Most people carry some medical history into a crash. Old knee surgery, a nagging back, migraines that flare during stressful weeks, a herniated disc that behaved until a rear-end impact turned it into a daily problem. Insurers know this, and they push hard on it. If they can frame your pain as “just the old issue,” they reduce payouts. That is where experienced car accident attorneys earn their keep, not by pretending you were a blank slate, but by proving how a collision changed the trajectory of what came before.
The law allows for that distinction. You take your victim as you find them, fragile bones and all. Juries can compensate for the difference between how you were functioning before the crash and after it. The challenge is evidentiary, not theoretical. You have to show the before-and-after with care, one record, one voice, one image at a time.
How insurers weaponize your medical history
Adjusters rarely deny the crash happened. They deny that it caused what matters. The common playbook has patterns. An adjuster requests a blanket medical authorization, scours years of records, and pulls every mention of neck tightness or headaches. They then argue your cervical strain is a “recurrence,” or your shoulder tear “degenerative.” Degeneration, in their framing, means “not our problem.”
A car crash lawyer who has handled these fights expects this. The question is not whether your spine had age-related changes. Most adults do. The question is whether the collision transformed manageable wear and tear into disabling pain or accelerated the timeline of needed treatment. That argument requires nuance. When handled properly, it is persuasive.
I once worked a case involving a 58-year-old warehouse supervisor with a decade-old lumbar MRI showing disc desiccation and a mild bulge. He used Advil on bad days and missed no work. After a T-bone crash at a slow city intersection, he developed radicular symptoms he had never reported before, plus measurable weakness in dorsiflexion. The defense waved the word “degenerative” like a flag. We answered with a dated timeline of his job attendance, supervisor memos praising his physical reliability, and a post-crash EMG demonstrating acute nerve involvement. The claim settled midway through depositions, not because we denied his history but because we anchored causation in function, timing, and objective findings.
The eggshell principle in practical terms
Courts often apply what lawyers shorthand as the eggshell plaintiff rule. If a defendant’s negligence aggravates a pre-existing condition, the defendant is responsible for the aggravation. The law does not let an at-fault driver off the hook simply because the injured person was predisposed to harm.
In practice, that means your recovery focuses on two comparisons. First, the baseline: what your daily life looked like before the crash. Second, the delta: how the crash altered that baseline. A car wreck lawyer will encourage specificity. It is one thing to say your back hurt sometimes. It is stronger to https://rentry.co/mcad2k2b show that you bowled every Thursday, lifted a 30-pound grandchild without hesitating, and logged 45-hour workweeks without accommodations. When those activities vanish or demand pain management after a collision, causation becomes tangible.
Medical experts help bridge the legal standard and clinical reality. Many conditions are quiescent until a trauma adds fuel. A minor disc bulge can become a herniation with nerve compression. A shoulder labrum with fraying tolerates ordinary use until a seat belt’s restraint in a sudden deceleration finishes the tear. Orthopedic surgeons and physiatrists can explain mechanistically how that happens and why it matters.
The records you wish you had and the records you can build
Rarely does someone anticipate needing a clean pre-accident dossier. People seek care when needed and otherwise live their lives. After a collision, a car crash lawyer does not invent a past, they document it. Gym logs, performance reviews, prescription histories, even social photos showing hiking trips or home projects, all add texture to the baseline. A neutral narrative carries more weight than a scripted one, and it aligns better with the truth.
Post-accident documentation is equally important. Emergency records set the immediate tone, but follow-up notes, physical therapy attendance, and pain diaries reveal patterns. Consistency matters more than drama. If pain spikes in the evening after sitting at a desk, say so. If you skip therapy sessions, the defense will notice. Defense lawyers are trained to point to gaps and argue that if you truly hurt, you would have gone. Judges and juries listen to that.
A good car accident attorney coordinates with your treating providers to ensure your complaints are captured accurately. Providers are focused on care, not litigation. They may omit details that seem obvious to you. Lawyers who understand medical charting will ask for addenda when necessary, not to shape the truth but to complete it.
Causation: the quiet spine of your case
Causation sits between liability and damages. The other driver may be clearly at fault. Your symptoms may be real. If you cannot link the two convincingly, recovery shrinks. That link comes from a weave of sources.
Timing is the first thread. Symptoms that begin promptly after the crash are easier to tie to it. Delayed onset does not doom a case, especially for soft-tissue injuries that blossom over 24 to 72 hours, but it invites more scrutiny. Mechanism is the second thread. Rear impacts generate predictable whiplash kinematics. Side impacts strain shoulder girdles and ribs differently. Experts can map forces to injuries in a language jurors grasp.
The third thread is the pattern of care. An unbroken chain from ER to primary care to imaging to therapy reads cleanly. Gaps happen, often for reasons that make sense. People return to work, childcare consumes time, insurance approvals lag. A car accident lawyer anticipates these chinks and fills them with context and affidavits when necessary. Silence breeds doubt. Explanation preserves credibility.
When prior injuries help more than they hurt
Defense counsel treat pre-existing conditions as weak points. They also open doors. Prior MRIs, X-rays, and orthopedic notes create a baseline narrative that is not lawyer-crafted. If those records show intermittent complaints controlled by conservative care, and the post-crash period shows escalated pain, medication, injections, or surgery, the aggravation becomes quantifiable.
In a shoulder case a few years back, our client had MRI evidence of mild rotator cuff tendinopathy five years before the crash. She did home exercises and saw a physical therapist twice, then moved on. After a heavy T-bone crash at 35 miles per hour, an updated MRI revealed a full-thickness tear. The defense leaned into the word tendinopathy. The orthopedist testified that a partial tear or fraying can exist for years and remain stable, then rip with a tensile load like a seat-belted torso yanked laterally. The pre-existing diagnosis gave the jury a clean before-and-after. The settlement matched the surgery and rehab course, not because we erased the past, but because we framed change with medical logic.
Alleging aggravation versus new injury
Strategically, you decide whether to claim a new injury, an aggravation, or both. New injuries are clean but not always honest. If your lumbar spine showed degeneration and you now have a symptomatic herniation, alleging a brand-new injury invites attacks. Framing it as aggravation respects the medical reality and fits the eggshell rule.
Juries do not expect saints. They expect candor. Experienced car accidnet lawyers, even with a spelling error in a keyword on a website, know that credibility builds value. Overreaching devalues a case faster than a tough defense expert can. Better to concede what the imaging shows and then hang your hat on function and pain that crossed from nuisance to disabling.
The role of diagnostic imaging, and its limits
MRIs and CTs are powerful tools, but they are not the case. Plenty of people carry disc bulges with no pain. Others hurt like hell with imaging that looks ordinary. Defense medicine exploits this disconnect, arguing that mild findings equal mild injury. Treaters argue the inverse and risk sounding biased.
What helps is correlation. If your MRI shows a left-sided C6-7 protrusion, and your pain radiates down the left triceps into the index finger with diminished triceps reflex, the story aligns. If the EMG reveals acute denervation in muscles served by that root, alignment tightens. A car wreck lawyer who knows the dermatomes, at least enough to question an expert, keeps the conversation anchored in anatomy rather than adjectives.
For soft tissue injuries, imaging can be misleading. Microtears rarely appear clearly. Ultrasound sometimes helps for tendons. For brain injuries, normal CTs are common, and even MRIs can miss diffuse axonal injury. Neuropsychological testing then becomes the linchpin. None of this is cookie-cutter. That is the point. Good advocacy adapts the proof to the injury, not the other way around.
Pain scales, employment records, and the human ledger
Pain scales are blunt tools but still useful. A consistent 3 to 5 that spikes to 7 with bending says more than random tens. Employers can corroborate changes in performance and attendance. Performance plans issued after the crash, lifting restrictions granted by HR, or the simple fact of switching to remote work all add weight to the damages side.
Insurers often argue that plaintiffs could have mitigated by pushing harder in therapy or by taking the recommended injection sooner. Sometimes they are right. Pain management can be frightening. Injections involve needles near sensitive structures, and people hesitate. A car crash lawyer counsels clients about the optics, but never pressures them into treatment for a legal advantage. The record should reflect real choices, including reasonable caution. Jurors sense when care decisions feel lawyer-driven.
The independent medical examination that is not independent
If your claim persists, the defense will likely demand an IME. The term suggests neutrality, but the examiner is paid by the defense. That does not make the doctor dishonest. It does mean their report tends to spotlight gaps, inconsistencies, and alternative explanations.
Preparation helps. Review your history. Be consistent about onset, frequency, and triggers. Do not minimize or exaggerate. When people try to perform through pain to look stoic, examiners record normal range of motion and normal strength, then write that you are recovered. If a test hurts, say so. If you cannot complete a maneuver, stop. Car accident attorneys often provide clients with measured guidance before these exams and follow with rebuttal reports when necessary.
Settlement dynamics with pre-existing conditions
Cases with pre-existing conditions often settle in a bandwidth rather than at extremes. The insurer applies a discount for prior issues. The plaintiff seeks a premium for aggravation and long-term impact. The longer the documented post-crash course, the clearer the value. Surgical cases tend to resolve for higher amounts. Chronic pain with conservative care only can still command fair settlements if work and life disruptions are well documented.
Timing matters. Early settlements may look attractive when bills pile up, but they carry risk if your condition deteriorates. A car crash lawyer will track reaching maximum medical improvement, the point at which your doctors believe your condition has plateaued, before pushing for resolution. That protects against underestimating the future.
For negotiation posture, the most persuasive demand packages do three things. They show a sturdy baseline with concrete examples. They present a coherent medical narrative linking the crash to current limitations. They translate that narrative into money by tying each dollar to something real: past bills, future care, lost wages, household services, and the daily discomfort that now governs choices.
How subrogation and liens shape the net recovery
When health insurance or Medicare pays your medical bills, those payers often claim reimbursement from your settlement. That reduces your take-home number if unmanaged. A car wreck lawyer negotiates lien reductions, especially when liability is contested or when pre-existing conditions complicate causation. Hospitals assert statutory liens in many states, and the fine print matters. If your care overlapped with prior conditions, a precisely itemized ledger can limit the lien to crash-related treatment.
Lawyers also coordinate med-pay benefits under your auto policy. Med-pay is no-fault and can cushion early bills. Some policies have reimbursement clauses. Understanding the hierarchy of payers and the interplay of state statutes can change the bottom line by thousands.
Trial, if it comes to that
Most cases settle. Some should not. When an insurer undervalues an aggravation case because they think a jury will punish the prior condition, trial becomes an option. Jurors are more sophisticated than many adjusters believe. They distinguish between a person with a history and a person looking for a payday. They often respect transparency and detailed proof.
At trial, the story arcs around function. Display a calendar of pre-accident activities and a calendar of post-accident limitations. Use co-workers and family, not to sing praises, but to give texture. A spouse describing how you now sleep in a recliner two nights a week says more than a pain scale printed on a chart. A foreman testifying that you once shouldered the heavy aisle and now trade for lighter tasks grounds the claim.
Defense experts will harp on degenerative findings. Your expert accepts that and pivots back to change. The jurors do not need medical school. They need a clear path from the defendant’s negligence to your altered life.
Choosing counsel when you carry a medical past
Not all lawyers are the same. If you have pre-existing conditions, pick counsel who welcomes complexity. Ask how they approach baseline proof. Ask how they work with treating physicians versus hired experts. Ask to see a sample demand letter with a medical chronology. Firms that understand medicine can move a case faster because they anticipate the evidence battle.
The right car accident attorneys invest early in records and narrative. They push back on broad authorizations that let insurers rummage through unrelated histories. They talk plainly about risks. If surgery was on the horizon before the crash, they will say so and calibrate the claim around acceleration, not invention. That honesty often leads to higher, not lower, settlements because it builds trust in the numbers.
Practical steps in the first weeks after a crash
Small choices in the early window shape the case. Document symptoms while memories are fresh. If you had similar symptoms before, say it, then detail how the intensity or frequency changed. Keep appointments. Save receipts for medications and devices like braces or TENS units. Tell your doctor what tasks now hurt. Vague notes lead to vague offers.
Here is a short, clean checklist that helps clients with pre-existing conditions stay organized without turning their life into a spreadsheet:
- Keep a simple weekly log of pain levels, activities attempted, and what you had to decline or modify. Gather pre-crash proof of function, such as job descriptions, pay stubs with overtime, club or gym attendance, and travel or hobby photos. Follow medical advice that aligns with your comfort and values, and explain in the record if you decline or delay a recommendation. Centralize records and bills in a single folder, including mileage to medical appointments. Do not sign blanket medical authorizations without your car wreck lawyer reviewing them.
Social media and the optics problem
Insurers hire vendors to scan public profiles. A single photo at a barbecue, lifting a toddler with a brave smile, can turn into a trial exhibit. The issue is not that you faked your pain. It is that static images lack context. You may have paid for that moment with a night of spasm. Jurors will not see the aftermath unless you show it.
Prudent advice is not performative. Live your life, but be mindful. Avoid posts that project peak wellness while your claim highlights restrictions. If you do share, narrate context honestly. Better yet, set accounts to private and let your car crash lawyer guide the communication plan.
Future damages with imperfect bodies
Forecasting future care for a person with a medical past is tricky. Life care planners and treating physicians can map likely needs: maintenance therapy, periodic injections, imaging, medication, even surgery if degeneration accelerates. The key is probability, not possibility. A projection that reads like a shopping list will be discounted. A plan grounded in clinical patterns and your trajectory carries weight.
Work capacity evaluations help when jobs demand physical labor. If a forklift operator can no longer climb in and out of a cab repeatedly, vocational experts can identify transferability of skills and wage differential. These numbers often dwarf medical bills over a career. A car crash lawyer who knows to secure this analysis early sets the table for realistic settlement discussions.
What it feels like from the client’s chair
Beyond strategy and statutes, there is the lived experience of navigating pain while proving pain. People get tired of repeating themselves to adjusters, doctors, and sometimes to their own families. They resent the insinuation that prior aches make them unworthy of compensation. A good car accident attorney carries some of that load, filters the noise, and keeps the client focused on health and work.
The best case outcomes tend to come from steady, unglamorous work. No viral moments, no courtroom theatrics. Just thorough documentation, credible voices, and a narrative that honors both the past and the harm the crash added to it.
When to say yes, and when to keep going
There is no perfect number. Settlements feel fair when they cover the known and respect the unknown without pretending to conquer it. If you can pay the liens, secure future care, replace lost wages, and receive something meaningful for the daily friction of a body that now complains louder, the yes becomes easier. If an offer glosses your history and treats your aggravation as a rounding error, keep going.
A car crash lawyer with trial experience is not a luxury at that fork. Insurers track which firms try cases. The posture you take early influences the respect you get later. Calm readiness to try a case often begets a better settlement, especially when pre-existing conditions give insurers a talking point they underestimate but a jury may reject.
The throughline
Pre-existing conditions are not a curse on an injury claim. They are a reality to be managed with candor and craft. The defense will highlight them. Your team will measure them. The law will account for them. Between those poles lies the work: building a baseline that is recognizable, proving change that is believable, and translating both into dollars that mean something in the real world.
If you carry a medical past into a crash, do not shrink from it. Bring it to your car accident lawyer. The story begins there, not in the wreck, and that truth is exactly what can make your case.