If you have a history of back pain, a prior knee surgery, or a cluster of headaches from years ago, you already know how nuanced pain can be. Then a crash happens. Suddenly, an insurance adjuster is telling you nothing is “new,” so nothing is owed. That moment is where a seasoned personal injury lawyer earns their keep, because pre-existing conditions sit at the center of many disputes and they require careful strategy, clear proof, and the kind of patience most people only learn after years of doing this work.
I have sat with clients who brought stacks of records, some from childhood injuries, others from last year’s MRI, and watched their shoulders drop as we color-coded timelines. It helps to see this as a medical story that needs to be told with precision. The goal is not to hide your history, it is to explain the difference between the old you and the post-collision you. Done right, a fair settlement follows. Done wrong, the carrier paints every symptom as recycled and lowballs you into frustration.
Why pre-existing conditions become a battlefield
Insurance companies rely on a simple tactic: blur the line between old symptoms and new harm. If your medical chart mentions “lumbar degenerative disc disease” before the crash, they latch onto that phrase and try to argue that a significant portion, or all, of your current pain stems from wear and tear. The law does not agree with that oversimplification. The eggshell plaintiff rule holds that a negligent driver takes the injured person as they find them. If a condition makes you more vulnerable to harm, the at-fault party is still responsible for the full extent of the injury they caused or aggravated.
The practical problem is proof. Not every worsening shows up clearly on a scan. Not every new pain pattern fits neatly into a report. Some injuries, especially soft tissue, live in the gray areas of medicine. That is why a personal injury lawyer invests energy in separating the threads, so that a jury, mediator, or claims manager can see what changed and how it changed.
The first conversation: not a cross-examination, a map
When a new client mentions a prior injury, I start by asking about function, not just diagnoses. What could you do the week before the crash? How many hours were you working? Could you sit through a movie, carry groceries, get through the night without waking up? Those details become anchors. I once represented a nurse who had mild lumbar issues after a sprain years earlier. She managed 12-hour shifts fine. After a rear-end collision, she had to leave her shift halfway through twice a week and use PTO to lie down. Same spine, new reality. Claims adjusters are less persuasive when concrete changes in daily life are documented this way, particularly when corroborated by supervisors or coworkers.
We also pull pharmacy histories. A person with long-standing knee arthritis might refill ibuprofen a few times a year. Suddenly, they are cycling through prescription-strength NSAIDs, muscle relaxants, and a short steroid course. That chronology tells its own story.
Disclose, then contextualize
Hiding a pre-existing condition is a shortcut to disaster. Defense counsel will find it in discovery, and once credibility cracks, even strong elements of your claim suffer. Full disclosure works if it comes with context. For example, I often summarize a client’s medical history like this: “Lumbar degenerative changes identified on MRI in 2018, treated conservatively with home exercise program and occasional chiropractic visits, stable without radicular symptoms. Post-collision in May 2025, onset of low back pain with right leg numbness, MRI shows new L4-L5 disc extrusion contacting the nerve root.” That side-by-side contrast is harder to brush away than a generic “back pain” label.
If you are working with a car accident lawyer or car accident attorney, expect them to ask for at least five years of prior medical records when spine, shoulder, or knee issues appear in your chart. For certain claims, we go back a decade. This is not to inflate the file, it is to show stability before the crash and change after.
Building a timeline that shows aggravation, not invention
I keep a wall calendar for complex cases. In chronic conditions, sequence is everything. Emergency room visit date and time. Onset of new symptoms documented in the first primary care follow-up. First time numbness was noted. Date physical therapy began. Gap periods. Work missed. When these points line up cleanly, the case gains momentum.
Take neck injuries. Many adults have asymptomatic cervical degeneration by their 40s. A low-speed crash can still cause acute symptoms by triggering an annular tear that irritates the nerve. The defense will point to the degeneration and call it “pre-existing.” A strong timeline answers that. No radiculopathy before, documented radiculopathy starting two days after, positive Spurling’s test noted by the physiatrist, and an updated MRI showing a new focal protrusion. It takes the wind out of the generic degeneration argument.
Getting the right words into the medical records
Doctors treat. Lawyers translate. Sometimes I call a physician, with the client’s permission, to clarify language in a chart. A note that says “chronic back pain” for a person with pre-accident maintenance aches undercuts a claim if the current issue is a new, constant sciatica. Clinicians often copy forward past language. That is not dishonesty, it is workflow. A car accident attorney will nudge the treating provider to separate baseline symptoms from current complaints in the assessment. A two-sentence addendum that states, “Patient had intermittent mechanical low back pain 1 to 2 times per month prior to MVC. Since MVC, daily pain with radiation to anterior thigh. This represents an aggravation,” can be the difference between a fair offer and a discount on your losses.
Pain diagrams help too. I ask clients to fill them out at each visit. If the shaded areas change meaningfully after the crash and stay consistent, those visuals speak to adjusters in a way narrative alone sometimes cannot.
Objective proof where possible, persuasive proof where necessary
Insurance companies love objective tests. X-rays, MRIs, nerve conduction studies, and ultrasound can all play a part. Not every case needs every test, and over-testing can look like padding. A personal injury lawyer weighs the cost and value. For a shoulder case with prior rotator cuff fraying, an ultrasound might capture a new partial tear with dynamic assessment. For a knee with mild pre-existing chondromalacia, weight-bearing X-rays before and after an acute pivot injury can show joint space changes over time, but an MRI within weeks can confirm a meniscal tear. For nerve pain, an EMG at around six weeks to three months can establish or rule out radiculopathy. The timing matters. Too early, and inflammation muddies the result. Too late, and defense will argue intervening causes.
When imaging is inconclusive, pattern evidence becomes key. A person who hiked five miles every Saturday now cannot walk the dog around the block. A self-employed electrician who climbed ladders daily now hires help for simple fixtures. Juries listen when the story is specific and consistent.
The aggravation model: how damages are framed
Courts generally allow recovery for the aggravation of a pre-existing condition. That means we are not asking the defendant to pay for your degenerative disc disease from twenty years ago. We are asking them to pay for the worsening that made it painful and disabling now. In practice, that separates damages into slices.
Medical expenses tie to post-accident treatment. Wage loss looks at your actual missed time and reduced capacity. Pain and suffering, or non-economic damages, focus on the change in your daily life. Expect defense to push for apportionment. They might suggest 60 percent of your pain is from degenerative changes and only 40 percent from the crash. Without a careful record and well-prepared testimony, that argument gains traction. With a clear aggravation framework, it falters.
Good experts are cautious about percentages. If apportionment is speculative, they say so. Many states do not require a plaintiff to quantify the aggravation to a percentage if the evidence does not support it. The credibility of your treating providers often outweighs a hired defense expert if their testimony stays within medical probability and is anchored to the record.
Common traps and how lawyers navigate them
Gaps in treatment are an easy target. People try to tough it out, especially if they juggled minor flares in the past. Then an adjuster claims the gap shows you were fine. A personal injury lawyer will document the reasons behind any gap. Maybe a lack of childcare, insurance approval delays, or a period when home exercises were tried before returning to formal therapy. If we can explain it, we can blunt the argument.
Social media posts hurt cases more than most clients expect. A single photo from a family barbecue can be twisted into a narrative of full recovery. Context matters. If you rested for two days after that event and needed medication to get through it, none of that shows up in a picture. I tell clients to avoid posting during their case. It is not about secrecy, it is about misinterpretation.
Prior accidents deserve attention. If you had a crash five years ago with a similar injury, the defense will claim the current symptoms are a continuation. I build side-by-side summaries: what body part was involved, what the diagnosis was, how long treatment lasted, when symptoms resolved, and what baseline function looked like before the new crash. If the earlier case resolved with a release that mentions full recovery, that language helps now.
The role of a car accident lawyer in coordinating care
People often assume lawyers only deal with courtroom issues. Much of the work happens in the messy middle, coordinating medical care. A car accident lawyer keeps an eye on the logical progression: acute care, primary care follow-up, conservative therapy, specialist referral if needed, and reassessment points. If conservative measures fail, a consult for interventional pain management or an orthopedic evaluation follows. This cadence is familiar to claims professionals. When care is coherent, offers improve.
For clients with limited insurance or high deductibles, we scout for providers willing to treat on a lien. That means they get paid from settlement proceeds. We also track prior authorizations and push back when health insurers deny reasonable care as “not medically necessary.” In a case with pre-existing conditions, those denials show up more often. A lawyer who knows how to write a targeted appeal can save months.
Communicating with the adjuster without giving away your case
Early letters to the adjuster set tone. I avoid sending all pre-accident records at once. Instead, I provide targeted excerpts that show stability and lack of recent complaints for the affected body part, with a note that full records are available upon request. That keeps the focus on change, not on the volume of old chart entries.
When the time comes to demand settlement, I include a concise narrative backed by citations to the record. If prior imaging exists, I place the pre- and post-accident studies side by side, sometimes with an orthopedic’s comparison report. I highlight function changes more than adjectives. Adjusters read dozens of files a week. Make yours clear: before the crash, the client ran three miles twice a week and lifted 40-pound bags at work; after, they walk thirty minutes on good days and need help with the heavy inventory.
When an independent medical exam is not so independent
If the defense schedules an examination, approach it with preparation, not panic. I brief clients on what to expect. Answer honestly, keep responses focused, and avoid minimizing or exaggerating. Bring a short list of current medications and a symptom timeline. If allowed in your jurisdiction, we ask to record the exam or send a nurse observer. Afterward, I debrief the client immediately and request the report. Often, the examination contains concessions helpful to your case, even if the ultimate opinion favors the defense. Pin those down before deposition.
Depositions: telling the story of “before and after”
Your deposition is where the difference between old and new can come alive. I rehearse specifics. If you say, “My back hurts all the time,” a defense lawyer will pull pre-accident notes that say the same phrase. Precision is your friend. Pre-accident, your pain flared once a month after heavy lifting. Post-accident, you wake nightly, need to stretch fifteen minutes before standing, and sit for no longer than twenty minutes without shifting. Teach the defense lawyer your daily routine. The more tangible you are, the less room there is for generalities.
Trial strategy when the case depends on aggravation
Most cases settle. The ones that do not often pivot on credibility and medical clarity. I pick two or three anchors and build the trial around them. For example, the first anchor might be a video from your workplace showing you on a ladder for ten minutes at a time before the crash compared with a supervisor testifying about how you now work from the ground. The second anchor could be a radiologist explaining, in simple language, how the new disc extrusion seen after the crash compresses a nerve that the prior MRI did not show. The third anchor might be your spouse recounting the shift from weekend hikes to short walks and the change in your mood.
Jurors lean into stories with detail. They know people get older and have wear and tear. They do not expect pristine spines. They want to know whether this crash mattered. If the answer is evident, they award fairly.
Working with a personal injury lawyer who understands nuance
If your case involves pre-existing conditions, you do not need a hired gun so much as a careful steward. The right personal injury lawyer will spend time on the unglamorous parts: requesting old records, reading them line by line, building a clean timeline, coordinating with doctors, and resisting the urge to chase every test. They will be clear with you about trade-offs. Sometimes surgery improves outcomes and strengthens a case, sometimes it is not medically indicated and conservative care is safer. Sometimes returning to work sooner helps your mental health, even if it reduces short-term wage loss. These decisions belong to you, and a good lawyer gives you the context, Personal Injury Lawyer not pressure.
You might also have overlapping claims, such as workers’ compensation if the collision happened on the job. That brings in liens and credits, which can be negotiated. Health insurance plans often assert reimbursement rights. A lawyer who tracks these issues can increase your net recovery by reducing paybacks at the end, especially when part of your care treated conditions that were present before the crash and did not change.
A brief, practical checklist for clients with pre-existing conditions
- Tell your lawyer everything about prior injuries and treatment, even if it feels unrelated. Ask your doctor to note how your symptoms changed after the incident, not just that you have pain. Keep a simple log of activities you cannot do now or do with difficulty, with dates. Follow through on reasonable treatment, and explain any gaps promptly so they can be documented. Avoid posting about your health or activities on social media while the case is pending.
What a fair resolution looks like
A fair settlement recognizes the reality of your body before and after the crash. It pays for treatment that addressed the aggravation, not just generic care. It covers real wage loss and reduced capacity. It acknowledges that living with an aggravated condition is not the same as living with the baseline. In numbers, this can range widely. Soft tissue aggravations with solid documentation might resolve in the mid five figures. Clear structural worsening with procedures or surgery can reach six figures or more. The spread depends on liability clarity, venue, medical proof, and your credibility.
What I have learned after many of these cases is that patience and precision win the day. The defense will try to make you your MRI. You are more than that. With the right strategy, your case becomes what it should be: a careful account of how a negligent act turned manageable issues into persistent limitations, and what it will take to make that right.