If you have a pre-existing condition and you’ve been injured in an accident in Suffolk County, you probably have questions. What exactly is a pre-existing condition? Does having one hurt your claim? Can you still recover if you had a condition before the accident? How much will having a pre-existing condition reduce your damages?
These are critical questions because many accident victims mistakenly believe that having any prior medical condition eliminates their right to recovery. This misunderstanding costs people thousands of dollars in lost compensation. At the Law Offices of Steven Gacovino P.C., we want to clarify how pre-existing conditions actually affect your personal injury claim under New York law.
What Exactly is a Pre-Existing Condition?
A pre-existing condition is any medical condition, illness, disease, injury, or disorder that you had before your accident occurred. Pre-existing conditions can be documented in medical records or undocumented but known to you.
Common pre-existing conditions include chronic pain disorders like fibromyalgia or chronic back pain, arthritis in various joints, diabetes, heart disease, asthma, previous injuries that healed but left weakness or vulnerability, mental health conditions like depression or anxiety, sleep disorders like sleep apnea, autoimmune diseases like lupus or rheumatoid arthritis, previous fractures that healed but left scarring or weakness, migraine disorders, and any other medical condition you managed or lived with before your accident.
Some pre-existing conditions are serious and well-documented in medical records. Others are minor and undocumented—you might have had a sore shoulder for years that you never saw a doctor about, or chronic headaches you managed without medical treatment. Both count as pre-existing conditions.
The key distinction is timing. If the condition existed before your accident, it’s pre-existing. If it started because of the accident, it’s not pre-existing.
Pre-Existing Conditions are Extremely Common
Nearly all accident victims have some pre-existing condition. Americans live longer lives and experience more health conditions before accidents occur. According to health statistics, the majority of adults have at least one pre-existing condition. If you have a pre-existing condition, you’re in the majority, not an exception.
The fact that you have a pre-existing condition is normal and doesn’t mean your accident claim is weak or invalid. Insurance companies would like you to believe otherwise, but the law doesn’t support their position.
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How New York Law Treats Pre-Existing Conditions
New York follows what’s called the “eggshell plaintiff” rule or “thin-skull plaintiff” rule. This rule states that a defendant is liable for all injuries they cause, even if the plaintiff is more vulnerable than average because of pre-existing conditions.
The classic example is an eggshell plaintiff—someone with extremely fragile bones. If a defendant commits a minor accident that would cause a normal person minor injuries, but causes an eggshell plaintiff severe injuries because their bones are fragile, the defendant is liable for the severe injuries. The defendant takes the plaintiff as they find them, vulnerabilities and all.
This rule makes intuitive sense. It would be unfair to allow defendants to escape liability simply because their victims have medical vulnerabilities. The defendant’s negligence is the cause of the accident. They should be responsible for the full consequences, even if those consequences are worse because of pre-existing conditions.
Under this rule, your pre-existing condition does not reduce your damages. You recover for the full injury you suffered, not for what a hypothetical healthy person would have suffered.
Documenting Your Pre-Existing Condition
For your claim to be strong, you need to establish that you had a pre-existing condition before the accident. This requires documentation.
If you have medical records from before the accident documenting your condition, that’s ideal. Medical records from your primary care doctor, specialists, or therapy providers all establish your pre-existing condition. These records become baseline evidence of your condition’s severity and your symptoms before the accident.
If you don’t have formal medical records but you have testimony from yourself or others who knew you before the accident, that can establish pre-existing conditions. You can testify about symptoms you experienced, limitations you had, or treatments you used. Family members can testify about changes they observed in you after the accident compared to before.
Prescription records showing you were taking medications before the accident help establish pre-existing conditions. Even if you don’t have doctor’s records, pharmacy records showing you filled prescriptions for a condition before the accident help prove the condition existed.
The point is to gather whatever evidence exists showing your condition before the accident. This baseline evidence is critical because it allows your medical providers to testify about how the accident aggravated your pre-existing condition.
Pre-Existing Conditions vs. Aggravation
This distinction is crucial. You cannot claim that an accident caused a pre-existing condition that existed before. But you can claim that the accident aggravated or worsened a pre-existing condition.
If you had arthritis in your knee before your accident, you can’t claim the accident caused your arthritis. But if the accident injured that knee and significantly worsened your arthritis, you can recover for the aggravation.
Aggravation means the accident made your pre-existing condition worse. Before the accident, your chronic back pain was manageable with occasional over-the-counter medication. After the accident, you have severe pain requiring prescription medication, physical therapy, and potentially surgery. That’s significant aggravation.
Aggravation claims must be supported by medical evidence. Your doctor must testify that the accident caused acute worsening of your pre-existing condition. It’s not enough to say your condition got worse; you must prove the accident caused the worsening.
Pre-Existing Condition Recovery Framework
Scenario | Recovery Allowed? | Damages Basis | Notes |
|---|---|---|---|
Pre-existing condition, no accident involvement | No recovery | N/A | Not caused by accident |
Pre-existing condition, minor aggravation | Yes | Aggravation damages | Reduced damages for minor worsening |
Pre-existing condition, major aggravation | Yes | Full aggravation damages | Eggshell plaintiff rule applies |
Accident caused new injury to same area | Yes | Full injury damages | Pre-existing condition doesn’t reduce recovery |
Accident triggered worsening of stable condition | Yes | Aggravation damages | Accident must be substantial factor in worsening |
Pre-existing condition naturally worsening | No | Not recoverable | If accident didn’t contribute to worsening |
Pre-existing condition, unrelated new injury | No (for pre-existing) | Only for new injury | Pre-existing isn’t accident-caused |
Note: New York law allows recovery for aggravation of pre-existing conditions. The at-fault party takes you as they find you, including your medical vulnerabilities.
How Pre-Existing Conditions Affect Damages Calculations
Having a pre-existing condition doesn’t reduce your damages under New York law. You recover for your actual injuries, not for what a hypothetical healthy person would have suffered. However, the calculation can be more complex when pre-existing conditions are involved.
Your economic damages (medical bills, lost wages) are calculated the same way regardless of pre-existing conditions. You recover for medical treatment related to the accident injury, even if you had a pre-existing condition in the same area.
Your non-economic damages (pain and suffering) are calculated based on your actual pain and suffering, not on what someone without a pre-existing condition would have suffered. If your pre-existing condition made you more vulnerable to serious injury, you recover for the serious injury you actually suffered.
However, you cannot recover for pain and suffering related to your pre-existing condition itself—only for the pain and suffering caused by the accident’s aggravation of that condition.
For example: You had chronic arthritis in your knee before your accident. Your pre-existing arthritis pain was perhaps a 3-4 on a 10-point pain scale, manageable with occasional medication. An accident injured your knee, causing an acute injury on top of the pre-existing arthritis. Your pain is now 8-9 on the pain scale and requires intensive treatment. You recover for the 5-6 point increase in pain caused by the accident, not for the baseline 3-4 pain that existed before. However, because the pre-existing condition made the injury worse, your recovery for the 5-6 point increase might be higher than if you didn’t have arthritis.
Insurance Company Arguments About Pre-Existing Conditions
Insurance companies make several arguments to minimize claims involving pre-existing conditions. Understanding these arguments helps you counter them.
They argue the pre-existing condition, not the accident, is causing your current problems. Response: Medical records showing the condition was stable before the accident, combined with medical testimony that the accident caused acute worsening, defeats this argument.
They argue you would have had the same symptoms without the accident because the condition naturally worsens over time. Response: Medical testimony distinguishing between natural progression of a condition and accident-caused aggravation defeats this argument. If your arthritis would have progressed minimally but the accident caused major worsening, you recover for the aggravation.
They argue that because you had the condition before, it wasn’t serious and shouldn’t affect your life. Response: If a pre-existing condition made you vulnerable to more serious injury from the accident, the eggshell plaintiff rule applies and you recover for the serious injury.
They request extensive pre-accident medical records hoping to find reasons to minimize your claim. Response: While you should provide records, insurance companies sometimes use medical history selectively to argue your condition was worse than it was or that treatment wasn’t related to the accident.
Medical Causation is Critical
For aggravation claims, medical causation is the linchpin. You must have medical evidence that the accident caused aggravation of your pre-existing condition.
Your doctor must examine you, review your medical history, review your pre-accident medical records, and testify that the accident caused acute worsening of your condition. This testimony is the foundation of your claim.
Sometimes, multiple opinions are helpful. If the doctor who treated you after the accident provides medical causation testimony, that’s powerful. But if that doctor didn’t have access to your pre-accident medical records, we might need another physician to review all records and provide expert testimony about causation.
Pre-Existing Conditions and Comparative Negligence
New York’s comparative negligence law applies to pre-existing condition cases. You recover 100 percent of your damages if the defendant is 100 percent at fault. If you’re partially at fault, your damages are reduced by your percentage of fault, but the pre-existing condition itself doesn’t reduce your recovery further.
The pre-existing condition doesn’t create comparative fault. Having a weak back doesn’t mean you’re partially responsible for an accident. The defendant’s negligence caused the accident. Your medical vulnerability doesn’t change that.
Special Considerations for Suffolk County Cases
Pre-existing conditions are common in Suffolk County because our population is aging and has access to medical care where conditions are documented. Insurance companies know this and often emphasize pre-existing conditions to minimize claims.
However, Suffolk County juries and judges understand that pre-existing conditions don’t eliminate liability. They apply the eggshell plaintiff rule fairly, allowing recovery for accident-caused aggravation of pre-existing conditions.
Local medical experts familiar with Suffolk County’s population and typical pre-existing conditions can provide strong testimony about how accidents aggravate common conditions.
Working with Your Medical Providers
If you have a pre-existing condition and are injured in an accident, tell your medical providers about the pre-existing condition and about the accident. Explain how your symptoms have changed since the accident compared to before.
Your providers need this information to properly assess your condition and testify about causation. If you don’t tell them, they might not understand the baseline and might attribute all your symptoms to the accident rather than distinguishing between pre-existing and accident-caused.
Similarly, ask your doctors to document the distinction in medical records. Have them note your symptoms before the accident, your pre-existing condition status, and how the accident changed your condition.
Interested in Learning More?
For detailed information about the eggshell plaintiff rule and how it protects you, read our guide on whether pre-existing conditions disqualify you from recovery.
To understand what damages you can recover beyond medical bills and lost wages, read our guide on what damages you can recover in a personal injury lawsuit.
For information about evaluating settlement offers when pre-existing conditions are involved, read our guide on evaluating insurance settlement offers.
External Resource: The National Institutes of Health provides information about pre-existing conditions and their medical management at https://www.nih.gov/
Protect Your Rights Despite Pre-Existing Conditions
Having a pre-existing condition does not disqualify you from recovering after an accident. New York law recognizes that people have medical histories and vulnerabilities, and defendants must take you as they find you. If an accident aggravates your pre-existing condition, you have every right to recover.
The Law Offices of Steven Gacovino P.C. understands how pre-existing conditions affect personal injury claims. We know how to document pre-existing conditions, how to prove aggravation, and how to respond to insurance company arguments minimizing your claim. We’ve recovered substantial compensation for countless clients with pre-existing conditions throughout Suffolk County.
Call 844-692-1200 today for a free consultation about your accident and pre-existing condition. Tell us about your medical history and how the accident changed your condition. We’ll assess your claim and explain your rights. We work on a contingency fee basis—you don’t pay unless we win.
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1. What counts as a pre-existing condition?
Any medical condition, illness, injury, or disease you had before your accident counts as a pre-existing condition. This includes conditions documented in medical records, conditions you managed with medication or therapy, and even undocumented conditions you lived with. Chronic pain, arthritis, diabetes, heart disease, mental health conditions, previous injuries, and countless other conditions all count.
2. If I have a pre-existing condition, does the accident have to have directly affected that same body part for me to recover?
No. Even if the accident injured a different body part, if it caused you to fall or exert yourself differently because of the accident, aggravating your pre-existing condition, you can recover for the aggravation. However, you must prove medical causation—that the accident actually caused the worsening, not just coincidental timing.
3. How much can I recover for a pre-existing condition that was aggravated?
You recover for the full aggravation, not reduced amounts. Under the eggshell plaintiff rule, the defendant is liable for all consequences of their negligence, including the consequence of aggravating your pre-existing condition. If the aggravation is significant, your damages can be substantial.
4. Do I have to have medical records documenting my pre-existing condition?
Medical records help prove your pre-existing condition, but they’re not always necessary. Testimony from yourself and others who knew you before the accident can establish pre-existing conditions. However, medical records strengthen your claim significantly. If you have them, provide them.
5. Can the insurance company argue that my pre-existing condition was going to get worse anyway?
They can argue it, but that argument doesn’t eliminate your recovery. If your condition would have naturally progressed minimally without the accident, but the accident caused major acceleration of worsening, you recover for the accident-caused aggravation. Medical testimony distinguishing natural progression from accident-caused worsening defeats this argument.