Car crashes rarely strike a perfectly healthy person. Real life carries old back strains, degenerative discs, past knee surgeries, migraines that come and go. When a wreck aggravates those vulnerabilities, the injured person often faces a more complicated path to fair compensation. Insurers lean hard on the phrase pre-existing condition, hoping it ends the conversation. It does not. The law recognizes that a negligent driver takes the victim as they find them. The task is to separate what was there before from what the crash made worse, then document that difference with clear evidence and credible experts.
I have spent years working with clients who walked into a collision with a medical history, sometimes a thick one. The best outcomes never come from hiding or downplaying that history. They come from owning it, explaining it, and proving what changed after the crash. This guide covers the ground from first medical visits through settlement negotiations and trial strategy, with practical details that car injury lawyers use every week.
The baseline matters more than most people think
Before a wreck, most folks treat their ailments informally. A sore neck from desk work. A physical therapy stint two years ago for a shoulder impingement. Occasional ibuprofen and heat. None of that feels like a condition until the impact turns a manageable ache into a daily problem. In a claim, that pre-crash baseline becomes the reference point for everything.
Insurers compare pre-crash and post-crash records line by line: frequency of doctor visits, medication types and dosages, diagnostic imaging findings, functional limits, even notes about sleep or mood. If your primary care physician wrote last year that your low back symptoms had resolved, and now you have radiculopathy confirmed by EMG, the differential is sharp. If the records show chronic low back pain at a four out of ten with sporadic flares, and now you report daily seven out of ten pain and new leg numbness, the trajectory is clear. The records tell the story if you help gather them.
A good car accident lawyer starts by building a timeline: symptoms and treatments before the crash, the crash itself and any immediate care, then the evolution of symptoms, referrals, imaging, and interventions. The timeline should be simple to follow. Jurors and adjusters do not live in the medical world. They need a clean picture of what was, what happened, and what changed.
The eggshell rule is powerful, but it is not magic
Many states follow the eggshell skull rule, which says a negligent person is responsible for all harm caused, even if the victim’s condition made the harm worse than expected. A driver who rear-ends a person with osteoporosis may be liable for a fracture that a healthier person would not have suffered. The principle is sound and humane. Still, it does not convert every prior complaint into a new injury. You can recover for aggravation of a pre-existing condition, but you must show aggravation, not just the existence of the condition.
This is where precise language and careful medical evidence matter. Doctors often write phrases like exacerbation of chronic cervical radiculopathy or aggravation of pre-existing degenerative disc disease. Those words carry weight. But they must be backed by specifics. Look for differences that can be measured or observed: new functional limits, increased treatment intensity, different clinical signs, objective test results, or a significant change in pain frequency.
The defense will try to reframe everything as a continuation of the old problem. If your medical notes are vague, they will succeed. If your providers chart concrete changes, the defense will struggle.
What adjusters look for when pre-existing conditions are involved
Claims adjusters are trained to identify arguments that reduce payout. Pre-existing conditions top that list. Expect them to scour:
- Prior complaints of the same body part, frequency and intensity of treatment, imaging findings, and any discussions of surgery or injections. They will print out old physical therapy attendance logs to compare consistency. Gaps in care after the crash. A six-week gap between the emergency room and the next appointment becomes an exhibit for the defense. If the gap had a real-world reason, document it. When a client paused treatment to care for a newborn, we secured daycare receipts and a note from the pediatrician to close that narrative loop.
Adjusters also analyze medication history. If you moved from occasional over-the-counter pain relievers to daily prescription meds, that escalation is objective. If you were already on opioids, the insurer will argue there is no meaningful change. Counter that by pointing to dosage increases, added adjuvant medications like gabapentin, or the introduction of interventional treatments such as medial branch blocks.
How a car injury lawyer approaches medical proof
A car injury attorney does not practice medicine, but we learn to translate it. The key pieces tend to be:
- Pre-crash primary care records for at least two to three years. Longer if there is a known history to the same body part. Emergency department or urgent care notes from the day of the crash. In many cases, adrenaline and shock mask symptoms. Document initial complaints even if mild. Early follow-up with a primary care physician and then targeted specialists, usually within 3 to 10 days after the crash, depending on severity. Imaging comparisons. A spine MRI from two years ago set against a post-crash MRI can be the anchor of your case. Degenerative changes such as disc desiccation or osteophytes are normal with age, but new annular tear signs, edema, or nerve root impingement shift the analysis. Functional documentation. Not just pain scales, but work notes, lifting restrictions, missed shifts, and activities you stop doing. When a client’s half-marathon training logs show a hard stop after the crash, the jury pays attention.
Word choice in medical notes matters. If a provider writes patient denies prior neck pain when the records show intermittent neck complaints, the defense will pounce. Accuracy helps your credibility. If your neck hurt on and off for years, say so. Then explain how this episode is different.
Degenerative findings are not a defense
By age 40, most people show some degenerative changes on imaging, often without symptoms. Radiology reports use terms like mild to moderate degenerative disc disease or bulging disc without significant stenosis. After a crash, defendants point to those lines and claim the pain must come from wear and tear. The real question is not whether there was degeneration, but whether the crash produced a symptomatic change.
I have seen cases where a client had a bland lumbar MRI before the wreck and then, after a rear-end collision, a new focal disc herniation compressing the L5 nerve root with concordant leg symptoms. That is not age. It is trauma superimposed on a spine that already had miles on it. On the other hand, sometimes the MRI findings are similar pre and post crash, but the person’s function and pain level are very different. Then the proof leans on clinical exams, treatment escalation, and credible testimony.
The credibility trap: never minimize old problems
People fear that admitting prior pain will tank their case. The opposite is true. Under oath, defense counsel will go page by page through your past visits. If you said you never had back pain before and the records show twelve entries about back pain, you have a credibility problem that bleeds into every issue. Jurors forgive injuries. They do not forgive perceived dishonesty.
A car collision lawyer prepares clients thoroughly. We review records together. We practice answering questions directly and simply. If you had a dull back ache before that you managed with stretching, say that. If the crash turned it into shooting pain down your leg that wakes you at night, say that too. The before and after contrast, told honestly, resonates.
Causation language that actually helps
Doctors are often wary of legal language. Asking them for certainty can backfire. The standard in civil cases is not absolute proof, it is more likely than not. The best medical causation notes reflect that standard in clear terms. Phrases that help include:
- Within reasonable medical probability, the motor vehicle collision aggravated the patient’s pre-existing cervical spondylosis, resulting in new radicular symptoms. The patient’s current symptoms are consistent with an acute on chronic lumbar disc injury temporally related to the crash. Compared to prior records, the patient’s function has declined and imaging shows new findings that correlate with the clinical exam.
Vague statements like may be related or could be related invite trouble. Where the evidence supports it, your car wreck attorney should ask the provider to chart in probability terms that align with the legal burden.
Handling the IME and the defense expert
In many cases, the defense will send you to an “independent” medical exam. The name is wishful. These doctors often perform hundreds of exams for insurers each year. They will lean into age-related degeneration, MMI (maximum medical improvement) declarations, and alternative causes like work activities.
Preparation matters. Bring a concise symptom timeline. Be polite, be brief, and avoid expansive answers. Note the start and end time. If permitted, have a companion observe. Your car accident attorney should supply a packet of key records to the examiner so they do not rely on a cherry-picked set from the defense. Later, at deposition, your lawyer will press the examiner on the data they ignored, their billing history with insurers, and the standards they applied.
Lost wages and the pre-existing employee
Work claims become thornier with prior medical limits. If you already had a five pound lifting restriction before the wreck and ended up with a twenty pound restriction afterward, the delta is measurable. The same logic applies to attendance. If you missed three days a month due to migraines pre-crash and now miss eight, the increase is compensable with solid documentation.
Employers vary in their support. Some HR departments cooperate; others drag their feet. A car accident claims lawyer coordinates with payroll to secure wage histories, attendance logs, job descriptions, and accommodation letters. In union settings, collective bargaining agreements can interact with light duty policies. The paper trail is often decisive.
Settlement dynamics when prior conditions exist
Expect lower initial offers. Insurers price risk, and pre-existing issues give them leverage to argue uncertainty about causation and future damages. The way to counter is with organization and clarity, not bluster.
A strong demand package will include a summary letter laying out the baseline, the post-crash change, and the objective anchors: imaging comparisons, treatment escalation, and functional losses. Attach a medical opinion on aggravation if available. Include before and after photos of activities, short statements from family or colleagues who can attest to changes, and cost estimates for future care. When available, add a life care plan for complex injuries.
In my experience, cases with clear, documented aggravation can still resolve fairly, though they often require more back and forth and sometimes a mediation. Cases with murky records or inconsistent statements tend to either settle at a discount or move toward litigation.
When trial is the right call
Trial becomes a realistic option when the defense refuses to value aggravation properly despite strong proof. Juries understand that bodies age and still deserve fair treatment when harmed. The trial presentation often hinges on three pillars:
- Baseline clarity. Show the jury the pre-crash snapshot with a few records and practical examples. A calendar with pre-crash gym attendance, a pay stub series without gaps, a photo from a recent hike. Objective anchors. Use radiology side-by-sides, treatment timelines, and discrete markers like the start of injections or the date of a surgical recommendation. Credibility. If the plaintiff owns their history and explains the change plainly, jurors listen. Expert witnesses translate medical facts without jargon. The story stays focused.
Defense arguments tend to overreach when they attribute every symptom to degeneration. Jurors often recognize that strain from the wreck is the more plausible explanation for a sudden change in daily life.
Practical steps in the first 30 days after a crash
Time is the enemy of documentation. Memories fade, records scatter, and small decisions compound. The first month sets the tone. Here is a short, focused checklist that protects a claim without overcomplicating your life:
- Get evaluated promptly, then follow through with the recommended follow-up, even if you feel “better enough.” Tell every provider about prior issues in the same body region and how your symptoms changed after the crash. Photograph visible injuries and damage, and write a brief journal entry once a week describing pain levels, sleep, and specific tasks you struggled with. Ask your employer for a copy of your job description and keep track of missed time and modified duties. Consult a car injury lawyer early to coordinate records, imaging, and benefit claims like PIP, MedPay, or short-term disability.
Those steps sound simple. They are also the difference between a murky file and a sharp case.
Policy limits and how they shape strategy
If the at-fault driver carries minimal liability limits, the conversation shifts to layers. Your car attorney will identify and notify UM/UIM carriers, coordinate benefits, and manage subrogation. With pre-existing conditions, underinsured motorist claims often become the main avenue for fair compensation, especially when a new surgery or long-term therapy is in play.
Policy language matters. Some UM/UIM policies require permission to settle with the liability carrier. Others have consent-to-settle clauses or complex setoff provisions. A car accident lawyer keeps those traps in mind so a good first settlement does not accidentally foreclose a larger recovery.
The role of pain management and surgery decisions
Surgery is never just a legal decision. It is a medical and personal one. From a claims standpoint, surgery can clarify causation and increase case value when imaging and symptoms align. But no one should undergo a procedure primarily to strengthen a claim. Juries can smell that, and more importantly, it risks your health.
Pain management like epidural steroid injections, RF ablation, or facet blocks serves twin roles: treatment and diagnostics. A targeted injection that reduces pain significantly lends credibility to the diagnosis. A lack of response may redirect the treatment plan. Documenting those responses helps the car accident attorney frame the medical narrative.
For degenerative cases, surgeons sometimes recommend waiting and conservative care. If the crash accelerated the timeline toward likely surgery by months or years, that acceleration is compensable. Most states allow recovery for the aggravation effect, including earlier-than-otherwise surgery, if you can show it is more likely than not.
Surveillance and social media pitfalls
When pre-existing conditions are in play, insurers often run surveillance. A five-minute video of you carrying groceries becomes the centerpiece of their argument that you are fine. Context fights that tactic. If you lifted a light bag once and spent the next day in bed, tell that story in your journal and to your doctor. Consistency beats snippets.
Social media creates similar risks. Posts lack nuance and travel fast. A car crash attorney will usually advise clients to make accounts private and pause posting about physical activities. Defense lawyers will scour old posts for evidence of prior complaints or strenuous activities. None of that is fatal if you are honest and your medical records are accurate, but it is needless friction.
Cost of care and how to present it
Medical billing has quirks that confuse juries. Chargemaster rates on hospital bills do not match insurer payments. In some jurisdictions, only paid amounts are admissible; in others, billed amounts come in with adjustments explained. Your car accident legal representation should tailor the presentation to local rules. What matters for value is reasonable cost of past care and the probable cost of future care.
Future cost projections should connect to medical recommendations. A life care planner, when warranted, estimates the frequency and price of follow-up visits, imaging, medications, injections, potential procedures, assistive devices, and therapy. With pre-existing conditions, the planner must parse which costs relate to the aggravation versus the underlying disease trajectory. Clarity here earns trust with jurors and adjusters.
Choosing the right lawyer for a pre-existing condition case
Not every attorney thrives on nuanced medical causation. When evaluating car accident attorneys, ask how they handle aggravation cases. Listen for specifics: timeline building, comparative imaging analysis, treating physician involvement, and strategy for the defense IME. A car crash lawyer who talks comfortably about radiculopathy versus referred pain, facet arthropathy versus discogenic pain, or the functional impact of cervical myelopathy will be better equipped to frame your story.
Capacity matters too. Aggravation cases require time with records, conversations with providers, and careful deposition prep. If a firm pushes for a quick settlement before the medical picture settles, that may shortchange you. On the flip side, waiting forever can harm a case if the delay looks like disinterest or if statutes of limitation loom. Good judgment threads that needle.
What fair compensation can look like
Numbers vary widely by jurisdiction, venue, and case facts. A rear-end collision that aggravates a previously asymptomatic degenerative disc with no surgery may resolve in the mid five figures, sometimes higher with strong proof and significant functional impact. Add injections and extended therapy, and the value can rise into the high five or low six figures in many venues. When a crash triggers a need for surgery that was not imminent before, six figures to low seven figures is not unusual, especially if there are lost wages and lasting restrictions. These ranges are descriptive, not predictive. The strength of your documentation and credibility often shifts the outcome more than any single medical term.
Final thoughts from the trenches
Pre-existing conditions are not a weakness to hide. They are part of you. When a negligent driver turns a manageable condition into a daily battle, the law allows recovery for that aggravation. The proof lives in records, in consistent storytelling, and in the careful work of a car accident lawyer who knows how to build a before-and-after case.
If you remember nothing else, remember this: be honest about your past, be diligent about your care, and keep the paper trail clean. The rest is craft and patience. A seasoned car collision lawyer car crash lawyer Colorado Car Accident Lawyers will translate the medicine, counter the insurer’s shortcuts, and steer toward the fair value your story deserves. And if the defense insists on pretending that decades of normal wear and tear explains a sudden collapse in your daily functioning after a car crash, a jury can and often will set them straight.