When a crash aggravates a bad back or a prior concussion, the legal questions turn thorny fast. Insurers lean on “you were already hurt” to discount claims. Treating doctors focus on patient care, not legal causation. Medical records stretch back years, sometimes with gaps. The result is a familiar tug of war: how much of the pain, expense, and lost function belongs to the collision, and how much would have happened anyway. A seasoned car accident lawyer knows that line rarely lands neatly, and uses a mix of medicine, records work, and strategy to make the distinction understandable, credible, and persuasive.
This is the practical playbook for how car accident attorneys navigate pre-existing conditions, with the nuance that real cases demand.
Why pre-existing conditions do not bar recovery
The law does not punish a person for being vulnerable. Most states follow some version of the eggshell plaintiff rule: if the defendant’s negligence injures someone with a fragile condition, the defendant is responsible for the full extent of harm caused by that negligence, even if a healthier person would have suffered less. An arthritic knee that degenerates more quickly after a side impact, a fused spinal segment that becomes symptomatic after a rear-end collision, a dormant PTSD history that flares with driving anxiety, all can be compensable. The hard part is tying worsening symptoms to the crash with evidence strong enough to survive adjuster skepticism and, if necessary, a jury’s common sense.
Law also draws a line at “inevitable decline.” Defendants do not pay for the baseline condition itself or for degeneration that would have occurred regardless. The compensable slice is the aggravation, the acceleration, or the new harm layered on top. The car accident lawyer’s job is to sharpen that slice with clarity, not to inflate it. Overreach backfires. A measured, evidence-led approach usually goes further than an all-or-nothing pitch.
Building the medical narrative, not just a stack of records
Most injury cases turn on medical documentation. With pre-existing conditions, the quality of that documentation matters even more than the quantity. Records must show a before-and-after picture that a layperson can follow. This requires deliberate curation.
A good attorney starts with a thorough intake. They ask for prior providers, clinics, physical therapists, chiropractors, and imaging centers. They look for health insurers’ explanation of benefits to identify missing records. They map symptoms along a timeline: routine stiffness before, breakthrough pain after; occasional headaches before, daily migraines after; half-marathoner before, can’t jog a block after. That timeline later anchors expert opinions and damages claims.
Raw records arrive messy. Entries may be sparse, incomplete, or inconsistent. A car accident attorney reviews them with two questions in mind: what did the client report before the crash, and what changed afterward? If prior notes show intermittent lumbar discomfort rated 2 out of 10 that required occasional ibuprofen, and post-crash notes show constant 6 out of 10 pain requiring prescription medication and epidural injections, that differential becomes the case’s spine. If a prior MRI showed mild degenerative disc disease at L4-L5, and a post-crash MRI shows a new focal disc extrusion impinging the nerve root, the causation story gains anatomical footing. If pre-crash mental health treatment had tapered off, and post-crash therapy escalated with new driving-related panic, that matters too.
The strongest presentations pair records with clinician explanations. Treating doctors often write chart notes for medical continuity, not forensic precision. A lawyer asks for an opinion letter or deposition that answers two narrow questions in plain language: what was the patient’s baseline before the crash, and is it more likely than not that the crash aggravated the prior condition or caused a new one? When a spine surgeon or physiatrist can say, “Degeneration accumulates over years, but the acute herniation on the right side is new and consistent with the mechanism of a rear impact,” jurors and adjusters usually understand.
Recognizing the science beneath the symptoms
Lay explanations work only if they match medical reality. Attorneys who routinely handle these cases study the difference between degenerative changes common with aging and trauma markers typical of acute injury. They learn how radiologists phrase certainty, such as “compatible with,” “consistent with,” or “cannot exclude,” and how those phrases play at trial. They understand that osteophytes and desiccation show wear, while high-intensity zones on T2-weighted images or Modic changes may capture a more acute process. They know that imaging can lag symptoms, and that pain without a clear radiographic “smoking gun” remains medically valid if it aligns with mechanism and examination.
Soft tissue injuries complicate things. A neck strain on top of age-related spondylosis can last months, or longer if muscle guarding and facet joint irritation persist. Skeptical adjusters point to guidelines suggesting most strains resolve within 6 to 12 weeks. The attorney counters with specific facts: failed conservative care, objective findings on exam like restricted range of motion or trigger points, and functional change such as reduced work hours. Where imaging is equivocal, the lawyer may call on a physiatrist or pain specialist to explain why persistent myofascial pain still tracks back to the crash.
With concussions and prior head injuries, the medicine is even more nuanced. Neuropsychological testing can quantify deficits, but it is sensitive to effort and other factors. Lawyers lean on pre-accident baselines if available, school or work records, and testimony from people who saw the person daily. Video clips of pre-injury athletic performance or workplace presentations, contrasted with post-injury limitations, carry weight that check-the-box forms cannot.
The apportionment problem, and how to approach it
Insurers rarely concede aggravated damages without pushing apportionment. They want a percentage breakdown: how much of the current impairment is accident-related, how much is pre-existing. Some states ask juries to apportion; others leave it to experts. Either way, precision is often impossible. Biology does not allocate damage in round numbers.
Experienced attorneys do not pretend otherwise. They ask clinicians to use ranges with medical reasoning. A surgeon might say, “The patient’s baseline degeneration contributed, but the extrusion requiring microdiscectomy was precipitated by the crash. I would attribute most of the surgical need to the collision, with perhaps 20 to 30 percent unrelated.” A pain specialist might say, “Prior intermittent pain became chronic after the crash, a classic transition. The majority of current limitations relate to that transition.”
Where experts cannot apportion, many jurisdictions place the burden on the defendant to separate harm caused by pre-existing conditions from harm caused by the accident. If the defense cannot do so, the plaintiff may recover for the whole. A car accident lawyer uses that principle carefully, not as a cudgel, but to discourage speculative reductions.
Documentation gaps, and how to handle them without losing credibility
Many clients did not seek regular care before the crash. They self-managed with stretching, OTC painkillers, or occasional chiropractic visits. Gaps in records create openings for adjusters to claim that the post-crash complaints are not new. The solution is candid context. The lawyer gathers pharmacy purchase history if possible, testimony from family or coworkers about the old routine, and any wearable or app data that shows pre-crash activity levels. Weekend hiking mileage, gym check-ins, or a Strava log can be more persuasive than memory alone.
When the first post-crash visit occurs weeks later, the file needs a reason. Lack of insurance, hope that symptoms would fade, caregiving responsibilities, or transportation problems are common. These explanations should appear in the medical notes, not just in the demand letter. A thoughtful car accident attorney coordinates with providers to capture the story contemporaneously, not retrofitted at settlement time.
Working with the right experts, for the right reasons
Not every case needs experts. Some do, and those cases often hinge on choosing carefully. Treating physicians carry built-in credibility because they are focused on care. Their testimony, if supportive, usually anchors causation. Independent experts add value when specialized interpretation is needed, such as neuroradiology reviews or biomechanical analysis in low-speed collisions.
Defense teams frequently hire IME doctors who attribute symptoms to age or prior problems. A plaintiff’s car accident lawyer picks experts who explain rather than argue. Jurors prefer teachers over advocates. A well-chosen physiatrist who walks through exam findings, explains pain referral patterns, and acknowledges uncertainty where it exists often outperforms a bombastic hired gun. Cost matters too. Experts can consume large portions of a settlement. The attorney weighs the expected impact against the burn rate, and sometimes seeks limited-scope opinions or affidavits to keep expenses proportionate.
Causation mechanics: making the crash fit the injury
Mechanism matters. Saying “the crash caused it” is not enough. A rear impact that pushes a head into extension, then flexion, can plausibly aggravate cervical facet joints or provoke a disc injury. A T-bone collision that twists the torso can shear lumbar structures, especially in someone with prior degeneration that reduces shock absorption. A dashboard knee strike can accelerate pre-existing patellofemoral chondromalacia. These connections should be drawn explicitly, preferably by medical professionals, and illustrated when possible with anatomically correct visuals. Simple, accurate diagrams often beat glossy animations that look like advertising.
With low property damage, the defense will argue that the forces were too small to cause injury. The attorney anticipates this by decoupling visible vehicle damage from biomechanical load on the body. A stiff bumper can transfer energy into occupants without crumpling. Conversely, high damage does not automatically prove severe injury. The better route is to align mechanism, symptoms, imaging, and clinical course.
Pain, function, and credibility
Pain is subjective, yet juries care. Judges and adjusters do too. The most persuasive pain stories are functional: what changed, with examples. Before the crash, a client carried 50-pound feed bags at work without issue. After, they needed help with 20 pounds. Before, they slept through the night. After, they woke twice in pain and napped midday to cope. Before, weekend soccer with kids. After, sideline coaching. Functional changes translate into dollars for lost wages, reduced earning capacity, and loss of enjoyment of life.
Consistency is the thread. If the client describes severe limitations but social media shows strenuous activities, credibility craters. Most attorneys now run a social media audit early and coach clients to avoid posting about activity or recovery. They also encourage accurate pain diaries shared with providers, not written for the file. A diary that tracks pain spikes, medication usage, and triggers helps clinicians adjust treatment and provides contemporaneous proof that is hard to fake.
Settlement posture: calibrating asks and anchors
Demand letters in pre-existing condition cases need a steady hand. Inflated asks invite lowball responses and stall negotiations. Detailed, sourced demands fare better. The letter should walk through the baseline condition, the aggravation or new injury, the treatment course, the present state, and the likely future. It should attach key excerpts: imaging reports, surgical notes, independent clinician letters, work restrictions, and receipts. If the attorney expects the defense to raise apportionment, the letter can preempt by acknowledging baseline issues and explaining a fair allocation rooted in medical opinion.
Sometimes, the most productive move is a structured offer. The attorney might propose a range that ties to specific apportionment scenarios, such as a top number if the defense accepts the treating surgeon’s apportionment, and a lower fallback if they insist on a more aggressive split. It is not weakness to show conditional flexibility. It is more often the difference between settlement and trial.
When to file suit, and what discovery achieves
If the insurer refuses to engage, filing suit may be the only way to access discovery tools that can surface truth. Depositions of treating physicians, defense IME doctors, and radiologists sharpen causation. Subpoenas to prior providers fill record gaps. Company records can show whether the defendant driver had prior incidents or whether telematics contradict their version of events. The lawsuit also unlocks court-ordered independent medical examinations, which, properly managed, can help by forcing defense experts to commit to opinions under oath, open to cross-examination.
Litigation, of course, carries cost and risk. A car accident lawyer balances the medical picture, client tolerance for delay, venue tendencies, and the clarity of apportionment. A case with a clean post-crash MRI finding and supportive treating opinions may warrant trial if the insurer remains entrenched. A case with primarily subjective pain and long-standing degeneration might be better resolved through mediation with a realistic valuation.
The special problems of gaps, comorbidities, and overlapping life events
Real life rarely waits for a case to tidy itself. Clients get pregnant, change jobs, or develop unrelated illnesses. Comorbid conditions like diabetes, obesity, or autoimmune disorders can slow healing. Defense will point to these factors as alternative causes. The attorney’s response is not to dismiss them, but to show how they interact with the injury and the timeline. A slower recovery does not break causation if the crash remains the precipitating event. It may, however, affect damages projections, especially for future care.
Overlapping events can prove tricky. Suppose a client has a low-speed crash in January, then a more serious crash in April. Or a lifting injury at work after a car crash. The file must separate symptoms cleanly. Providers should note which event a flare-up relates to. Where separation proves impossible, counsel may consider separate claims, tailored releases, or mediation strategies that allocate portions of a global settlement to minimize contribution disputes.
Practical steps that strengthen cases from day one
A few habits consistently improve outcomes when pre-existing conditions are in play:
- Encourage prompt, appropriate medical care with honest reporting of prior issues, so providers can document the delta and avoid later accusations of concealment. Gather complete pre-accident records early, at least two to three years back for the body part at issue, plus imaging histories and any relevant mental health care. Ask treating clinicians for written causation and apportionment opinions in plain language, anchored to specific findings and the timeline. Track functional limitations with examples and third-party observations, and curate corroborating artifacts like work schedules, activity logs, or wearable data. Prepare the client for defense tactics, including IME exams and social media scrutiny, and coach on consistent, non-exaggerated reporting.
These steps are simple, but they separate well-built files from shaky ones, and they dramatically reduce the room for the “you were already hurt” defense to take hold.
Damages: projecting the future without speculation
Valuing future medical care requires discipline. Estimating the cost of injections, imaging, medications, and possible surgery over time involves current pricing and expected utilization rates. When pre-existing conditions exist, the plan should identify which services address the aggravated component versus baseline care. Life care planners can help in complex cases. They extrapolate from physician recommendations, clinical guidelines, and patient response. Insurers attack speculative plans, so recommendations from treating physicians carry more weight than wish lists.
Lost earning capacity is often significant where a client had adapted to a pre-existing condition and functioned well before the crash. Vocational experts assess transferable skills, labor market demand, and likely accommodations. Financial experts discount future losses to present value. The attorney avoids double counting by distinguishing between temporary wage loss during recovery and permanent erosion of earning power.
Non-economic damages, the human impact, depend on story and credibility. Jurors respect effort. A plaintiff who tries physical therapy diligently, follows medical advice, goes back to modified duty if feasible, and speaks plainly about limitations resonates far more than one who appears to seek maximal time off with minimal participation. Lawyers can neither manufacture nor fake that. They can, however, present the truth well.
Managing client expectations without diminishing their experience
Nobody likes to hear that a prior condition will reduce the claim’s value. Yet setting expectations early preserves trust. A frank conversation about apportionment, the eggshell rule’s limits, and venue realities avoids later disappointment. The attorney explains that acknowledging prior issues does not weaken the case. It strengthens it by preventing cross-examination gotchas and supporting a believable damages model.
Case length also matters. Aggravation cases can take longer because doctors wait to see how symptoms evolve. Rushing to settle before reaching maximum medical improvement often leaves money on the table or risks buyer’s remorse if surgery becomes necessary. A car accident lawyer balances financial pressure with the need for a stable prognosis, sometimes using med-pay coverage, PIP benefits, or negotiated treatment liens to bridge the gap.
Ethical edges and the importance of accuracy
Pre-existing conditions tempt shortcuts. Omitting unfavorable records, pressuring clinicians to overstate causation, or burying inconsistent statements might score a short-term win but invites disaster. Defense subpoenas find what demand packages omit. Judges sanction discovery abuse. Juries punish perceived exaggeration. The better path is transparency matched with careful framing: here is what existed before, https://trentonsljg804.iamarrows.com/collision-attorney-protecting-you-from-comparative-fault-claims here is what changed, and here is why medicine supports that the crash made a meaningful difference.
Accuracy about timelines matters especially. Date the onset of new symptoms carefully. Distinguish between mild, intermittent prior issues and the sustained, severe post-crash state. Where the client’s memory conflicts with records, investigate rather than bulldoze. Clinic notes can be wrong, but proving that requires corroboration, not wishful thinking.
The role of a car accident lawyer when the facts are less than perfect
Few cases are perfect. Great lawyering shows most when facts are messy. A client with prior similar complaints can still recover if this event changed their trajectory. The car accident lawyer’s role is to knit medicine and narrative, help clinicians express their opinions clearly, and anticipate the defense’s best points. It also means conceding the defense’s valid points where they exist and folding them into a fair valuation rather than ignoring them.
Sometimes the right answer is to scale back the damages ask, focus on medical bills and a measured pain-and-suffering number, and resolve without costly experts. Other times, particularly with a new structural injury on imaging or a well-documented step-up in care, the right answer is to invest in discovery and present a strong case at trial.
A brief example from the trenches
Consider a 48-year-old warehouse supervisor with a 10-year history of episodic low back pain, managed with stretching and occasional chiropractic adjustments. He gets rear-ended while stopped at a light. The bumper shows minimal damage. He wakes the next day with radiating pain down the left leg. Primary care refers him to PT. After six weeks, symptoms persist. MRI shows a left paracentral L4-L5 herniation contacting the L5 root, with background multilevel degeneration. He undergoes two epidural steroid injections with partial relief, then a microdiscectomy. He returns to full duty after four months but avoids overtime due to fatigue and residual numbness.
The insurer argues that degeneration explains the herniation and points to low vehicle damage. The car accident attorney secures the prior records showing no radiculopathy, no imaging, and only intermittent axial pain before. The treating surgeon writes that the herniation is acute and consistent with the collision’s mechanism. A radiologist confirms no prior imaging showed a herniation. A supervisor testifies that the worker routinely lifted 60-pound boxes before and needed help after for several months. The settlement reflects medical bills, a modest wage loss, future risk of re-herniation, and measured non-economic damages. The prior condition does not vanish, but it does not erase the crash’s contribution. The case resolves for a number that feels sensible to all participants because the evidence supports the delta.
Final thoughts for clients and counsel
Pre-existing conditions complicate, but they also humanize. Most adults have some wear, some history, some vulnerability. Car accident cases that address those truths head-on tend to fare better than cases that pretend clean slates exist. The experienced car accident attorney treats medicine as the foundation, narrative as the frame, and credibility as the finish. Build all three, and the “you were already hurt” defense becomes just one voice in the room, not the final word.