Can You Be Compensated for a Pre-Existing Condition Worsened by an Accident?

You were in a car accident. You’re in pain, but you’re also worried. Why? Because you’ve dealt with this before—an old back injury, a bum knee, or a chronic condition. Now, the insurance company is using your medical history as a weapon, suggesting your prior health issues disqualify you from compensation. Don’t let them dismiss your claim. 

Pre-existing condition accident compensation remains possible, and in New Jersey and Pennsylvania, the law recognizes that an accident can make an existing condition catastrophically worse. The critical question isn’t whether you were already injured, but whether the accident caused additional, significant harm. Understanding how an aggravation claim works is the first step to fighting back and securing the compensation you need.

Key Takeaways for Pre-Existing Condition Accident Compensation

• Both New Jersey and Pennsylvania follow the eggshell plaintiff rule, which holds defendants responsible for all harm caused by an accident, even if the victim was more vulnerable due to prior conditions.
• Compensation covers the aggravation or worsening of a pre-existing condition, not the underlying condition itself, meaning medical evidence must show what changed after the accident.
• Insurance companies frequently dispute claims involving prior injuries, making documentation of your condition before and after the accident essential for fighting for fair compensation.
• Under N.J.S.A. 2A:15-5.1 and Pennsylvania common law, injured parties may recover damages proportional to the harm caused by the defendant’s negligence.
• Treating physicians play a critical role in establishing medical causation by comparing baseline health status to post-accident symptoms and limitations.

How the Eggshell Plaintiff Rule Protects Injured People

The eggshell plaintiff rule is a longstanding legal doctrine that applies in personal injury cases across New Jersey and Pennsylvania. This principle holds that defendants must take victims as they find them, including any pre-existing vulnerabilities that make injuries more severe.

This rule is why prior conditions do not automatically bar recovery and why courts focus on what the accident caused rather than what existed before.

What the Eggshell Plaintiff Rule Means in Practice

The name comes from a simple analogy. If someone has a skull as fragile as an eggshell and a minor impact causes serious injury, the person who caused the impact remains fully responsible. The victim’s unusual vulnerability does not reduce the defendant’s liability.

Courts in both states apply this principle to car accidents, slip and fall incidents, and other personal injury cases. A person with degenerative disc disease who suffers a herniation after a rear-end collision may pursue compensation for that worsening.

Eggshell Plaintiff Rule in New Jersey

New Jersey courts have consistently upheld the eggshell plaintiff doctrine in personal injury cases. The principle recognizes that many accident victims have some degree of prior injury or age-related degeneration. The focus is on proving that the accident caused measurable harm beyond what existed before. Medical records from before the accident become important baseline evidence.

Eggshell Plaintiff Rule in Pennsylvania

Pennsylvania follows the same fundamental principle through its common law tradition. A person who causes harm to someone with a pre-existing condition remains responsible for any aggravation. Juries receive guidance to separate prior conditions from accident-related harm when calculating damages.

Aggravated Pre-Existing Condition Claims Explained

An aggravated pre-existing condition claim focuses on proving that an accident made an existing health problem worse. This differs from claiming the accident caused a condition that already existed. The distinction matters for both legal strategy and medical documentation.

Insurance adjusters may attempt to blur this line, suggesting that any prior treatment means current symptoms are unrelated to the accident.

The Difference Between Aggravation and Causation

Aggravation means worsening or acceleration of a condition. Someone with mild arthritis in their knee who falls on a wet floor and tears cartilage has suffered an aggravation. The arthritis existed before, but the acute injury happened because of the fall.

Pure causation claims argue the accident created a new condition. Many pre-existing condition cases involve both elements. A collision might aggravate chronic back problems while also causing new soft tissue injuries.

What Compensation May Cover in Aggravation Cases

Damages in aggravated injury claims typically address the additional harm caused by the accident. This may include increased medical treatment, new symptoms, lost work capacity beyond prior limitations, and pain and suffering related to the worsening.

Courts do not award compensation for the original condition or its natural progression. However, if the accident accelerated the need for surgery by years, compensation may reflect that acceleration.

Workers’ Compensation vs. Personal Injury Claims

The rules and compensation mechanisms differ between workers’ compensation and personal injury law. In workers’ compensation cases, New Jersey’s Second Injury Fund may be responsible for the balance of disability if a pre-existing condition is aggravated by a work-related accident, whereas personal injury claims follow the eggshell plaintiff rule.

The following differences affect how aggravation claims proceed in each system:

• Workers’ compensation provides benefits regardless of fault, while personal injury claims require proving another party’s negligence caused the accident.
• Pain and suffering damages are generally available in personal injury cases but not in workers’ compensation claims.
• Settlement structures differ significantly, with workers’ compensation often involving ongoing benefit arrangements rather than lump-sum payments.
• In workers’ compensation, settlements may sometimes include provisions for future medical expenses related to the aggravated condition, depending on the terms of the settlement and applicable law.

These distinctions affect both the evidence needed and the types of compensation available.

Why Medical Evidence Matters in Pre-Existing Injury Claims

Medical evidence forms the foundation of any accident-worsened prior injury claim. Without documentation showing the difference between before and after the accident, insurance companies have room to argue that current symptoms represent natural progression rather than accident-related harm.

Building a strong medical record requires attention to both historical documentation and post-accident care.

Baseline Medical Records Establish Prior Status

Records from before the accident show what your condition looked like at baseline. If you had occasional back pain managed with over-the-counter medication, that documentation establishes your functional level.

After the accident, records showing constant pain and surgical recommendations tell a different story. The contrast between baseline and current status helps demonstrate aggravation.

Post-Accident Diagnostics Show Changes

Imaging studies like MRIs, X-rays, and CT scans provide objective evidence of structural changes. Comparing post-accident images to prior studies can reveal new herniations, fractures, or other injuries that occurred as a result of the accident.

Physicians reviewing these comparisons can offer opinions about what the accident caused versus what existed before. These opinions may become critical evidence in disputed claims.

Treating Physician Opinions on Medical Causation

The doctors who treat your injuries regularly are often the most persuasive voices in aggravation cases. They review your complete history, examine you in person, and observe how your condition has changed over time. A treating physician’s opinion that the accident worsened your condition carries significant weight with courts and juries.

Insurance Denial Tactics for Pre-Existing Condition Claims

Insurance companies may dispute claims involving prior injuries more aggressively than claims involving healthy individuals. Understanding common tactics helps injured people prepare for pushback and gather appropriate evidence. These disputes do not mean claims lack merit. They reflect standard insurance practices aimed at reducing payouts.

Blaming Everything on Prior Conditions

Adjusters may review medical records and argue that all current symptoms relate to prior conditions. This approach ignores the concept of aggravation entirely. Someone may have had periodic back pain for years but functioned normally and worked without restrictions. If an accident causes constant severe pain and an inability to work, the change represents compensable harm.

Questioning Causation Without Medical Basis

Insurance companies sometimes hire medical reviewers who examine records but never actually examine the injured person. These paper reviews often reach conclusions that contradict treating physician opinions. Courts and juries typically consider that treating physicians have direct knowledge that record reviewers lack.

Proving the Accident Worsened Your Condition

The burden of proof in aggravated injury claims rests with the injured person. The standard is a preponderance of the evidence, meaning it must be more likely than not that the accident caused measurable worsening of the pre-existing condition. This standard does not require absolute certainty.

Meeting this burden requires evidence showing that the accident caused harm beyond what existed before.

Documenting the Change in Symptoms

Keeping detailed records of how symptoms changed after the accident helps establish the timeline of worsening. Notes about pain levels, activity limitations, and medication needs all contribute to the picture. Physicians rely on patient reports to understand symptom progression. Clear communication about changes helps treating physicians form accurate opinions about causation.

Key Evidence That Helps Strengthen Your Claim

The following types of evidence are valuable in aggravation cases:

• Pre-accident medical records showing baseline condition, treatment frequency, and functional limitations before the incident occurred.
• Post-accident imaging studies compared directly to any prior imaging to reveal new or worsened structural damage.
• Treating physician opinions specifically addressing whether the accident caused or contributed to current symptoms and limitations.
• Employment records demonstrating work capacity before the accident and any changes afterward.
• Personal documentation, including journals and statements from family members describing how daily activities changed.

This evidence collectively helps establish the contrast between your condition before and after the accident, which forms the core of any aggravation claim.

How Comparative Fault Affects Pre-Existing Condition Claims

Both New Jersey and Pennsylvania follow modified comparative negligence systems that may reduce compensation if the injured person shares some fault for the accident. Having a pre-existing condition is not considered a form of comparative fault. Comparative fault only relates to the conduct of the parties involved in the accident, not their health status.

New Jersey’s Comparative Negligence Standard

Under N.J.S.A. 2A:15-5.1, an injured person may recover damages if their negligence does not exceed that of the defendant. If the individual is found more than 50% at fault, recovery is barred entirely. If they are found 50% or less at fault, recovery is reduced proportionally.

Pennsylvania’s Comparative Fault Approach

Pennsylvania follows a similar rule under 42 Pa.C.S. § 7102. Injured parties may not recover if they bear more responsibility for the accident than the combined fault of all defendants. The pre-existing condition itself is not a form of comparative fault. Having prior injuries does not make someone responsible for an accident.

FAQ for Pre-Existing Injury Personal Injury Claims

Does the at-fault driver’s insurance have access to all my medical history?

Insurance companies may request records related to the injuries claimed in your case. However, unlimited access to your entire medical history is not automatic. Records from unrelated conditions and time periods may be protected from disclosure. Disputes about the scope of medical record requests often arise in personal injury cases.

What if I did not have symptoms from my pre-existing condition before the accident?

Asymptomatic pre-existing conditions still qualify for the eggshell plaintiff rule. Someone with degenerative changes visible on imaging but no pain before an accident may still pursue compensation if the accident makes those changes symptomatic. The relevant question is whether the accident caused the symptoms, not whether the underlying condition existed.

How long do I have to file a claim involving a pre-existing condition?

New Jersey and Pennsylvania both have two-year statutes of limitations for most personal injury claims. This deadline runs from the date of the accident in most cases. Claims involving government entities may have shorter notice requirements. Missing these deadlines may bar recovery regardless of case strength.

What role do independent medical examinations play in these cases?

Insurance companies may request that you attend an examination with a physician of their choosing. These independent medical examinations give the insurance company’s doctor an opportunity to evaluate your condition. The examiner’s opinions may differ from treating physician opinions. Understanding the purpose and limitations of IMEs helps injured people prepare appropriately.

What happens if my condition continues to worsen after the case settles?

Most personal injury settlements are final and release all claims related to the accident. Future worsening of conditions typically cannot form the basis for additional claims against the same defendant. In workers’ compensation, settlements may sometimes include provisions for future medical expenses related to the aggravated condition, depending on the terms of the settlement and applicable law.

Protecting Your Rights After an Accident Worsens a Prior Condition

A prior condition does not cancel your rights after an accident. It changes what must be proven. The eggshell plaintiff rule in both New Jersey and Pennsylvania recognizes that many accident victims bring some degree of prior vulnerability to a crash, and defendants remain responsible for the harm they cause.

If you are dealing with insurance pushback because of your medical history, Grungo Law offers free consultations to residents throughout South Jersey and the Philadelphia area. Our attorneys work on a contingency fee basis, meaning you pay nothing unless we recover compensation for you. Contact us to discuss your situation and learn how we fight for fair compensation in pre-existing condition cases.