Insurance carriers investigate prior medical history in every serious injury case. If you had a prior back injury, a prior neck complaint, a prior car accident, or a prior workers’ compensation claim involving the same body parts, the carrier will find it — through your medical records, through ISO ClaimSearch databases, or through your deposition testimony. Prior injuries do not destroy your claim. But how they are addressed — by your attorney and by your treating physician — determines whether the carrier uses them to reduce the settlement or whether they are explained in a way that supports the claim.
One of the most common concerns clients raise at the first meeting is whether their prior medical history will disqualify them from recovery. The short answer is no. Prior injuries are not a disqualifier. They are a fact that must be addressed. The carrier’s strategy in nearly every serious case is to argue that the current complaints are a continuation of pre-existing problems rather than the result of the accident. This argument is predictable, and a well-prepared case defeats it. The preparation starts with honest disclosure of the prior history and careful treatment planning that addresses how the accident changed the pre-existing condition.
The eggshell plaintiff doctrine protects you
New York follows the eggshell plaintiff doctrine: the defendant takes the plaintiff as they find them. If you had a degenerative disc condition that was stable and asymptomatic before the accident, and the accident aggravated that condition to the point where you now need surgery, the defendant is responsible for the aggravation. The defendant does not get a discount because you had a pre-existing vulnerability. If you had a prior back surgery that was successful and you were functioning normally, and the new accident re-injured the same area, the new injury is compensable. The key is establishing that the accident caused a change — new symptoms, worsened function, or the need for additional treatment that was not required before the collision.
The doctrine applies even when the plaintiff’s pre-existing condition would have produced eventual problems without the accident. If the plaintiff had degenerative disc disease that would have become symptomatic at some point in the future, and the accident accelerated the onset of symptoms, the defendant is liable for the acceleration. The question is not what the plaintiff’s condition would have been in the future without the accident — it is the difference between the plaintiff’s condition before the accident and after.
How the carrier uses prior injuries
The carrier’s argument is predictable: the condition existed before the accident, therefore the accident did not cause it. The carrier’s IME physician will review the prior medical records, note every prior complaint involving the same body part, and conclude that the current symptoms are a continuation of the pre-existing condition rather than a result of the collision. The IME physician will point to pre-existing imaging findings — disc bulges, arthritis, degenerative changes — and argue that these findings existed before the accident and explain the current complaints without any need to attribute them to the collision.
This argument is effective only if the treating physician’s records do not address the prior history and explain the aggravation. When the records are silent on the prior condition, the IME physician’s opinion fills the vacuum. When the records carefully address the prior history and distinguish it from the post-accident condition, the IME physician’s opinion is contradicted by the treating physician’s clinical analysis. The battle between these two medical opinions is often the central issue in the threshold motion and, if the case goes to trial, in the jury’s evaluation of damages.
The imaging distinction is the heart of the case
Degenerative changes are common in asymptomatic adults. Medical literature has established that a substantial percentage of people over 40 have disc bulges, arthritis, or other degenerative findings on imaging without any symptoms. MRI studies of asymptomatic volunteers have shown disc herniations in people who reported no back pain at all. This is well documented in peer-reviewed medical literature and is widely known among spine specialists. The mere presence of degenerative changes on imaging does not mean the plaintiff’s current symptoms are caused by those changes.
A treating physician who explains the distinction between asymptomatic degeneration and symptomatic post-traumatic injury strengthens the causation case. The physician should document that the degenerative changes on imaging are common findings that do not, by themselves, explain the plaintiff’s current symptoms; that the plaintiff was functioning normally before the accident despite any pre-existing degenerative changes; and that the accident caused a new clinical presentation — new symptoms, new functional limitations, new treatment needs — that was not present before the collision. A treating physician whose records address this distinction neutralizes the IME physician’s pre-existing-degeneration argument.
The treating physician must address the prior history in the records
The treating physician’s records should document the prior condition, note that it was stable or asymptomatic before the accident, and explain how the accident caused the condition to worsen. If the prior condition was treated and resolved years ago, the records should note that the patient had been symptom-free and functioning normally before the collision. If imaging shows pre-existing degenerative changes, the physician should explain the difference between asymptomatic degeneration — which is common in the general population and does not require treatment — and symptomatic injury caused by trauma. This causation opinion is the counterweight to the IME physician’s conclusion.
When the prior records show a prior accident with the same body part involved, the treating physician should review those records, note the outcome of the prior treatment, and opine on the current injury’s relationship to the current accident. A physician who acknowledges the prior injury and explains why the current presentation is different — new symptoms, new imaging findings, new functional loss — builds a stronger causation case than one who tries to minimize or ignore the prior history. The honest acknowledgment followed by the medical explanation is more credible than silence or denial.
Preparing for the deposition on prior injury questions
The defense attorney will ask about every prior injury, every prior accident, every prior claim, and every prior treatment to the same body parts at your deposition. You are under oath. If you deny a prior injury the defense has documented, you create a credibility problem that can undermine the entire case. Once a jury decides the plaintiff lied under oath about one thing, they question everything else the plaintiff says. Even an honest mistake — forgetting a physical therapy course you had five years ago — can be characterized by the defense as a deliberate concealment.
If you disclosed the prior injury to your attorney before the deposition, the attorney can prepare you to address it truthfully and in context — acknowledging the prior history while explaining that you had recovered, were functioning normally, and the new accident caused a new injury or aggravated the prior condition. Specific preparation includes reviewing the prior records with the client, identifying the key dates and facts, and practicing answers that are truthful, specific, and supportive of the case. A plaintiff who answers deposition questions about prior injuries with confidence and specificity appears credible. A plaintiff who is surprised by questions about prior records appears evasive, even if the evasion is unintentional.
Social security disability and workers’ compensation records
Claimants sometimes have prior Social Security Disability or Workers’ Compensation records that the carrier obtains during discovery. These records can be particularly damaging if they contain statements about the plaintiff’s limitations that are inconsistent with the current claim. A claimant who told the SSA in 2019 that they could not lift more than ten pounds due to a prior back injury, and who is now claiming that the 2024 car accident caused a new limitation on lifting, has a credibility problem that must be addressed in advance. The attorney needs to know about these records at the outset so the case theory can be developed consistently with the prior statements or so the prior statements can be distinguished.
Prior workers’ compensation claims are particularly common and particularly useful to the defense. A client who had a workers’ compensation case for a lumbar strain in 2017 that resolved with treatment has a file somewhere in the system. The defense finds it through discovery demands to the Workers’ Compensation Board. The attorney who knows about the prior claim at the outset can address it proactively. The attorney who discovers the prior claim for the first time when the defense produces it at a deposition has a problem.
How Schwartzapfel Holbrook addresses prior injury issues
At Schwartzapfel Holbrook, we review every client’s prior medical history at the outset of the case. We identify the prior conditions the carrier will find, ensure the treating physician addresses the aggravation in the clinical records, and prepare the client to testify about the prior history truthfully and in context. We obtain prior medical records, prior accident records, and prior SSA or workers’ compensation records where applicable, and we integrate them into the case theory rather than treating them as problems to be hidden. Prior injuries are not a weakness if they are addressed proactively. They become a weakness only when they surprise the attorney or the treating physician at a critical moment. The cases we win are the cases where the prior history is known, addressed, and explained — not the cases where the history is hidden until the defense uncovers it.
Schwartzapfel Holbrook / Fighting For You