Are Elder Pre-Existing Medical Conditions Compensable?

Elder Law | October 01, 2009 | by Ramsey Bahrawy

Many people live their lives with medical conditions to their neck, back, knees, hips, ankles, elbows, shoulders, arms, etc.

Elderly people often suffer from what is often termed as “pre-existing medical conditions”. The one I encounter most frequently is arthritis. The cases I see involve significant worsening of an arthritic condition resulting in disability, reduced quality of life and the need for surgery. Are you entitled to recover for damages in a personal injury accident when a pre-existing medical condition is exacerbated or worsened?  Absolutely!

The Egg Shell Theory

Under Massachusetts law, if the conduct of a negligent party contributes to cause an ultimate outcome, then that party is responsible for the aggravation of that injury.  Some Massachusetts lawyers refer to this concept as the “one percent rule of causation”.  In other words, if the negligent act of a party plays some role in an injury, even if that role is slight (1%), that party is legally responsible for all damages which flow from the aggravation of the injury.  This standard would clearly be important to persons who live with a pre-existing medical condition, which is worsened as the result of the negligent conduct of another person.

This is also known as the Egg Shell Theory. This theory says that a negligent person takes his victim as he finds him, egg shell and all. The Massachusetts law of personal injury requires persons who are negligent to be liable for reasonably foreseeable injuries they cause. Court decisions have concluded causing an injury to a person with a pre-existing medical condition is reasonably foreseeable. Put another way, a negligent person, must take the injured person as he finds him. The egg shell theory holds a negligent person liable for all consequences resulting from his or her conduct resulting in an injury to another person, even if the victim suffers an unusually high level of damage. Let’s say someone is caused to fall his knees by the negligence of another person. Let’s also say that such a fall usually does not result in significant injury. However in this case the person who falls to his knees suffers from a pre-existing arthritic condition of his right knee. As a result of the trauma to his knees he can no longer use the right knee as he had previously and now needs knee replacement surgery to regain pain free use of his knee. This person is considered and “egg shell.”

Various Kinds of Pre-Existing Conditions

I handle many personal injury cases where a person suffers an injury due to the negligence of another. The diagnosed injury is to a body part that was already injured prior to the accident. Where the prior injury was exacerbated or developed pain symptoms after the accident, the injury can be compensated.

Many people who have pre-existing conditions learn to live with the discomfort associated with their conditions.  Others are pain or symptom free (this is especially true of backs) Others may live with a significant pain accompanied by loss of mobility or function. However, if a trauma worsens this condition to the point where, for example, a knee or hip replacement surgery is now necessary, then the injury is compensable. Although the law states that a negligent person is responsible for the cost of the surgery, rehabilitation, physical therapy, occupational therapy and continued medical care as well as  “pain and suffering damages” insurance companies are often reluctant to settle these cases. In fact insurance companies will try to avoid or minimize  responsibility to pay compensation for pre-existing conditions. They will claim that the injured person did not sustain injury in the accident, at all.

Therefore, ligation is often the only method by which to obtain reasonable compensation.

The bottom line is that any person who is injured due to the negligence of another, and who has a worsening of pre-existing medical condition, is entitled to recover compensatory damages directly related to the accident.

The legal treatment of preexisting conditions may differ depending on the State where you live.  Accordingly I have developed relationships with personal injury lawyers in other states to assist me with claims  that require the application of another State’s law.

It takes a good, aggressive personal injury lawyer, armed with knowledge and experience to get you what you deserve.

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