HOW PRE-EXISTING CONDITIONS AFFECT PERSONAL INJURY CLAIMS
April 18, 2022
Insurance companies will often use a pre-existing medical condition as a means to limit or deny a claim you make for a personal injury, whether it be because of a car accident, a slip-and-fall in a grocery store, or a back injury suffered while lifting boxes at work.
A pre-existing condition could be something you suffered previously, and the insurance company will claim that your accident didn’t actually cause the injury for which you’re making a claim. Instead, the injury was already there and was only aggravated. This could be, for instance, a previous back strain you suffered, a neck injury, healed broken bones, a degenerative disk disease, or arthritis.
However, the law in Massachusetts, as in most states, adheres to what is called the eggshell skull rule, also known as just the eggshell doctrine. This means that even if you are more susceptible to injury because of something you suffered or something that happened to you previously, you are still protected under the law.
If you or a loved one has suffered an injury due to the negligence of others in or around Shrewsbury, Southborough, or Webster, Massachusetts, contact the Law Office of James A. Maniatis. I have been helping personal injury victims recover their just compensation for more than three decades, and I stand ready to help you, too.
I also proudly serve clients in Westborough, Northborough, Grafton, Boylston, Millbury, Upton, Dudley, and Oxford.
WHAT IS A PRE-EXISTING CONDITION?
Insurance companies will often claim they don’t owe you compensation if you merely aggravated some problem or medical condition you already had. As mentioned above, this could be a back sprain from a previous injury, a neck injury, loss of hearing or vision, or even anxiety and depression.
Pre-existing conditions can be termed as either active or inactive. Active means that you are being treated for the condition at the time of your accident. Inactive means that you were free of any symptoms at the time of the accident resulting in your injury.
Regardless of whether your condition is active or inactive, insurers can use that as a reason to deny or limit any compensation you file for. Active conditions obviously pose more of a challenge when you file a claim for your injury as you will need to compile sufficient medical evidence to show that the accident worsened your condition.
WHAT TO DO AFTER YOUR ACCIDENT
Even if your pre-existing condition is showing no symptoms, to press your claim for compensation, you will need to seek immediate medical attention and evaluation as quickly after your accident as possible. Your physician or medical group will need to provide X-rays, MRIs, and other test results to show that the accident led to your current state.
Even if you feel no symptoms immediately after your car accident, slip-and-fall incident, or work-related injury, you need to seek immediate medical evaluation. Injuries have a way of not showing up until hours, days, and sometimes even weeks after an accident, and you will need medical documentation for any claim you file for compensation.
THE EGGSHELL DOCTRINE
The eggshell skull rule, or eggshell doctrine, legally protects those whose pre-existing conditions make them more susceptible to injury. The eggshell rule stems from an 1891 Wisconsin case but is now recognized in every state, including Massachusetts.
However, there is another doctrine called the crumbling skull rule, which holds that the negligent party should be liable for returning the accident victim to their physical state prior to the accident, but they are not responsible for bringing the victim to a better or improved state.
For example, if you suffer fractures in your slip-and-fall because of brittle bones and your medical bills are $100,000, the store owner would be liable for the $100,000, but if you decide to have experiment surgery to correct the brittleness, the owner would not be liable for that.
RELY ON THE LAW OFFICE OF JAMES A. MANIATIS
If you’ve suffered an injury through the negligence or actions of others, contact me at the Law Office of James A. Maniatis. My team is experienced in dealing with insurance companies and their denying tactics.
We can help you compile the medical documentation you need and then deal with the claims adjusters. While you recover, let us work on negotiating a fair and proper settlement or seeking compensation through a personal injury lawsuit.