What If I Had a Preexisting Injury Before My Alabama Car Wreck?

What If I Had a Preexisting Injury Before My Alabama Car Wreck?

One of the first things an insurance company may investigate after a serious Alabama car wreck is your medical history.  If you injured your back five years ago, had previous neck surgery, already had arthritis in your knee, or had an MRI showing degenerative disc disease before the wreck, the insurance company may argue: “The car wreck didn’t cause this. You already had it.”

But having a preexisting medical condition does not automatically prevent you from recovering damages after an Alabama car wreck.

Alabama law recognizes an important distinction between damages caused by a condition that existed before the wreck and damages caused when the wreck aggravates a preexisting injury or condition; so, the central question is usually not simply: “Did you have this condition before the wreck?”

The better question is: “What did the wreck do to your condition?”

Can I Recover If I Was Already Injured Before the Car Wreck?

Yes, if the evidence establishes that the defendant’s negligence proximately caused a new injury or aggravated your preexisting condition.  The Alabama Supreme Court addressed this issue directly in Prescott v. Martin, 331 So. 2d 240, 246 (Ala. 1976). The Court approved instructions allowing the plaintiff to recover damages proximately resulting from the defendants’ negligence even though her injuries were more serious because of a preexisting condition. At the same time, the jury was instructed that she could not recover damages merely for a condition or ailment that existed before the accident.

That gives us both sides of the rule.

A negligent driver does not become responsible for every medical problem you had before the collision, but the driver does not escape responsibility merely because you were more vulnerable to injury than someone else.

What Does “Aggravation of a Preexisting Condition” Mean?

An aggravation occurs when the wreck makes an existing injury, disease, or medical condition worse.  For example, suppose you had occasional lower-back pain before the wreck but continued working full time and rarely needed medical treatment.  After the collision, your back pain becomes constant. An MRI shows spinal abnormalities. You require injections or surgery. You can no longer lift what you could lift before the wreck, and your doctor places permanent restrictions on you.

The defense may focus on the fact that your spine was not “normal” before the collision.

But that does not answer the causation question.  The relevant issue is whether the collision aggravated the existing condition and caused additional symptoms, treatment, limitations, or disability.

Alabama has recognized that distinction for decades.

In Matheny v. Petersen, 276 Ala. 478, 480–81, 163 So. 2d 635, 636–37 (1964), an automobile-collision case, the Alabama Supreme Court recognized that damages can be recovered for the aggravation of a previously existing condition. The Court reversed because the particular jury instruction failed to require the necessary additional element: the aggravation had to be proximately caused by the defendant’s wrongful conduct.

That causation requirement is critical.  Preexisting condition + car wreck is not enough.  The evidence must connect the worsening of the condition to the wreck.

What If My Preexisting Condition Was Not Causing Problems Before the Wreck?

This can be an especially important fact.  Many people have abnormalities on X-rays or MRIs without experiencing disabling symptoms.  A person may have:

degenerative disc disease;

disc bulges;

arthritis;

spinal stenosis;

an old shoulder tear;

prior surgical changes;

or another medical condition

without that condition substantially interfering with everyday life before the collision; then a traumatic event occurs and the condition becomes symptomatic.

The Alabama Supreme Court considered a similar situation in J.B. Hunt Transport, Inc. v. Credeur, 681 So. 2d 1355, 1362–63 (Ala. 1996).

Credeur was a truck driver injured after his tractor-trailer left the roadway and overturned while he attempted to avoid another tractor-trailer. His physicians testified that the accident aggravated his previously asymptomatic spondylitic disease. Before the accident, the disease had not been producing symptoms. Afterward, he experienced neck problems, arm numbness, loss of cervical range of motion, pain, and difficulty performing heavy labor. His attempt to return to truck driving was unsuccessful.

The Alabama Supreme Court rejected the defendant’s argument that Credeur had failed to present substantial evidence connecting his future losses to the accident and affirmed the judgment. Id. at 1362–63.

That case illustrates an important point: An abnormal MRI that predates a wreck is not necessarily the same thing as a disabling condition that predates the wreck.

The medical images are part of the evidence. So is the person’s actual condition before and after the collision.

Does the Defendant Have to Take Me as He Finds Me?

You may sometimes hear this described as the “eggshell plaintiff” rule.  The basic idea is that a defendant does not get to choose a perfectly healthy person to injure.

If a person’s preexisting physical condition makes the consequences of an accident more serious than they might have been for someone else, that vulnerability does not automatically reduce the defendant’s responsibility for the harm the defendant actually caused.

But the phrase can be misleading if taken too far.  It does not mean the defendant is responsible for everything medically wrong with the plaintiff.  The plaintiff must still prove that the defendant’s negligence proximately caused the injury or aggravation for which damages are sought.

That distinction is consistent with Matheny, Prescott, and Credeur.  So I would not describe Alabama law as: “You had a bad back, therefore the defendant pays for your entire bad back.”  Nor would I describe it as: “You had a bad back, therefore you cannot recover.”

The actual question is what additional harm the collision proximately caused.

What If I Had the Same Symptoms Before the Wreck?

This makes the case more complicated, but it does not necessarily end it.  Suppose you had neck pain before the collision and neck pain afterward.  The issue then becomes one of degree and causation.

How frequent was the pain before the wreck?

How severe was it?

Were you receiving regular treatment?

Were you taking medication?

Did you have physical restrictions?

Were you missing work?

Had surgery been recommended?

Could you perform your job?

What recreational and household activities could you perform?

How did those things change after the collision?

A person who occasionally experienced a pain level of two out of ten before a wreck but experiences constant severe pain afterward is not necessarily in the same medical condition simply because both sets of records contain the words “neck pain.”

The comparison must be more precise.

What If I Previously Had Surgery on the Same Part of My Body?

Prior surgery is another fact an insurance company is likely to examine carefully.  Suppose you underwent lumbar surgery several years before the wreck.  That history does not automatically prevent recovery for a later lumbar injury.

But it makes the before-and-after medical evidence particularly important.  Relevant questions may include:

What surgery was performed?

Why was it performed?

How well did you recover?

What symptoms remained afterward?

When was your last treatment before the collision?

Had you returned to work?

Did you have permanent restrictions before the wreck?

What did the pre-wreck imaging show?

What changed after the collision?

Did the wreck cause a new structural injury?

Did it aggravate the previously operated condition?

Did your doctors recommend additional treatment or surgery because of the new trauma?

The mere existence of prior surgery does not answer those questions.

What If My MRI Shows “Degenerative Changes”?

This issue arises frequently in neck and back cases.  Radiology reports may use terms such as:

degenerative disc disease;

spondylosis;

stenosis;

disc desiccation;

facet arthropathy;

or osteophytes.

Those findings can give an insurance company a basis to argue that the claimant’s symptoms result from age-related or preexisting degeneration rather than trauma, but again, the imaging cannot always answer the entire causation question by itself.

Credeur is useful precisely because the plaintiff had preexisting spondylitic disease. The medical evidence nevertheless supported the conclusion that the collision aggravated a condition that had previously been asymptomatic. J.B. Hunt Transport, Inc. v. Credeur, 681 So. 2d 1355, 1362–63 (Ala. 1996).

The real medical analysis may therefore require comparing:

pre-wreck condition + pre-wreck symptoms + pre-wreck function

with

post-wreck condition + post-wreck symptoms + post-wreck function.

Why Are My Old Medical Records Important?

Because preexisting-condition cases are often comparison cases.

The insurance company may obtain medical records showing that you complained about the same body part before the collision, and that can be significant evidence.

But the records may also show something favorable.  Old medical records can therefore hurt or help, depending upon what they actually show.

A record documenting back pain six years before the collision tells us that back pain existed six years earlier.  It does not, standing alone, tell us what the person’s condition was immediately before the new collision.

Should I Tell My Lawyer About Old Injuries?

Yes.

Trying to hide a preexisting condition is usually much more damaging than the condition itself.  Your lawyer needs to know about prior:

accidents;

workers’ compensation claims;

personal-injury claims;

surgeries;

MRIs and other diagnostic testing;

chiropractic treatment;

physical therapy;

pain-management treatment;

injections;

orthopedic treatment;

and treatment involving the same areas of the body injured in the current wreck.

The reason is practical.  If the defense discovers a significant prior injury that the plaintiff denied or failed to disclose, the case may stop being primarily about medical causation and become a case about credibility.

That is often a much harder problem to fix.

A prior injury can be explained.  A misleading answer under oath can be much more difficult to explain.

What If I Had a Previous Workers’ Compensation Claim?

A previous WC claim does not automatically prevent recovery from a negligent driver in a later motor vehicle related accident, but it may contain important evidence about your pre-wreck condition.

A prior workers’ compensation file may include medical records, diagnostic studies, impairment ratings, work restrictions, functional-capacity evaluations, deposition testimony, vocational evidence, or a settlement describing the earlier injury.

For example, suppose you claim that an Alabama car wreck left you unable to perform heavy work because of a lumbar injury.  If a previous WC case contains medical records showing that you already had a permanent 25-pound lifting restriction because of the same lumbar condition, that evidence may be highly relevant to what the later collision actually changed.

On the other hand, if the prior WC records show that you recovered, returned to unrestricted heavy work, and successfully performed that work for years before the new MVA, those records may help demonstrate the difference between your condition before and after the wreck.

The existence of the old claim is therefore not necessarily the problem.  The facts contained in it matter.

What If I Was in an Earlier Car Wreck?

The same analysis applies.

An insurer may investigate prior accidents involving the same part of the body.

The questions should include:

What was injured in the first wreck?

What treatment did you receive?

How long did treatment last?

Did your symptoms resolve?

Were you released?

Did you return to normal activities?

Were there permanent restrictions?

Was another accident or injury responsible for some portion of the current symptoms?

Again, chronology matters.

A prior wreck followed by two years of continuous neck treatment presents a different causation problem from a prior wreck followed by treatment, recovery, and five symptom-free years before the new collision.

What If I Have Never Had Symptoms but an Old MRI Shows the Same Problem?

That is precisely where the distinction between an anatomical condition and a symptomatic injury becomes important.

A person may have degenerative changes visible on imaging before a collision without experiencing pain or functional limitations.  If the person was working, exercising, performing household activities, and living without meaningful symptoms before the wreck but develops significant symptoms immediately afterward, those facts may be important evidence of aggravation.

That does not mean temporal sequence automatically proves medical causation, but neither should a preexisting radiographic abnormality automatically be treated as proof that the collision caused nothing.

In Credeur, the Alabama Supreme Court specifically noted medical testimony that the accident aggravated previously asymptomatic disease. J.B. Hunt Transport, Inc. v. Credeur, 681 So. 2d 1355, 1362 (Ala. 1996).

Do I Need a Doctor to Say the Wreck Aggravated My Condition?

Medical causation can become especially important when the claimant has significant preexisting problems involving the same body part.  A treating physician may be asked to compare the patient’s condition before and after the collision and address whether the trauma caused a new injury or aggravated an existing condition.

In Prescott, medical testimony supported the conclusion that the accident was the causative event that altered the plaintiff’s previously existing cervical condition enough that she could no longer perform the work she had previously been doing. Prescott v. Martin, 331 So. 2d 240, 246 (Ala. 1976).

Likewise, in Credeur, two physicians testified that the accident aggravated the plaintiff’s previously asymptomatic spondylitic disease. J.B. Hunt Transport, Inc. v. Credeur, 681 So. 2d 1355, 1362 (Ala. 1996).

Medical evidence can therefore become crucial when the defense argues that the current problems are merely the natural continuation of an older condition.

What If the Doctor Says the Wreck “Could Have” Aggravated My Condition?

The language used by a physician when discussing medical causation can become important, particularly when the insurance company argues that the claimant’s symptoms were caused by a preexisting condition rather than the new collision.

It is not enough simply to establish that a wreck could possibly have aggravated a medical condition. The evidence must be sufficient to support the required causal connection between the collision and the injury or aggravation being claimed.

The Alabama Supreme Court discussed this issue in J.B. Hunt Transport, Inc. v. Credeur, 681 So. 2d 1355, 1361–62 (Ala. 1996)—the same case discussed earlier involving a truck driver with preexisting but previously asymptomatic spondylitic disease.

In Credeur, the Court explained that expert testimony must establish more than a mere possibility when expert evidence is relied upon to prove causation. But the Court also emphasized that the evidence must be considered as a whole rather than isolating a physician’s particular word or phrase from the rest of the testimony.

That distinction can be important in an actual car-wreck case.

A physician’s statement that a collision “could have” caused a condition, standing alone, may establish only a possibility. But a medical opinion should not necessarily be evaluated by pulling one phrase out of the physician’s testimony. The doctor’s complete testimony, the medical records, the nature of the trauma, the onset of symptoms, the patient’s prior medical history, diagnostic studies, and other evidence may all bear upon whether the plaintiff has established that the wreck probably caused or aggravated the condition.

In Credeur, there was evidence that the plaintiff’s spondylitic disease had been asymptomatic before the wreck, together with medical testimony concerning the relationship between the trauma and his subsequent condition. The Supreme Court concluded that there was substantial evidence from which the jury could find the necessary causal relationship. J.B. Hunt Transport, Inc. v. Credeur, 681 So. 2d 1355, 1361–63 (Ala. 1996).

Can the Insurance Company Blame Everything on My Age?

Age and degeneration are not synonymous with causation.  It may be undisputed that an older plaintiff has degenerative changes, the relevant question remains whether the collision proximately caused a new injury or aggravated the existing condition.

A 65-year-old plaintiff does not have to possess the spine of a 20-year-old before another driver can be responsible for injuring him.

At the same time, the plaintiff cannot recover from the defendant merely for deterioration that would have occurred independently of the collision.

That is why a careful medical chronology matters more than slogans from either side.

What Damages Can I Recover for an Aggravated Condition?

If an Alabama car wreck aggravates a preexisting condition, the fact that part of the medical problem existed before the collision does not necessarily limit the injured person to recovering only for a completely new diagnosis.  The Alabama Supreme Court explained this principle in Prescott v. Martin, 331 So. 2d 240, 244–45 (Ala. 1976).

Mrs. Martin had experienced neck problems before the automobile accident and had previously undergone treatment and surgery. The defendants therefore argued that the jury should not be permitted to compensate her for physical problems that existed before their alleged negligence.

The Supreme Court agreed with the basic proposition that the defendants were not responsible merely for a condition or ailment that existed before the accident-but that was only half of the analysis.

The Court also held that the jury could award Mrs. Martin all damages proximately resulting from the defendants’ negligence even if her injuries were more serious because of her preexisting condition. The trial court had specifically instructed the jury that Mrs. Martin could not recover damages simply for a condition or ailment that existed before the accident. Read together, the Alabama Supreme Court found no error in those instructions. Id. at 244.

What Does That Mean in a Real Car Wreck Case?

Suppose two people are involved in identical collisions.

One has a perfectly healthy lower back.

The other has degenerative disc disease and previously underwent lumbar surgery.

The first person suffers a relatively minor strain and recovers within several weeks. The second person’s previously stable condition becomes severely symptomatic, requires additional medical treatment, and leaves that person with permanent physical restrictions.

The negligent driver cannot necessarily argue: “A healthy person would not have been injured this badly, so I should only be responsible for the injury a healthy person would have suffered.”

That is the important principle reflected in Prescott.

If the collision proximately causes a preexisting condition to become substantially worse, the defendant may be responsible for the greater injury actually caused by the collision, even though the plaintiff’s preexisting physical condition made the consequences more severe than they otherwise might have been. Prescott v. Martin, 331 So. 2d 240, 244–45 (Ala. 1976).

But the rule works in both directions.  The negligent driver does not become responsible for the medical condition simply because it existed when the collision occurred.

If the plaintiff already had chronic back pain, the defendant does not automatically become responsible for all of that preexisting pain. If the plaintiff already had permanent restrictions, the defendant does not automatically become responsible for those preexisting restrictions. And if surgery was already necessary before the collision, the mere occurrence of the wreck does not automatically make the defendant responsible for that surgery.

The damages must still be tied to what the defendant’s negligence caused or aggravated.

Prescott Shows Why the Plaintiff’s Condition Before the Wreck Matters

The facts in Prescott make this principle easier to understand.  Mrs. Martin did not enter the accident with a medically perfect neck. She had previous neck problems and had undergone prior treatment, but there was evidence that she had recovered sufficiently to return to her work before the new collision.

Her post-accident physician was specifically asked whether the new accident was the causative factor in her subsequent inability to work. He explained that Mrs. Martin already had neck pathology, but that she had previously been doing her work and that the hyperextension injury from the new accident altered her condition sufficiently that she could no longer perform the work she had been doing. Id. at 244–45.

That is an excellent example of the distinction between a preexisting condition and an aggravation of that condition.

The defendant did not cause Mrs. Martin’s original neck pathology, but the evidence permitted the jury to determine whether the defendant’s negligence caused an additional injury that changed what that preexisting condition actually meant in Mrs. Martin’s life.

Before the wreck, she could work.

After the wreck, the evidence indicated that the aggravated neck condition prevented her from continuing her employment or similar employment. The record also contained evidence of medical expenses, anticipated future medical expenses, and an inability to perform normal housework. Id. at 247.

That before-and-after difference is often the heart of an aggravation case.

The Defendant Is Responsible for the Aggravation—not for the Mere Existence of the Condition

This distinction can be summarized fairly simply: The defendant does not get a discount because the plaintiff was unusually susceptible to a serious injury. But the plaintiff does not get to charge the defendant for medical problems the defendant did not cause or aggravate.

That is why evidence concerning the plaintiff’s condition immediately before the wreck can be so important.

If the evidence establishes that the plaintiff was working full time, living independently, exercising, performing household activities, or otherwise functioning despite an existing medical condition—and those abilities materially changed after the collision—that comparison can help establish the extent of the aggravation.

Conversely, if the plaintiff was already receiving extensive treatment, missing work, facing surgery, or living under significant physical restrictions before the wreck, those facts also matter when determining what additional harm the new collision actually caused.

What Types of Damages May Result From the Aggravation?

Once the plaintiff proves that the wreck proximately aggravated the preexisting condition, the damages analysis focuses upon the additional harm caused by that aggravation.

Depending upon the evidence, that may include:

medical expenses attributable to the aggravated condition;

additional or different medical treatment made necessary by the wreck;

future medical treatment resulting from the aggravation;

lost wages caused by the worsened condition;

loss of future earning capacity;

additional physical pain and suffering;

mental anguish;

new or increased permanent physical limitations;

and other compensatory damages proximately resulting from the collision.

The critical word is additional.

The objective is not to pretend that the plaintiff had no medical history before the wreck. It is to determine how the plaintiff’s health, symptoms, treatment needs, physical abilities, work capacity, and quality of life changed because of the defendant’s negligence.

That is why a preexisting-condition case is often best understood as a before-and-after case.

What could the person do before the wreck?

What can the person do now?

And what does the medical and other evidence establish caused the difference?

Recommended Reading: What Damages Can I Recover After a Car Wreck in Alabama?

What Evidence Helps Prove That the Wreck Made Me Worse?

Preexisting-condition cases are often won or lost through chronology.  Useful evidence may include:

medical records from before the wreck;

pre-wreck and post-wreck MRIs or X-rays;

testimony from treating physicians;

work records;

prior physical restrictions;

evidence showing successful return to work after an older injury;

gym, recreational, or activity records where relevant;

testimony from family members or coworkers concerning the person’s functioning before and after the collision;

prescription histories;

records showing long periods without treatment;

and documentation of the symptoms and treatment that began after the new wreck.

The objective is not to pretend the old condition never existed-it is to accurately demonstrate what changed because of the new collision.

What If I Have a Gap in Treatment After the New Wreck?

That creates a related but distinct issue.

Suppose the plaintiff says: “My back was dramatically worse after this wreck,” but the medical records show that the person received treatment for two weeks and then did not seek any additional treatment for eight months.

The insurance company may argue that the treatment gap undermines the claimed connection between the wreck and the later symptoms.

That does not automatically defeat the claim. There may be legitimate explanations for a gap in medical care, but it can affect how the evidence of causation and severity is evaluated.

That is why our next article will address the issue separately: Can a Gap in Medical Treatment Hurt My Alabama Car Wreck Case?

The Bottom Line

If you had a preexisting injury before an Alabama car wreck, do not assume that you cannot recover damages.  The important questions are:

What was your condition before the wreck?

What did the collision change?

What additional treatment became necessary?

What new symptoms or limitations developed?

What does the medical evidence say caused the change?

How did your ability to work and function change after the collision?

And perhaps most importantly: Can the evidence demonstrate the difference between the condition you already had and the harm caused by the new wreck?

At Powell & Denny, P.C., we understand that serious injury cases often involve people who did not enter an accident in perfect health. Prior injuries, degenerative conditions, old surgeries, and previous workers’ compensation claims do not automatically answer whether a new collision caused additional harm.

The proper analysis requires looking at the entire medical and functional history—before the wreck and after it.

If an insurance company is arguing that your injuries were “already there,” and you have questions about your rights — don’t hesitate to contact and speak with one of the experienced Alabama Car Wreck attorneys at Powell and Denny today for a free consultation. Appointments are available in person, or virtually via Zoom if more convenient.  Powell and Denny would appreciate the opportunity to help.  And remember, there is no fee unless you win.

Powell & Denny: We Work When You Can’t.

Recommended Readings:

I Was Injured in a Car Wreck in Alabama. What Are My Rights?

What Damages Can I Recover After a Car Wreck in Alabama?

The Insurance Company Says the Car Wreck Was Partly My Fault. Can I Still Recover in Alabama?

Can I Have Both a Workers Compensation Claim and a Personal Injury Claim?