The CDC reports that 51.8% of adults have at least one chronic health condition. Most people have a medical condition or previous injury of some kind.
What happens when you have a pre-existing injury and you’re then in a personal injury accident? Do you receive less in compensation? How does the case change?
Our experienced San Bernardino personal injury lawyers at LA Century Law explain.
Can you still receive compensation in a personal injury claim with a pre-existing condition?
Yes. A person with a pre-existing condition can receive compensation for a personal injury claim. The amount of compensation is based on the extent of injury aggravation, meaning the plaintiff is compensated to the extent that the condition is made worse or because of new conditions that develop because of personal injury.
Understanding the Impact of Pre-Existing Conditions on Injury Claims
A person with a pre-existing condition can receive compensation for a personal injury. The pre-existing condition affects the claim in two ways.
Recovery for aggravation of a pre-existing injury
First, someone with a pre-existing condition can recover only to the extent that the injury is made worse by the accident. If a person already has medical bills and pain because of a medical problem, they recover only for amounts above and beyond what existed before.
The person with the pre-existing condition will receive less than someone whose medical conditions are due to the accident.
Eggshell plaintiff in California
Second, someone with a pre-existing condition is not limited by the fact that they may have been more susceptible to injury. Even if someone in better health may have been injured to a lesser extent in the same scenario, a victim may recover fully for their damages. In California, this is called the eggshell plaintiff rule.
Who decides the issue of a pre-existing condition in a personal injury claim?
The question of aggravation of a pre-existing condition in a personal injury claim is for the jury.
The jury decides if the person has a medical condition if it existed before the personal injury, and the extent to which the issue was made worse. The plaintiff has the burden of proof.
How To Prove Your Injuries Were Worsened by the Accident
As the plaintiff, you must prove that your injuries were worsened by the accident. To make your case, you need sound medical evidence, which may include records, tests, and opinion testimony from your treating physician. You may also use an expert who can speak in detail about the specifics of your medical condition and how it was made worse by the accident.
In addition to detailing the aggravation of the medical condition itself, you must also prove the damages you deserve. A claim may include future damages, which may be significant in a scenario where a person has a pre-existing injury. An expert can speak to this issue as well.
Be mindful of some distinctions in California law regarding admission of medical billing. For example, in Corenbaum v. Lampkin, 215 Cal.App.4th 1308 (2013), the court said that a full bill is not relevant to a determination of future medical expenses if the care providers agreed to accept less. See also State Farm Mutual Automobile Ins. Co. v. Huff, 216 Cal. App. 4th 1463 (2013), stating that the total amount billed for charges, by itself, does not establish the reasonable amount charged for services. This may be especially true where Medicare and Medicaid programs pay a fraction of the amount typically billed.
Sufficient attention must be given to proving both the medical aggravation of the pre-existing condition and the damages. As the plaintiff, you may meet your burden of proof by relying on factual and expert testimony. There is a protocol to follow to admit expert testimony into evidence.
Common Challenges Faced in Claims With Pre-Existing Conditions
- Getting fair compensation for pain and suffering when the insurance company says that it’s due to previous medical issues.
- Establishing that aggravation is due to the accident and would not have happened otherwise.
- Identifying the value of future damages specifically for the aggravation.
- Accounting for pre-existing mental health conditions in determining compensation for mental health injury and non-economic suffering.
- Preparing medical experts and following procedural rules for admitting their testimony.
- Responding to the insurance company’s attempts to minimize compensation based on the pre-existing condition.
In most personal injury claims, the victim proves their case through negligence. That means establishing the duty of the defendant, breach of duty, causation of injury, and damages. When there are pre-existing injuries, the task of proving duty and breach of duty are the same. Proving causation and damages becomes more challenging when there are pre-existing conditions. It is a more complicated factual scenario with critical procedural steps.
What You Can Claim If You Have a Pre-Existing Condition
When you have a pre-existing condition, you may claim the same economic and non-economic damages that are available to all personal injury victims. LA Century Law can give you a personalized consultation about the value of your case, including how pre-existing injuries may impact it. Be sure to tell your attorney about all pre-existing conditions.
California Jury Instructions for Pre-Existing Conditions in Personal Injury Claims
Pre-existing conditions – CACI 3927—The plaintiff is not entitled to compensation for a physical or emotional condition they had before the defendant’s conduct. If their physical or emotional condition is made worse, the jury may award reasonable damages for the effect on the condition.
Eggshell defendant – CACI 3928—The jury should award the amount that reasonably and fairly compensates the plaintiff for the defendant’s wrongful conduct. Even if the plaintiff is more susceptible than a normal, healthy person would have been, they may still recover for their damages.
See California Civil Jury Instructions.
Contact an Experienced San Bernardino Personal Injury Lawyer
If you have been in a personal injury accident, pre-existing conditions may impact your case.
You may still receive the compensation you deserve, but you must thoroughly prepare and present your case. At LA Century Law, we’ve recovered millions for our clients.
Work with a premier San Bernardino law firm that understands pre-existing conditions. Call or message us now.