As you may already know, personal injury claims are designed to provide financial compensation to individuals who have suffered harm due to the negligence or wrongdoing of another party. However, when a claimant has a pre-existing condition, the process of calculating a settlement can become more challenging.
That’s because pre-existing conditions, such as chronic illnesses or previous injuries, make it harder to fully understand the level of suffering that can be attributed to the accident. Similarly, the claimant might argue that their pre-existing condition has worsened because of the accident, so the extra level of suffering needs to be determined somehow.
Understanding how these conditions can affect compensation is vital for claimants seeking a fair settlement. In this post, we explore the role of pre-existing conditions in personal injury claims, the legal principles involved, and the steps claimants can take to strengthen their case.
What Is Considered A Pre-Existing Condition?
It might seem obvious, but, for clarification, when making a personal injury claim, a pre-existing condition refers to any medical issue or injury that existed before the accident occurred. As part of the claims process, you may need to disclose many different types of conditions, including arthritis, muscular problems, previous fractures, and even mental health conditions.
That’s because any settlement only covers the suffering caused by the defendant, so it’s important to understand your current level of suffering versus previous levels.
For example, somebody with a history of back pain may find that being involved in a road traffic accident worsens the amount of back pain they now have to deal with. Similarly, a person with a pre-existing mental health condition may experience heightened anxiety following a traumatic event such as a serious road traffic accident.
Pre-existing conditions matter in personal injury claims because they can complicate the assessment of damages. Insurers and, in some cases, courts must determine whether the accident caused a new injury, aggravated an existing condition, or had no impact at all. This distinction is critical as it can directly affect the amount of compensation awarded.
How Pre-Existing Conditions Impact Compensation
The legal principle known as the eggshell or thin skull rule plays a significant role in personal injury claims involving pre-existing conditions. This rule states that a defendant must take the claimant as they find them, meaning they are liable for the full extent of the injury caused during the accident, even if the claimant’s pre-existing condition makes them more at risk of being harmed.
For example, if somebody with a fragile bone condition suffers a fracture in an accident, the defendant cannot argue that the injury would have been less severe in a healthier individual.
However, establishing causation and aggravation is key. Claimants must prove that the accident either caused a new injury or worsened their pre-existing condition. In all personal injury claims, medical evidence is vital in this process because it helps demonstrate the link between the accident and the injury.
For example, a medical report might show that a claimant’s pre-existing back pain significantly worsened after a car accident, leading to increased disability and pain.
Due to the complexity of assessing pre-existing conditions in personal injury claims, it’s usually a good idea to seek specialist legal advice. In many cases, solicitors may hire specialist medical professionals to help determine how much suffering has increased as a result of the accident.
Establishing A Baseline For Pre-Existing Conditions
To determine the impact of an accident on a pre-existing condition, it is essential to establish a baseline of the claimant’s health before the incident. This involves a thorough review of the claimant’s medical history covering past treatments, diagnoses, and any prior injuries. Usually, this will mean that copies of your medical records will be obtained by your solicitor as they provide a clear picture of your condition before the accident.
Independent medical assessments are often required to evaluate the extent of the injury or aggravation. These assessments are conducted by medical experts who can provide an unbiased opinion on how the accident has affected the claimant’s health. For example, a specialist might compare MRI scans taken before and after a workplace accident to determine the degree of aggravation.
Honesty is also vital when making a claim. Claimants must disclose all relevant health information to their solicitors and medical experts. Failing to do so can lead to disputes, delays, or even the rejection of the claim. That’s because if a claimant fails to disclose their pre-existing injuries, the defendant’s insurers will more than likely find out about them during their own investigations.
Calculating Compensation With Pre-Existing Conditions
When pre-existing conditions are involved, compensation is awarded for the additional harm or aggravation caused by the accident. In other words, claimants are compensated for the difference between their condition before and after the incident, rather than for the original condition itself.
For example, if a claimant had a pre-existing neck injury that was worsened after a slip on wet flooring, they would only be compensated for the additional pain and suffering caused by the aggravation. As we’ve discussed, this is quite a complex process that can take some time.
There are two main types of compensation in personal injury claims, general damages and special damages. General damages cover non-financial losses like pain, suffering, and loss of amenity (the impact your injuries have on your hobbies, for example). Special damages compensate for financial losses, including medical expenses, lost earnings, and rehabilitation costs.
Several factors influence how much compensation is awarded, including:
- The severity of the aggravated condition.
- The prognosis for recovery.
- The impact on the claimant’s daily life.
For instance, a claimant who can no longer work due to the aggravation of a pre-existing condition may receive higher compensation to account for their lost earnings and reduced quality of life. Similarly, somebody who was a pianist in a local orchestra could be compensated if they are no longer able to enjoy their hobby as a result of ongoing wrist problems sustained in their accident.
Challenges In Claims Involving Pre-Existing Conditions
As you might expect, claims involving pre-existing conditions often face challenges, particularly when it comes to proving causation. Insurers may argue that the claimant’s injuries were solely due to their pre-existing condition and not the accident. After all, insurers will always try to reduce the amount of compensation they pay out wherever possible.
For example, if a claimant with a history of knee pain suffers a knee injury at work, the insurer might claim that the injury would have occurred regardless of the accident or that the pain is no worse than it was before the accident.
These disputes can lead to delays in settlement as additional evidence, such as medical reports and expert opinions, may be required to establish the link between the accident, injury, and the increased level of suffering. One of the best ways to try and overcome these challenges is to work with a No Win No Fee solicitor with experience of claiming when pre-existing conditions are involved.
Our team of solicitors has decades of experience in complex claims, so please feel free to get in touch if you’d like to discuss your case.
How To Strengthen Your Claim
To maximise the chances of a) making a successful claim and b) being compensated correctly, claimants should take steps to strengthen their case.
The first step is essential to gather comprehensive medical evidence. This includes obtaining medical records, specialist tests, and expert reports that show the state of injury before and after the accident.
For example, a claimant with a pre-existing broken leg injury should provide evidence of any prior treatment and any changes in their symptoms following the accident.
Working with a personal injury solicitor can also be crucial. Our team of solicitors who specialise in personal injury claims can provide valuable guidance and support throughout the process. They can help to gather evidence, negotiate with insurers, and represent the claimant in court if necessary. In our experience, only a small percentage of claims require court intervention as both parties try to avoid extra costs by reaching an amicable settlement.
Finally, claimants must be transparent about their medical history. Providing accurate and complete information about pre-existing conditions ensures that the claim is based on a solid foundation and reduces the risk of disputes or delays.
Conclusion
Pre-existing conditions can significantly impact personal injury compensation because they complicate the assessment of damages. Therefore, careful consideration of causation and aggravation must be performed as part of the claims process.
However, with the right legal and medical support, claimants can find it easier to handle these challenges and secure a fair settlement.
If you have a pre-existing condition and are considering a personal injury claim, call us on 0800 6524 881 for a free consultation to discuss your case today.