let the fact that a diagnosis was made earlier be the end of the discussion.

The key question is whether the accident caused additional harm and what evidence supports that conclusion.

How is Compensation Regarded?

If another party’s wrongful actions made your condition worse, losses related to the aggravation could be included in your claim. These may include additional medical costs, lost income, and the impact of increased pain on your life, depending on the situation. The emphasis is on the consequences of the new incident.

Assume that you used to attend a medical appointment once a month prior to an accident. Those previously scheduled appointments are not new expenses associated with the accident. If the accident resulted in further treatment because your condition worsened, then a different question arises.

There is no single measure that applies to every case. The degree of the worsening, the evidence available and other facts all influence the assessment. Our guide, “Personal Injury Damages After an Auto Accident,” provides a general overview of the various types of damages that could be involved in a personal injury case.

Does a Personal Injury Lawsuit Have a Time Limit?

In most personal injury cases in California, the statute of limitations is two years from the day of the injury. Different deadlines can apply in some cases, including claims against a government agency.

The general rule is covered in the California Courts’ personal injury guide. Do not assume that having an existing medical condition gives you more time. If the deadline is unclear, ask for guidance as soon as possible.

Be Sure to Consult With a San Diego Personal Injury Lawyer.

If you’ve suffered an injury before, don’t assume that an accident cannot make it worse. Your medical history matters, but so do your symptoms, your treatment and what you can do after the incident.

If you were injured in San Diego and think an accident made a pre-existing condition worse, our personal injury lawyers can review the details of your case, help gather evidence of how your condition changed and explain your options for filing a claim.