What is a Pre-Existing Condition, and why does it matter for my Virginia Car Accident Case?

If you’ve suffered a serious injury in a Virginia Car Accident case, you need to be aware of what Pre-Existing Conditions are and why they matter. 

Fortunately, most people haven’t had to make personal injury claims for acar accidents.  When they do, they are often so focused on proving that the accident was caused by the other party that they forget an important reason why car insurance companies undervalue claims: pre-existing conditions.

What is a Pre-Existing Condition?

A pre-existing condition is an “abnormality” of your anatomy that existed before your accident that the insurance company will point to and say “we don’t owe you money, you already had this injury before this accident.”  If you’ve suffered a rotator cuff tear or disc herniation due to an accident, the insurance company will review all medical records from your past, hoping to find an imperfection in your medical history to claim is a pre-existing condition.

Have you ever injured your shoulder in a pick-up basketball game?  Have you ever had to get physical therapy for a back strain after shoveling snow?  Ever had to ice your knee after a fall.  If you’re now facing a car accident injury to that same body part, the car insurance will do their best to raise that prior history as a defense to your claim, hoping to either not pay you or minimize payment as much as possible. 

So, you’ve never had a pre-existing condition before?  That doesn’t mean you’re in the clear.

Even if you’ve never had any prior pain or treatment to a particular body part, that won’t stop the insurance company from pointing to your anatomy and claiming a pre-existing condition.  I can tell you that for a vast majority of people that undergo an MRI past the age of 20 years old, there will be findings that the insurance company will point to and claim that’s a pre-existing condition

This is especially true for shoulder, knee, and back injuries.  Through the normal course of wear-and-tear as we age, there will be findings on MRIs and x-rays that will naturally occur – that are not sources of pain or treatment – that insurance companies will scour the records for to undervalue your claim.

As a natural course of treatment, serious accident injury claims warrant MRIs and x-rays to determine the extent of injuries.  Don’t be surprised when the insurance companies point to these same tests to argue that you were actually injured before your accident.

What if there are no findings (Brain Injury Cases).

If you’ve suffered a brain injury, you may be surprised to learn that most brain injuries have no findings on MRIs or other tests.  That’s because injuries occur at the cellular level, which current, generally used testing can’t detect.  In this case, the insurance company will make two claims: 1) you couldn’t have been injured, and 2) any cognitive issues you have are because of pre-existing conditions that have nothing to do with striking your head.

Indeed, for brain injury cases, they will claim that your sleep apnea, hypertension, diabetes, high cholesterol, mental health issues, etc. is the reason you can’t think and work the way you did before the accident.

How do I get compensated if I have a pre-existing condition?

To be clear, simply because an insurance company claims that you have a pre-existing condition and, therefore, you should be compensated minimally doesn’t mean we, at Abrenio Law, give up.   We expect that, in most cases, car insurance companies will claim that you have a pre-existing condition.  In some cases, they may have a point.  If you’ve had prior surgery or injury, they may be right.

With that said, even if you have a pre-existing condition, that doesn’t mean that you should not get full value for your claim.  Virginia applies the “Egg Shell Plaintiff Rule,” which says that you, the Plaintiff, come as you are in an accident.  Let’s say that you have bones that are very brittle due to a calcium deficiency.  Because of the defendant’s negligence, you were impacted, and your brittle bones broke (even when a person without such a defect would not have suffered a fracture).  Under Virginia’s rule, we argue that the defendant is still liable for your injuries.

Of course, every case is different.  And if your pre-existing condition is significant, we need to know as juries may not correctly apply this rule.  And you may lose out as a result. 

As your attorney, our job is to properly evaluate how strong their pre-existing condition argument may be at trial. 

I won’t tell anyone that I suffered a pre-existing condition.

As a human, I understand this mentality.   You hope that if you keep quiet, no one will ever find out.  Having handled hundreds of cases, we can tell you that this strategy rarely (if ever) works.  That’s because insurance companies will get your medical records and review them thoroughly, or you will be forced to come clean in litigation.

As such, as your attorney, it’s vital that tell us if you had a pre-existing condition so that we can provide you the best strategy under the circumstances.  What’s more, while we deal with pre-existing conditions all the time, we cannot tolerate our clients not being fully transparent with us.  That’s because litigation is already stressful enough.  Adding in the inability to trust only makes our job more difficult.  Dishonesty may also be the ammunition the insurance company needs to sink your case.

We rarely fire clients.  But when we do, it’s for one of two reasons: 1) they treat our people with disrespect, or 2) they are dishonest with us about the fundamental facts of their case.

So, the moral of the story is – be honest with us, so we can do the best job for you. 

Still have questions?

Make sure to check out our Personal Injury & Criminal Defense Practice Pages where we’ve answered many other questions you likely have.  James Abrenio is a Fairfax-Based Personal Injury & Criminal Defense attorney who practices throughout Northern Virginia. You can learn more about James Abrenio, some of our Prior Results, and Read Our Reviews.  Make sure to contact us at Ph. 703-570-4180 for your Free Consultation.