Car crash injuries rarely land on a blank slate. Most adults have some medical history, from a stiff lower back after yard work to a decades-old knee surgery that still flares in cold weather. When a car accident crops up in that context, insurers often pounce on the pre-existing issue to argue that your pain isn’t new, or that the crash didn’t make it worse. That does not end the case. It does change how a personal injury lawyer builds the proof, how negotiations unfold, and sometimes how a jury evaluates damages.
I have seen relatively minor collisions trigger serious consequences for someone with a fragile spine, and hard‑hitting wrecks that left a previously healthy person with similar long‑term outcomes. The law makes room for both truths. The goal is not to erase your history, but to separate what the crash caused or aggravated from what existed before, and to do it with credible documentation.
The eggshell plaintiff rule and why it matters
The starting point is a bedrock principle known in most states as the eggshell plaintiff rule. Defendants take victims as they find them. If a negligent driver rear‑ends someone with a prior neck condition and that person suffers a larger harm than a typical person would, the defendant is still responsible for the full extent of the injuries caused by the crash. The law does not discount your claim because your body was vulnerable.
Insurers know this, so they do not argue that a fragile plaintiff cannot recover. Instead, they focus on causation and apportionment. They will say that most of what you are feeling today is simply the natural course of your pre‑existing condition. They mine your medical records for any mention of prior pain, no matter how mild or sporadic, to claim the crash added little. That is where evidence, chronology, and careful medical testimony carry the day.
What counts as a pre-existing condition in a car accident case
Pre‑existing condition simply means a health issue that existed before the crash. It does not need to be severe, and it does not need to be formally diagnosed. Common examples in auto cases include degenerative disc disease, prior whiplash, herniated discs, osteoarthritis, old fractures or surgeries, autoimmune conditions, migraine disorders, vertigo, depression or anxiety, and prior concussions.
Degenerative changes, particularly in the spine, show up on imaging in most middle‑aged adults and even many younger people. Defense lawyers like to hold up an MRI and point to age‑related wear as if it explains everything. The presence of degenerative disc disease doesn’t mean your neck pain was inevitable or that the crash is off the hook. The question is whether the collision lit up an otherwise quiet condition, took manageable symptoms and made them chronic, or caused a new structural injury layered on top of degeneration.
Aggravation versus new injury
Aggravation means a pre‑existing condition was made worse by the crash. New injury means the crash caused a separate harm that did not exist before. In practice, many cases involve both. A client with a previously tolerable L4‑L5 disc bulge may suffer an acute herniation at L5‑S1 and also experience increased pain from the old bulge because the entire biomechanical system gets stressed.
Why that distinction matters: damages. If you had prior neck pain rated at a two out of ten, flaring a few times a year, and after the crash you have daily six‑out‑of‑ten pain with radiating numbness, your auto accident attorney will frame the damages around the delta, the change brought by the collision. The prior two points don’t disappear. They set the baseline. The crash is accountable for the move from two to six and for the functional losses that flow from that change.
How medical evidence carries the burden
The strongest car accident claims involving pre‑existing conditions have a tight medical story. That story usually includes a before‑and‑after comparison, objective findings that line up with new symptoms, and treating providers willing to explain causation with clear language.
Key medical building blocks often include:
- A short, honest history of prior symptoms. Vague or evasive answers about your past care undermine credibility. If you had ten physical therapy sessions for your back last year, say so. Then describe how different the pain is now. Imaging and diagnostics. New MRIs or CT scans taken after the crash can show changed findings. A radiologist can compare measurements, like the size of a disc herniation, or note fresh edema or annular tears. Not every meaningful injury lights up on scans. That is where nerve conduction studies, positive Spurling’s or straight‑leg raise tests, and consistent exam findings matter. Temporal correlation. Acute onset after a crash, especially within 24 to 72 hours, supports causation. Delayed symptoms can still be consistent with soft tissue or brain injury, but the timing requires a more careful explanation from your providers. Functional changes. Concrete shifts in what you can do weigh heavily. If you moved furniture on weekends before the crash and now can’t carry groceries without numbness, that contrast helps tie the aggravation to the collision. The surgeon’s or specialist’s opinion. A spine surgeon, neurologist, or physiatrist can lay out how a specific mechanism of injury from a rear‑end impact would aggravate your condition. Courts value opinions grounded in clinical notes, imaging, and the mechanics of the crash.
Good documentation is not a data dump. Your car accident lawyer will work with treating doctors to nail down the differential diagnosis and to use plain words. Phrases like aggravated a pre‑existing cervical degenerative condition or new traumatic herniation superimposed on degenerative changes are common, but they need meat on the bones: what changed, why it matters, how it tracks with the collision.
The insurer’s playbook and how to counter it
Claims adjusters and defense lawyers use a predictable set of moves when a pre‑existing condition shows up. They request years of medical records, looking for any mention of similar complaints. They argue gaps in treatment mean the injury resolved. They assign minor property damage photos outsized significance, as if a small dent proves the physics could not injure you. They hire independent medical examiners who will say your current symptoms are the natural progression of degeneration rather than trauma‑induced aggravation.
The counter is not outrage. It is careful, consistent proof. Your car accident attorney will chart a timeline, sometimes down to the week, to show how your symptoms escalated after the crash and what efforts you made to get better. If you tried conservative care, followed home exercise plans, used injections before considering surgery, and documented all of it, the defense’s narrative weakens. If you went back to work despite pain because you needed the income, that shows motivation, not malingering.
Low‑property‑damage arguments can be blunted with biomechanics literature, but juries often understand intuitively that the human body doesn’t mirror the stiffness of steel. The bumper can bounce back while a neck with underlying degeneration suffers a significant insult. This is where a seasoned motor vehicle accident lawyer leans on both common sense and credible expert analysis.
When a pre-existing condition helps your case
It sounds counterintuitive, but some pre‑existing conditions can clarify causation. If you had years without treatment and clear documentation of high function, then a crash followed by immediate, consistent complaints and objective findings creates a sharp contrast. A clean baseline helps. Detailed pre‑injury records from a primary care physician or a prior specialist can show what your normal looked like. Defendants can’t have it both ways. If they comb your history, they also inherit the evidence that you were doing well before the crash.
There is another edge. Jurors often believe that people with long‑standing conditions work harder to get by. If you lived with manageable pain and still raised kids, worked construction, or cared for a parent, and the crash took that relative equilibrium away, your credibility increases, not decreases.
What not to hide
Do not minimize prior issues. Your auto injury lawyer would rather deal with the truth head‑on. Surprises in litigation are costly. Defense counsel will almost always find prior claims, worker’s comp files, or chiropractic records. Consistency matters more than perfection. If you forget a minor urgent care visit from five years ago, that is human. If you deny any history in the face of repeated documentation, your case takes a hit that no expert can fix.
Be precise. If you had headaches once a month before and now have them three times a week with light sensitivity, say that. If your knee locked occasionally before but now gives way on stairs, say that. Vague statements like my back has hurt forever invite a defense theme that nothing has changed.
Special issues with mild traumatic brain injury
Pre‑existing conditions complicate brain injury claims in unique ways. Prior concussions, ADHD, learning differences, depression, or sleep disorders can blur the clinical picture. After a crash, clients describe brain fog, word‑finding problems, irritability, and fatigue that sound like pre‑existing issues to a skeptical ear. Neuropsychological testing becomes central. A well‑conducted battery compares performance across domains and uses validity checks. If testing shows new deficits in processing speed or working memory relative to expected baselines, that weighs heavily.
Here, collateral sources help. Family members, coworkers, and supervisors can speak to specific before‑and‑after changes. A boss who saw you run a 30‑person team without a missed deadline for years has meaningful context when you suddenly make mistakes and need extra supervision. A personal injury lawyer will gather those voices early and weave them into the claim.
Surgery decisions in the shadow of degeneration
Surgeons face tough calls when imaging shows both degenerative disease and post‑crash findings. The question becomes whether surgery is reasonable and necessary due to the collision. Timing matters. If you tried therapy and injections, documented transient relief, and a surgeon explains how the mechanics of the injury destabilized a level or created symptomatic compression, surgery can be tied to the crash even with background degeneration.
Defense experts often say the surgery would have been necessary anyway due to the pre‑existing condition. The real‑world response is probability. Would the plaintiff likely have needed this operation in the next one to five years absent the crash? If the answer is probably not, that supports causation and damages. Even if a surgery might have been in your future, accelerating it by years has value. Pain now, time off work now, risk now, and the earlier start of a fusion’s adjacent segment disease all carry damages.
Wage loss and career trajectory
Pre‑existing conditions rarely impact only medical bills. They ripple through work. Imagine a warehouse employee with a well controlled back condition, lifting with good technique and no missed time for two years. After a collision, he can stand for an hour, but two hours sets off sciatica that sidelines him for the remainder of a shift. He moves to a lighter duty role at lower pay. The defense says the move reflects his pre‑existing back. Your car accident claim lawyer reframes the issue: employment records show full duty before, then restrictions and accommodations after, tied to new clinical notes and objective findings. That delta has a number, and it belongs in the demand.
For salaried professionals, the shift can be subtler. A marketing director misses travel opportunities, stalls on promotions, and loses bonuses because migraine frequency doubled after a crash. The file needs calendars, performance reviews, and supervisor testimony. A transportation accident lawyer will press for these details because salary history alone rarely captures the long tail of reduced opportunity.
The role of pre-accident lifestyle evidence
Juries respond to snapshots of life before the crash. Recreation, parenting, community work, and household responsibilities all show function. Photos of you hiking every weekend carry more weight when backed by gear receipts, park passes, and Strava logs. Coaching youth soccer, caring for a disabled spouse, or volunteering at a shelter reveals stamina and commitment. After a crash, when you can’t kneel to tie a kid’s cleats or stand through a three‑hour shift, those losses have dimension.
Lawyers sometimes call this the day‑in‑the‑life story. It is not fluff. It builds the baseline in concrete terms, which is where cases with pre‑existing conditions find traction.
Practical steps if you have a prior condition and just had a crash
- Be candid at the ER and with all follow‑ups about your medical history and the new changes you feel since the collision. Precise language on day one prevents later attacks on credibility. See your primary care physician early. They know your baseline and can document the contrast. Follow medical advice, do the home exercises, and keep appointments. Gaps in care are fertile ground for defense arguments. Keep a simple symptom and function journal for the first 90 days. Note what tasks you couldn’t do that you did easily before. Keep it factual and short. Talk to a personal injury lawyer promptly. Early guidance on records, diagnostic timing, and communication with insurers often doubles the quality of your file.
How lawyers apportion damages when the past complicates the present
Not every claim goes to trial. In negotiations, a car crash lawyer often assigns ranges to components of damages that reflect the uncertainty pre‑existing conditions create. Medical specials tied to new treatment are straightforward. The friction comes with future care and non‑economic damages. If your prior knee arthritis made stairs painful twice a week and now the pain is near daily with popping, a reasonable range accounts for the increase without pretending the past didn’t exist. The best defense to the insurer’s haircut is contemporaneous records and credible testimony.
When cases do try, https://pressadvantage.com/story/79317-new-knoxville-car-accident-attorney-firm-offers-free-consultations-and-no-fee-promise juries receive instructions on aggravation. They are told to award damages caused by the crash, including the worsening of pre‑existing conditions, but not to compensate for the portion of the condition that existed before unrelated to the crash. Good plaintiff’s lawyers embrace that instruction and help jurors understand the before and after with specific examples. The more concrete the comparison, the less room there is for speculation.
Independent medical exams and what to expect
Insurers frequently request an independent medical exam, better called a defense medical exam, especially where a prior condition exists. The doctor is chosen by the insurer and often testifies regularly for the defense. That doesn’t make the exam meaningless, but you should go in prepared. Be courteous, answer questions directly without volunteering long narratives, and avoid minimizing or exaggerating. If something hurts during a test, say so. Your auto injury attorney may provide a letter outlining scope and timing, and in some jurisdictions, may send a nurse observer or record the exam.
Afterward, the defense doctor will issue a report. They often emphasize degeneration and use language like at baseline or consistent with natural history. Your treating physician’s opinion usually carries more weight with a jury if the explanation is thorough, but defense reports shape negotiations. Your lawyer may address inaccuracies with a rebuttal letter or deposition of your treater that explains the differential.
Social media, surveillance, and the optics of daily life
Pre‑existing conditions already seed doubt. Do not give the defense easy angles. Avoid posting gym selfies, yard projects, or long travel narratives without context during your claim. Insurers use surveillance in a minority of cases, but when they do, thirty minutes of you lifting a toddler can get blown up in a courtroom even if you paid for it with two days on ice afterward. The problem is not living your life. It is the absence of documented nuance. Tell your providers what activities flare symptoms. If you try something and suffer for it, have that in your chart.
Selecting the right counsel when your history is complicated
Not every car accident attorney handles pre‑existing condition cases with the same discipline. When interviewing a motor vehicle accident lawyer, ask how they approach baseline evidence, which experts they prefer for spine or brain cases, and how they plan to handle old records. A good answer includes a timeline, coordination with treating doctors, and a clear plan for explaining aggravation to a jury. Ask about verdicts or settlements where the client had degenerative changes or prior injuries. You want someone fluent in the nuances, not just someone who says insurers always blame degeneration.
A strong personal injury lawyer will also manage expectations. Pre‑existing issues can trim the value of a claim, but they do not erase it. The right strategy narrows the dispute to the honest change in your life caused by the crash.
A brief, real-world example
A client in her late fifties came to us after a side‑impact collision. She had a documented history of cervical spondylosis and occasional neck stiffness, managed with yoga and sporadic physical therapy. Post‑crash, she developed right arm numbness and loss of grip strength. The defense pointed to MRI notes from two years earlier mentioning multilevel degenerative changes.
We gathered eight years of primary care notes showing minimal complaints, a yoga studio attendance record that became a proxy for activity level, and a dated video of her doing a sustained Crow pose. Post‑crash, the EMG confirmed right C6 radiculopathy. The surgeon tied the mechanism of the collision to the foraminal narrowing at C5‑6 that had been asymptomatic before. She completed injections and home exercise programs with modest relief before opting for a foraminotomy. Wage records showed missed time and reduced hours for four months.
The case settled for a figure that reflected full medicals, wage loss, and meaningful non‑economic damages. The degenerative baseline didn’t kill value because the before‑and‑after was concrete and the medical narrative was tight. The eggshell principle mattered, but the evidence did the heavy lifting.
Final thoughts for people with a history who just got hurt
Pre‑existing conditions are common, and insurers count on that to confuse responsibility. You can beat the confusion with honesty, detail, and a plan. If pain was background noise before and the crash turned it into the main soundtrack, that difference belongs in your claim. A seasoned car injury lawyer or automobile accident lawyer will not ask you to pretend the past away. They will help you document the change, line it up with sound medical reasoning, and push back on shortcuts the insurer wants a jury to take.
Good cases live in the particulars. The three hours you can no longer sit through for a grandchild’s recital, the overnight truck route you can’t run without triggering numbness, the staircase you used to climb without thinking, and the migraine that now hijacks your Tuesday morning meeting all occupy the space where liability meets life. With the right evidence and the right vehicle accident lawyer, those particulars become the spine of a persuasive claim, even, and especially, when the past is part of the story.