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Posted on 06-12-2013

Car Accidents and Pre-Existing Conditions

A segment of my practice deals with treating acutely injury patients suffering from whiplash, concussions, headaches, neck pain and back pain. I often see these types of injuries resulting from auto accidents (properly referred to as motor vehicle collisions) in Baltimore.

Many people think that if they are injured in a non-fault car accident that the adverse (other person's) insurance company will deal with them fairly and give them access to needed chiropractic and medical care. Often, it is a real fight for injured clients to get the care they need. One tactic that insurance companies and claims adjustors use is the "pre-existing condition" arugment. They state that the pain that a patient has is due to a condition that they already had before their car accident, and that as such, the insurance company should not have to pay for care.

A pre-existing condition can be "active" in that the patient was already having a complaint which was worsened as a result of the car accident (i.e. lower back pain that was present 2x/week at a 3/10 which is now daily at a 7/10) or it can be "inactive" such as a prior resolved lower back injury resulting from a car accident three years ago.

When taking a history of patients involved in a car accident in Baltimore I attempt to "tease out" old injuries from new and so that I can properly apportion any pre-existing complaints. Many doctors do not take the time to do this, as they rush to see patients. What patient's often do not realize is that if a proper honest history isn't in a doctor's report that it WILL BE USED AGAINST YOU!

Most claims adjustors and insurance companies read through your medical records with a fine toothed comb looking for anything they can claim might be a reason why you were a) not injured in this car accident or b) if you were injured, you were already injured from a pre-existing condition or c) you were injured unrelated to this car accident.

Dr. Art Croft in his book "Whiplash and Mild Traumatic Brain Injuries: A Guide for Patients and Practitioners" sheds some light on the pre-existing condition tactics used by insurance companies (page 102):

"Disc disease and spondylosis (spinal degeneration) are part of the normal aging process, like wrinkles, sagging flesh, gray hair, and age lines. About 50% of all people will have radiologically demonstrable spondylosis by their mid-30s and about 85% will have them by the time they are in their 50s. This condition is quite common, being found at autopsy in more than 80% of persons by the age of 50 years. Since it can not be said that 80% of persons over the age of 50 have chronic spinal pain, it provides no valid probative evidence of pre-existing symptoms in a forensic setting. Most people with moderate degenerative disease, in fact, do not have spinal pain."

What Dr. Croft is saying is that while it is true that spinal degeneration becomes more likely as we age, most people with this condition do not have pain. Therefore, it is safe to conclude that pre-existing spinal degeneration (spondylosis) is NOT the cause of spinal pain following a car accident. This is an extremely important statement and one that needs to be understood by treating Chiropractors and other professionals involved in the rehabilitation of spinal injuries following car accidents in Baltimore.

My best advice to patients involved in a car accident in Baltimore is be honest. If you are injured, say so. If you are not, say so. If you have prior injuries from other car accidents, say so. Insurance companies know more about you than you know about yourself. The more honest you are with your care providers the more likely you will be treated fairly by the adverse insurance company. 


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