How Pre-Existing Conditions Affect Your Personal Injury Claim in NY
Filing a personal injury claim in New York becomes more complicated when pre-existing conditions are involved. Insurers often focus on these conditions to reduce payouts or deny claims entirely. However, New York law offers legal protections to individuals whose pre-existing conditions have been aggravated by an accident. This guide explains how pre-existing conditions impact personal injury claims, what legal principles protect claimants, and how to strengthen your case.
What Are Pre-Existing Conditions?
A pre-existing condition is any documented health issue or injury you had before the accident occurred. These conditions vary widely but often include:
- Chronic Conditions: Such as arthritis, asthma, or diabetes.
- Old Injuries: Healed fractures or soft tissue injuries from previous incidents.
- Degenerative Diseases: Conditions like degenerative disc disease or osteoarthritis.
- Surgical History: Past surgeries or long-term health complications.
Do Pre-Existing Conditions Affect My Claim?
Many claimants worry that having a pre-existing condition disqualifies them from seeking compensation. This is a common misconception. New York law allows claimants to recover damages if an accident aggravated their existing condition. The key is to prove that the accident caused a measurable worsening of the condition.
Legal Principles That Protect Your Claim
Several legal principles ensure that claimants with pre-existing conditions are treated fairly under New York personal injury law.
Eggshell Skull Rule
The eggshell skull rule is a legal doctrine stating that defendants are fully liable for the injuries they cause, even if the claimant was more vulnerable due to a pre-existing condition. This means the defendant must compensate you for the full extent of your injuries, regardless of your prior health.
Example: If you had a herniated disc before the accident and the crash made it significantly worse, the defendant cannot argue that your vulnerability reduces their liability.
Comparative Negligence in New York
New York uses a comparative negligence system. Under this rule:
- If you are partially responsible for the accident, your compensation is reduced by your percentage of fault.
- Even if you are 20% at fault, you can still recover 80% of your total damages.
This principle ensures that claimants aren’t barred from recovery, even when pre-existing conditions or partial fault come into play.
How to Prove Aggravation of a Pre-Existing Condition
Proving that an accident worsened a pre-existing condition is one of the most critical aspects of your case. Clear and compelling evidence is essential.
- Use Medical Records
Medical records provide the foundation for your claim. These records should document:- The state of your condition before the accident.
- New or worsening symptoms after the accident.
- The progression of your injury with treatment.
Diagnostic tools like X-rays, MRIs, or CT scans can offer objective evidence of how the accident aggravated your condition. These comparisons are especially useful when insurers attempt to argue that your condition hasn’t changed.
- Leverage Expert Testimony
Medical experts can provide professional opinions that strengthen your case. They can:- Explain how the accident caused or worsened your condition.
- Describe the impact of the aggravation on your overall health and daily life.
- Provide evidence-based predictions for your recovery or ongoing treatment needs.
- Stay Consistent with Treatment
Consistency in medical treatment demonstrates the seriousness of your injury. Follow all prescribed treatment plans, attend medical appointments, and avoid gaps in care. Insurers may argue that a lack of consistent treatment indicates your condition isn’t as severe as claimed.
Challenges with Insurance Companies
Insurance companies often attempt to exploit pre-existing conditions to minimize payouts. Understanding their tactics can help you counter them effectively.
Common Tactics Insurers Use
- Blaming the Pre-Existing Condition: Insurers may argue that your symptoms are entirely due to your prior condition, not the accident.
- Requesting Extensive Medical History: They might demand years of medical records, hoping to find unrelated issues to dispute your claim.
- Offering Lowball Settlements: Insurers may offer a reduced amount, assuming you’ll accept quickly to avoid a lengthy legal process.
How to Counter These Tactics
- Limit Disclosure: Share only the medical records directly related to your claim.
- Retain an Attorney: A personal injury lawyer can advocate for you, ensuring that insurance companies don’t exploit unrelated conditions.
- Prepare for IMEs: Insurers may require you to undergo an independent medical examination. Having your own doctor’s opinion can help refute any biased findings.
Settlement Considerations
Pre-existing conditions don’t automatically reduce the value of your claim. However, they do influence the settlement process. Here are key factors to consider:
- The Degree of Aggravation
The more evidence you have showing how the accident worsened your condition, the stronger your case becomes. Detailed medical comparisons and professional opinions can help demonstrate the severity of the aggravation. - Medical Expenses and Future Care
Your settlement should cover:- The cost of treatments you’ve already received.
- Ongoing care, such as physical therapy or surgeries, required due to the aggravated injury.
- Potential long-term impacts, like reduced mobility or chronic pain.
- Pain and Suffering
The increased pain, suffering, or loss of enjoyment of life caused by the aggravated condition should also be included in your claim. Personal accounts, pain journals, and professional testimony can help quantify these non-economic damages.
Common Problems Claimants Face
Filing a personal injury claim with pre-existing conditions comes with unique challenges. Here are some common problems and solutions:
- Difficulty Proving Causation
Insurers may argue that your symptoms are unrelated to the accident.
Solution: Present clear medical comparisons, diagnostic tests, and expert opinions to show the connection between the accident and the aggravation.
- Delays in Seeking Treatment
Gaps in treatment can weaken your claim by giving insurers grounds to question the severity of your injury.
Solution: Seek medical attention immediately after the accident and maintain consistent care throughout your recovery.
- Pressure from Adjusters
Insurers often push claimants to accept low settlements quickly.
Solution: Consult a lawyer who can handle negotiations and advocate for a fair settlement.
Frequently Asked Questions About Pre-Existing Conditions in NY Personal Injury Claims
Can I file a personal injury claim if I have a pre-existing condition?
Yes. You can file a claim if the accident aggravated your pre-existing condition. New York law protects your right to seek compensation for the worsening of your injuries.
How do I prove the accident aggravated my condition?
You’ll need medical records showing the condition before and after the accident, expert testimony, and evidence of changes in your symptoms or limitations.
Will my settlement be reduced because of my pre-existing condition?
Not necessarily. The eggshell skull rule ensures you are compensated for the full extent of injuries caused by the accident, even if you were more vulnerable due to a pre-existing condition.
Can insurers use my medical history against me?
Yes, insurers often review medical records to dispute claims. Limiting the records you share to those directly related to the accident can help protect your case.
What should I do if the insurance company offers a low settlement?
Consult with a personal injury attorney. They can negotiate on your behalf to ensure you receive fair compensation for your injuries and damages.
Contact Marvin A. Cooper, P.C. Today
Don’t let pre-existing conditions discourage you from pursuing justice. If an accident worsened your health, you have the right to seek compensation under New York law.
Contact Marvin A. Cooper, P.C. today. We can help you gather evidence, handle negotiations, and fight for a fair settlement. Protect your rights and take the first step toward recovery by scheduling a free consultation today!