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How Pre-Existing Conditions Affect an Injury Claim


If you were injured by another party’s negligence but already had a pre-existing condition, your claim could be affected. However, you are likely still entitled to recover compensation. 

How Can a Pre-Existing Injury Affect My Claim?

After an accident, the at-fault party can be liable for resulting damages if you suffered a severe injury. When you have a pre-existing injury or condition, it can be challenging to differentiate your new injuries from a pre-existing condition and prove your losses are related to the accident. It could be particularly difficult if you were already receiving treatment for a pre-existing condition. The insurance company will unlikely be willing to reimburse the costs for the medical care you were already undergoing.

Exacerbation or Aggravation of a Pre-Existing Condition

Pre-existing injuries or conditions do not disqualify you from recovering compensation. When an accident causes a previously diagnosed medical condition, ailment, or minor injury to worsen, medical professionals refer to this as “exacerbation” or “aggravation” of a pre-existing condition.

  • Exacerbation refers to a minor flaring up of a condition.
  • Aggravation is a severe injury that requires further medical treatment.

Therefore, you must be able to provide medical evidence that the accident exacerbated or aggravated your pre-existing condition, or you risk the insurer denying compensation for your medical care. An attorney can help you gather evidence to establish the difference in your injury severity before and after the accident, as well as demonstrate how your life has changed. 

What Are Common Types of Pre-Existing Conditions

Before a personal injury accident, any injury or condition you suffered from can be classified as a pre-existing condition. The pre-existing conditions injury victims most commonly report are prior: 

  • Back injuries (e.g., herniated or slipped disc, sciatica, chronic pain, degenerative disc disease, etc.)
  • Neck or head injuries
  • Past surgeries
  • Healed bone fractures
  • Arthritis
  • Blood pressure problems
  • Heart problems
  • Respiratory conditions
  • History of chiropractic care
  • Cancer
  • Diabetes
  • Chronic illness
  • Emotional or psychological conditions

If you were suffering from any of these pre-existing conditions or injuries, be especially vigilant during the claims process and provide careful and thorough documentation. If the insurance company does not deny your claim, they may try to diminish its value. Consult an attorney to discuss the value of your claim before accepting an insurer’s settlement offer. 

Should I Disclose a Pre-Existing Injury Condition?

It is highly advisable to report any pre-existing conditions or injuries to the at-fault party’s insurance company. Failure to do so can sabotage your claim and your chances of recovering the compensation you deserve. The at-fault party’s insurer may find out about your condition during their investigation, which will ruin your credibility. At that point, the insurer may be able to reduce or deny your claim successfully. 

How you disclose a pre-existing condition is also important. The best way to do it is to let your Westchester County Personal Injury Attorney notify the insurer upfront. If you report it yourself, there is a risk of the adjuster asking questions that can trip you up, and you may offer up information that unintentionally hurts your claim. The adjuster may also ask you to sign a medical release, but you are under no obligation to do so as you can limit the health information they review. They may only be requesting access to use your medical history against you.