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Accident Aggravating a Preexisting Condition

Suppose a person is injured in a motor vehicle accident. The victim is seriously hurt, and the accident worsens a previous injury that the victim had suffered. May the victim recover for his or her injuries, and to what extent?

A pre-existing condition is an injury or illness of the victim that preceded the accident for which he or she is seeking damages. Underlying a pre-existing condition may be a disease, an injury from a previous accident, a congenital trait, or just the natural effects of the aging process. A pre-existing condition may be asymptomatic, yet leave the victim vulnerable to injury that could be aggravated by a motor vehicle accident. The victim may pursue claims for existing and anticipated medical expenses, physical pain and mental anguish, and such damages may be augmented if the injured party can prove that the motor vehicle accident exacerbated a pre-existing condition.

Massachusetts law holds negligent parties responsible for the harm that they cause, but not for conditions for which they are not blameworthy. Nevertheless, if a plaintiff suffers an injury because of a defendant’s negligence and that affliction combines with a pre-existing or later-acquired injury or disease to cause greater harm to the plaintiff than would have resulted from the motor vehicle accident injury by itself, liability may attach. The defendant may be liable for all damages that naturally flow from the combined effect of the negligent conduct and the pre-existing condition.

According to the well-established “eggshell plaintiff” rule, a negligent defendant takes the plaintiff accident victim as the defendant finds him or her. The wrongdoing defendant is liable for all of the harmful results of a greater-than-normal injury that the defendant’s negligence inflicts on the eggshell plaintiff. For example, if a defendant driver carelessly rear-ends a vehicle driven by a plaintiff with a cardiac condition who then suffers a heart attack, the defendant will be on the hook for increased damages. It does not matter that, by contrast, a healthier plaintiff might have sustained a lesser whiplash injury, so long as medical evidence demonstrates a causal link between the accident and the cardiac episode.

The Massachusetts Appeals Court has ruled regarding aggravation/exacerbation of a pre-existing injury that a juror must receive more than vague instructions that defendants take plaintiffs as they find them. In a 1976 case, the Court addressed a plaintiff with a chronic back condition based on previous surgery for a ruptured disc, exacerbated by the actions of the defendant, who rear-ended the plaintiff’s vehicle. The Court faulted the trial judge for not specifically instructing the jury that the defendant could be responsible for the combined effects of a back injury caused by the defendant’s wrongful act and aggravation of the plaintiff’s chronic back condition.

In another case the Supreme Judicial Court grappled with the issue of whether the plaintiff decedent’s suicide was causally linked to injuries he sustained in an accident. The SJC upheld the lower court’s finding that the decedent’s pre-existing paranoia had been in remission for years until the trauma and mental distress of the motor vehicle accident triggered a recurrence.

As far back as 1935, Massachusetts law was settled that “where an injury arising from a cause which entails liability on the defendant combines with a preexisting or a subsequently acquired disease to bring about greater harm to the plaintiff than would have resulted from the injury alone, the defendant may be liable for all the consequences.” In that case, it was alleged that the plaintiff decedent’s weakened state from injuries she suffered in an accident left her vulnerable to, and unable to resist, a fatal blood infection.

Triggering a plaintiff’s pre-existing condition because of accident-related injuries enables the plaintiff to recover the difference between what his or her condition would have been had the accident not occurred and what the injury is (or will be) due to the accident. Proving aggravation of a pre-existing condition may involve the plaintiff’s own credible testimony; expert testimony from a treating or examining physician; prior medical records; testimony from family members; and life expectancy tables.

Much trickier are circumstances in which the car accident-related injuries occur on the job, bringing the matter into the realm of Worker’s Compensation law. Pre-existing condition is the principal argument insurance carriers use to deny benefits on the grounds that work did not cause the injury. Briefly, the resulting condition of a compensable work-related injury combined with a pre-existing medical issue will yield benefits only if the compensable harm was a major, but not necessarily predominant, cause of the resulting condition/disability.

If you have any questions about motor vehicle accidents, personal injury law or tort law, contact our offices. Call 978-225-9030 during business hours or complete a contact form online for a free consultation.

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