Settling a personal injury claim involving the aggravation of a pre-existing condition can be complex. Insurance companies often attempt to minimize their liability by arguing that the injury is solely attributable to the pre-existing condition, not the accident. Understanding the nuances of this type of claim is crucial for obtaining a fair settlement. This article will explore the key aspects of negotiating settlements in such cases.
What is Aggravation of a Pre-Existing Condition?
Aggravation of a pre-existing condition refers to a situation where a pre-existing medical condition, such as arthritis or a back injury, is worsened or made significantly more painful due to an accident or injury. The key difference from a completely new injury is that the underlying condition already existed, but the accident exacerbated its symptoms and limitations. Proving aggravation requires demonstrating a causal link between the accident and the worsening of the pre-existing condition.
How is Aggravation Proven in a Settlement?
Proving aggravation requires a strong medical case. This typically involves:
- Comprehensive Medical Records: Detailed medical records documenting the pre-existing condition before the accident are essential. These records should clearly outline the condition's severity, symptoms, and treatment.
- Post-Accident Medical Records: Similarly, comprehensive medical records documenting the condition after the accident are critical. These records must show a clear increase in pain, limitation of function, or need for treatment directly resulting from the accident.
- Medical Expert Testimony: An expert medical witness, often a specialist familiar with the pre-existing condition, is usually required to testify that the accident aggravated the condition. The expert will analyze the medical records and explain the causal link between the accident and the worsening symptoms.
- Independent Medical Examination (IME): The insurance company may request an IME, where an independent physician examines the injured party. It's crucial to cooperate fully with the IME, ensuring the physician understands the full extent of the injury and its aggravation.
How Do I Calculate Damages in an Aggravation Case?
Calculating damages in an aggravation case requires careful consideration of several factors:
- Medical Expenses: This includes all reasonable and necessary medical expenses incurred due to the aggravation, such as doctor visits, physical therapy, medication, and surgery.
- Lost Wages: Compensation for lost wages resulting from the inability to work due to the worsened condition.
- Pain and Suffering: Compensation for the increased pain and suffering experienced due to the aggravation of the pre-existing condition. This is often the most challenging aspect to quantify.
- Future Medical Expenses and Lost Wages: If the aggravation is expected to cause long-term effects, future expenses should also be considered.
What if the Insurance Company Disputes the Aggravation?
Insurance companies often aggressively dispute claims involving aggravation, attempting to minimize their payout. Common tactics include:
- Minimizing the severity of the injury: They may argue that the symptoms are solely due to the pre-existing condition.
- Challenging the causal link: They may argue that there is no proof the accident worsened the pre-existing condition.
- Offering a low settlement: They may offer a significantly low settlement, hoping to avoid a trial.
How Can I Maximize My Settlement?
To maximize your settlement, consider these strategies:
- Strong medical documentation: As previously mentioned, thorough and detailed medical records are vital.
- Experienced legal representation: An experienced personal injury attorney can effectively negotiate with the insurance company and represent your interests.
- Detailed documentation of damages: Thoroughly document all medical expenses, lost wages, and other damages.
- Consider mediation or arbitration: These alternative dispute resolution methods can be more efficient and cost-effective than trial.
What are the common challenges in settling aggravation of a pre-existing condition claims?
Common challenges include proving causation between the accident and the worsening of the pre-existing condition, accurately assessing damages, and dealing with insurance company tactics to minimize liability. The pre-existing condition's medical history often becomes a significant point of contention.
How do I prove the extent of my injuries and the resulting damages?
Comprehensive medical records before and after the accident are critical. Detailed documentation of medical expenses, lost wages, and limitations in daily activities due to increased pain and restricted mobility are also essential to support your claim.
Can I still file a claim if my pre-existing condition was not previously diagnosed?
Yes, even if your pre-existing condition was not previously diagnosed, you can still file a claim if the accident demonstrably aggravated a latent or undiagnosed condition. However, proving this requires strong medical evidence establishing the causal connection.
This information is for educational purposes only and should not be considered legal advice. If you have been injured in an accident that has aggravated a pre-existing condition, consult with a qualified personal injury attorney to discuss your legal options and pursue a fair settlement.
