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How Do Pre-Existing Conditions Affect My Claim? 

Vaccine Injury Pros Nov. 3, 2023

Many people suffer from various kinds of injuries and illnesses throughout their lifetimes. It is not uncommon for someone to be in less than optimal health when filing a claim for compensation. Despite this fact, pre-existing conditions still play a major role in personal injury claims.  

Insurance companies often try to deny personal injury claims by using the claimant’s pre-existing conditions as an excuse. If you have a pre-existing condition that could negatively impact your compensation, our attorneys at Vaccine Injury Pros work to help you get the compensation you deserve. We handle personal injury claims and vaccine injury cases throughout the United States.  

What Are “Pre-Existing Medical Conditions?” 

Many people live with different types of pains, aches, conditions, and disabilities. These conditions may be the result of previous accidents, wear and tear, or other causes. No matter how a condition occurs, it becomes a “pre-existing medical condition” when a person is seeking compensation for new injuries. Some common examples of pre-existing conditions in personal injury cases include: 

  • Back and neck injuries 

  • Head injuries 

  • Heart conditions 

  • Healed broken bones 

  • Degenerative disk disease 

  • Arthritis 

  • Osteoporosis 

  • Sprains and strains 

A condition can be considered “pre-existing” for the purposes of an injury claim based on several factors, including how long the claimant had the condition, the severity of the condition, and whether the condition was being treated, among others.  

How Do They Affect a Personal Injury Claim?

Insurance company adjusters are trained to protect their employer’s bottom line. As a result, insurance adjusters use a variety of tactics to deny claims or pay claimants as little as possible. Pre-existing conditions are one of the most common reasons to deny or undervalue claims, which is why insurers almost always ask claimants to provide access to their medical records.  

But can your pre-existing condition be used as an excuse to deny your claim or pay you less than you deserve? It depends on the pre-existing condition’s relation to the new injury, if any. If the pre-existing has nothing to do with the new injury, it will typically not affect the claimant’s right to obtain full compensation. If the condition was aggravated or exacerbated by the latest accident or event, the claimant can recover for the extent to which their condition was aggravated/exacerbated.  

Thus, while the insurance company is not expected to compensate the claimant for their original condition, the claimant can obtain compensation if their condition was in any way worsened by the accident. Under the “eggshell plaintiff” rule, insurance companies must consider the claimant’s health and conditions as-is. In other words, even if a person’s pre-existing conditions make him or her vulnerable to a specific injury or health problem, that person would still be entitled to compensation. However, the apportionment between the pre-existing condition and the current condition may be tricky and usually requires the assistance of a skilled attorney.  

How to Protect Your Rights When You Have a Pre-Existing Condition

There are several things you can do to protect your right to fair and full compensation when filing a claim for compensation with a pre-existing condition that could potentially complicate the claims process:  

  1. Inform your attorney of any pre-existing conditions. When discussing your case with your personal injury attorney, inform them of any conditions that have existed before the recent accident or event. If your attorney is kept in the dark about your pre-existing conditions, they will not be able to formulate an effective plan to obtain the compensation you deserve.  

  1. Seek immediate medical attention. The longer you wait to seek medical attention after the accident or traumatic event, the more difficult it will be to prove how the accident or event aggravated or exacerbated your condition.  

  1. Do not give the insurance company access to your medical records. If the insurer asks for access to your medical records, speak with an attorney first. Your attorney will review your medical history and explain how allowing the insurer to have access to your records can affect your chances of getting the compensation to which you are entitled.  

  1. If the insurance company starts asking questions about your pre-existing condition, refer the insurer to your attorney. Insurers are trained to ask questions in a way that induces a claimant into saying something that could later be used against them. Your attorney will handle the communication with the insurance company on your behalf and protect your rights throughout the claims process.  

If you have a pre-existing medical condition and are concerned about its potential impact on your injury claim, seek the legal advice and guidance of Vaccine Injury Pros.  

Reliable Representation When You Need It & Where You Need It

If you suffered an injury or illness but have a pre-existing condition that might impact your claim for compensation, contact our attorneys at Vaccine Injury Pros. We understand the intricacies involved when seeking compensation with pre-existing conditions and are ready to fight on your behalf with the goal that you obtain the compensation to which you are entitled. Reach out to our office to schedule a free case evaluation with our team.