Can an insurance company deny your Florida injury claim because of a preexisting condition? Learn about your rights and how Jalo Law can help.
Just because you were injured before doesn't mean you can't be injured again. And it certainly doesn't mean an insurance company can automatically avoid responsibility for making your condition worse.
Imagine being involved in a car accident that leaves you suffering from significant neck or back pain. You seek medical treatment, undergo an MRI, and discover injuries that may require injections, physical therapy, or even surgery. You submit a claim to the at-fault driver's insurance company, expecting fair compensation for your injuries. Instead, the insurance adjuster tells you: "Our investigation revealed that you had a preexisting condition. Therefore, we do not believe your injuries were caused by this accident."
Unfortunately, this is a common dispute in personal injury claims.
At Jalo Law, we believe accident victims should understand an important principle of Florida law: Having a preexisting injury does not automatically prevent you from recovering compensation when someone else's negligence aggravates or worsens that condition.
Here’s what you need to know.
What is Considered a Preexisting Injury?
A preexisting injury is a medical condition or injury that existed before the accident giving rise to your personal injury claim.
Common examples include:
Herniated or bulging discs in the cervical or lumbar spine
Degenerative disc disease
Arthritis or other degenerative joint conditions
Previous neck, back, shoulder, or knee injuries
Prior surgeries or orthopedic procedures
Chronic pain conditions
Injuries sustained in previous automobile accidents
Many people have degenerative changes in their spine or joints without experiencing significant pain or limitations in their everyday lives. For example, an individual may have mild degenerative disc disease but work full-time, exercise regularly, and perform normal daily activities without difficulty. Following a car accident, that same individual may develop severe pain, limited mobility, or neurological symptoms.
The critical question is not simply whether a medical condition existed before the accident. The question is whether the accident caused a new injury or aggravated an existing condition.
Can an Insurance Company Deny Your Claim Because of a Preexisting Condition?
An insurance company may investigate and dispute whether an accident caused the injuries being claimed. However, the existence of a preexisting condition alone does not automatically defeat a personal injury claim under Florida law.
Florida recognizes that a negligent party may be responsible for aggravating an existing injury or medical condition. This is particularly important because accident victims do not all begin with the same physical health. Some individuals are young and healthy. Others have undergone previous surgeries, suffer from arthritis, or have experienced earlier injuries.
The law does not automatically excuse a negligent driver from responsibility simply because the person they injured was more physically vulnerable. That principle is closely related to what is commonly known as the Eggshell Plaintiff Rule.
Florida’s Eggshell Plaintiff Rule: Why Your Injuries Matter
The Eggshell Plaintiff Rule is a longstanding legal principle recognizing that a negligent party generally takes an injured person as they find them. In simpler terms, a person who causes an accident cannot necessarily escape responsibility because the victim was more susceptible to injury than someone else.
Consider this example:
Driver A has no prior history of neck or back problems and experiences minor soreness that resolves after several weeks.
Driver B has a history of degenerative disc disease but was functioning normally before the accident. Following the collision, Driver B develops significant pain, radiating symptoms, and functional limitations requiring extensive medical treatment.
Although both individuals experienced similar collisions, their physical responses may be very different. The negligent driver may be responsible for the aggravation of Driver B's preexisting condition if the evidence establishes that the collision caused that aggravation. The fact that Driver B was more vulnerable to injury does not automatically eliminate the claim. However, compensation is generally limited to the harm legally attributable to the accident, rather than unrelated symptoms or limitations that would have existed regardless of the collision.
What if Your MRI Shows Degenerative Disc Disease?
One of the most common disputes in Florida automobile accident claims involves MRI findings. After an accident, an injured person may undergo an MRI revealing:
Disc herniations
Disc bulges
Spinal stenosis
Degenerative disc disease
Nerve root impingement
Other abnormalities affecting the spine
An insurance company may argue that these findings are degenerative, age-related, or unrelated to the accident. But there is an important distinction between having a preexisting abnormality and experiencing symptoms or limitations because of an accident.
For example, an individual may have a preexisting disc bulge that was previously asymptomatic. Following a collision, that individual may develop new radiating pain, numbness, weakness, or other neurological symptoms.
Even if the underlying disc abnormality existed before the accident, the collision may have aggravated the condition or caused it to become symptomatic. This does not mean every MRI abnormality is accident-related. Medical evidence is necessary to evaluate the cause and extent of the claimed injuries. The appropriate analysis should consider the patient's medical history, symptoms before and after the collision, examination findings, diagnostic imaging, and treating physicians' opinions.
An MRI finding described as "degenerative" does not, by itself, resolve whether an accident caused a compensable aggravation.
How Do You Prove That an Accident Aggravated a Preexisting Injury?
Establishing the connection between an accident and an aggravated medical condition often requires a careful review of medical records and supporting evidence.
Several factors may help establish causation.
Medical Records Before and After the Accident
Comparing medical records can reveal meaningful changes in symptoms, treatment, and functional limitations. For example, a person may have received occasional treatment for lower back discomfort several years before an accident but required extensive treatment, injections, or surgical evaluation afterward. That change may be relevant evidence of aggravation.
Diagnostic Imaging
MRI studies, X-rays, and other diagnostic tests may help physicians evaluate the nature and extent of an injury. When previous imaging exists, comparing it with post-accident studies may be particularly helpful.
However, the absence of prior imaging does not automatically prevent an injured person from establishing an aggravation claim.
Treating Physician Opinions
Medical professionals may provide opinions regarding whether an accident caused a new injury or aggravated a preexisting condition. These opinions may address changes in symptoms, objective findings, treatment requirements, and the anticipated need for future care.
Changes in Daily Acitivies
Evidence of how an individual's life changed after an accident may also be important. For example, someone who previously worked full-time, exercised regularly, and cared for their family without significant limitations may now struggle with those same activities. Testimony from the injured person, family members, coworkers, and other witnesses may help explain these changes.
What if You Had No Pain Before the Accident?
One of the most important distinctions in an aggravation claim is whether a preexisting medical condition was symptomatic or asymptomatic before the collision. A person may have degenerative changes in their spine without experiencing meaningful pain. Following an accident, those same anatomical structures may become painful or produce symptoms that interfere with daily life.
Consider the following example:
Before the accident:
No regular complaints of neck pain
No ongoing treatment for cervical spine symptoms
No significant limitations in daily activities
Able to work and exercise normally
After the accident:
Persistent neck pain
Radiating pain or numbness into the arms
MRI findings requiring further medical evaluation
Physical therapy, injections, or other treatment
Difficulty working or completing normal activities
These differences may support a claim that the collision caused a new injury or aggravated a previously asymptomatic condition. However, the timing of symptoms alone does not conclusively establish medical causation. The entire medical and factual record must be considered.
Can You Recover Compensation for an Aggravated Preexisting Injury?
Yes. Depending on the facts and applicable Florida law, an injured person may recover compensation for damages caused by the aggravation of a preexisting condition.
Potential damages may include:
Medical expenses: Reasonable, legally recoverable treatment expenses attributable to the accident-related aggravation.
Future medical care: Necessary future treatment associated with the injury or aggravation.
Lost wages: Income lost because of accident-related injuries.
Loss of earning capacity: Reduced ability to earn income when supported by the evidence.
Pain and suffering: Physical pain, mental anguish, and other qualifying noneconomic damages.
Loss of enjoyment of life: Accident-related limitations affecting normal activities and quality of life.
In Florida automobile accident cases, recovery of certain noneconomic damages is subject to the injury threshold established by Florida Statutes § 627.737, where applicable. Additionally, Florida law contains rules governing the proof and recovery of medical expenses. The amount of compensation depends on the particular injuries, evidence of causation, applicable legal requirements, and the damages attributable to the accident.
What Should You Do if the Insurance Company Blames Your Injuries on a Preexisting Injury?
If an insurance company is denying or undervaluing your claim because of your medical history, consider taking the following steps.
1. Be honest about your medical history - Do not attempt to conceal previous injuries, treatment, or medical conditions. Inaccurate statements may undermine your credibility and complicate your claim.
2. Obtain relevant medical records - Records documenting your condition before and after the accident may help establish whether your symptoms or limitations changed.
3. Explain your symptoms accurately to your medical providers - Make sure your treating physicians understand your previous medical history, current symptoms, and how your condition has changed since the accident.
4. Document the impact on your daily life - Keep track of meaningful changes in your ability to work, sleep, exercise, perform household tasks, and participate in normal activities.
5. Be cautious about accepting a settlement - Before accepting an offer, consider whether it adequately accounts for the injuries and damages legally attributable to the accident, including reasonably anticipated future medical needs.
6. Speak with a Florida personal injury attorney - An attorney can review the medical evidence, evaluate the insurer's position, and help determine whether the accident caused a compensable aggravation of your condition.
How Jalo Law Can Help With Preexisting Injury Disputes
Insurance companies frequently focus on prior medical conditions when evaluating automobile accident claims. But a medical history is only one part of the story. The more important questions may be how the individual was functioning before the accident, what changed afterward, and whether medical evidence connects those changes to the collision.
At Jalo Law, we help injured individuals evaluate personal injury claims involving disputed medical causation, preexisting conditions, and accident-related aggravations. Our firm can review relevant medical records, investigate the circumstances of the accident, evaluate the insurance company's position, and pursue compensation supported by the evidence and applicable law.
A prior injury should not automatically prevent you from seeking compensation for additional harm caused by someone else's negligence.
Don’t Let a Preexisting Injury Automatically End Your Claim. Contact Us Today.
If you were injured in a Florida car accident and the insurance company is blaming your symptoms on a previous injury or degenerative condition, you may still have a valid personal injury claim.
You may have had a medical condition before the accident. That does not mean you were experiencing the same pain, limitations, or need for treatment before the collision.
Understanding that distinction can be critical to evaluating your legal rights.
Contact Jalo Law to discuss your accident, your medical history, and your potential options for pursuing compensation.
Disclaimer: This article is provided for general informational purposes only and does not constitute legal advice. The outcome of any personal injury claim depends on the specific facts, medical evidence, insurance coverage, and applicable Florida law. Reading this article or contacting Jalo Law does not establish an attorney-client relationship.