Pre-Existing Conditions in Kentucky Car Accident Cases

A pre-existing condition is a health problem a person had before a crash, such as degenerative disk disease, arthritis or an old shoulder surgery. Having one does not end a Kentucky injury claim. In Drury v. Spalding, the Supreme Court of Kentucky held that a person can recover for an earlier condition to the extent a crash activated or aggravated it. The real question in these cases is what the collision added, and for a spine injury or any other injury, the medical records from before and after the crash answer it.

Old Injuries in the Medical Record

Prior conditions fall into two rough groups. An asymptomatic condition caused no pain and needed no treatment before the crash. It may show up on a scan, but the person never knew it was there. A symptomatic condition already caused pain or limits, and office notes, prescriptions or therapy visits show it.

Each kind shows up in claims for a different reason. With an asymptomatic condition, the records usually show a quiet history and then a sudden change after the collision. With a symptomatic one, the records have to show how the baseline shifted: more pain, new symptoms, a new diagnosis or new limits on work and daily life.

Imaging alone rarely settles the question. A systematic review in the American Journal of Neuroradiology concluded that degenerative imaging findings “must be interpreted in the context of the patient’s clinical condition.” A report that says “degenerative changes” describes what the scan shows. It does not say when the pain started.

Spine Degeneration in Adults Without Pain

Phrases like “degenerative disc disease” and “pre-existing degenerative changes” appear on a large share of adult spine MRIs, and age is the main reason. In a systematic review published in the American Journal of Neuroradiology, researchers pooled 33 studies covering 3,110 people who had no symptoms. They estimated that disk degeneration was present in 37% of 20-year-olds and 96% of 80-year-olds.

The estimate for disk degeneration reached 68% at age 40, 80% at age 50 and 88% at age 60. The authors wrote that many of these features “may be part of normal aging and unassociated with low back pain.”

For a crash case, the takeaway is direct. A disk finding on a post-crash MRI does not prove the person was hurting before the crash, because the same finding is common in people who feel fine. The history before the collision and the change after it carry the weight.

Kentucky Law on Aggravated Conditions

Kentucky has allowed recovery for aggravated conditions for more than a century. In Drury v. Spalding, the Supreme Court of Kentucky repeated a 1917 rule that “one may recover for injury which aggravates an existing one, or develops a latent one.” A latent condition is one that was there but quiet, like a degenerated disk that never hurt until the crash.

The same opinion restated the premise that the at-fault party “takes the claimant as he finds him.” The driver who caused the crash gets no credit or setoff because an earlier condition made the injured person more likely to be hurt, or hurt worse, than a healthier person would have been.

The rule has a boundary. Drury notes that defendants have long asked for jury instructions not to award damages for any pre-existing condition “except to the extent it was aggravated.” The court put it plainly in the same passage: the defendant must pay for the part of the condition its negligence caused. The claim covers what the crash caused or made worse, and the records have to show where that line sits. In Kentucky workers’ compensation, a prior condition counts against a permanent impairment rating only when it was symptomatic and ratable immediately before the work injury.

No-Fault Threshold and Prior Injuries

Kentucky’s no-fault law adds a gate for pain and suffering claims. Under KRS 304.39-060, a plaintiff may recover damages in tort for “pain, suffering, mental anguish and inconvenience” only when medical expense benefits for the injury exceed $1,000, or the injury includes a listed condition such as permanent disfigurement, a fracture to a bone, permanent loss of bodily function or death.

Pre-existing conditions raise a practical question here: do bills for treating an aggravated condition count toward the $1,000? Drury answered yes. The court held that the activation-or-aggravation rule “applies to the no-fault threshold as well as to other instructions on damages.” If the jury finds the crash activated or aggravated an earlier condition, it has to consider all medical expenses related to the accident when deciding whether the threshold was met.

Drury also flagged a wording trap. A jury instruction about losses “sustained directly by reason of the accident” can mislead, the court said, because “directly” suggests “exclusively.” That is not the test when a crash aggravates or activates an earlier condition.

Insurer Requests for Past Medical Records

After a claim opens, an insurance adjuster often asks the injured person to sign a broad medical authorization covering years of history. The adjuster then reads those records for any mention of pain in the same body part. One note about occasional neck stiffness from five years earlier can become the argument that a cervical spine injury was already there before the crash.

Take a person who mentioned lower back pain at a 2019 physical and saw a chiropractor twice in 2020. After a 2025 crash, the adjuster points to those entries and argues the lumbar spine injury is the old problem coming back. The argument skips over years with no treatment and full-time work without restrictions.

Federal privacy rules shape what an authorization can cover. Under the HIPAA Privacy Rule at 45 CFR 164.508, a valid authorization must include “a description of the information to be used or disclosed that identifies the information in a specific and meaningful fashion,” along with who receives it, the purpose and an expiration date or event. A person can revoke an authorization in writing at any time, with limited exceptions, such as when the provider has already acted on it.

Comparing Old and New Spine Imaging

A disk can move out of place or break open “from injury or strain,” according to MedlinePlus, the National Library of Medicine’s health site. The same entry lists a spine MRI or CT as the test that shows where a herniated disk is pressing on the spinal canal.

Earlier scans make those tests far more useful. Comparing pre-accident and post-accident MRI and CT imaging is one of the most direct ways to show crash-related aggravation. If a 2022 MRI shows mild disk degeneration and a 2025 post-crash MRI shows a new herniation at the same level, the two reports side by side show what changed.

Sam Aguiar Injury Lawyers sees the pre-existing condition defense often, in claims involving cervical disk herniations, degenerative disk disease, prior shoulder surgeries, arthritis and prior hip replacements. In those files, the older imaging is often the record that answers the adjuster’s argument.

Baseline Records From Before the Crash

Imaging shows structure. The rest of the file shows how the person lived. Records from before the crash set the baseline: primary care notes with no mention of back pain, years without chiropractic or therapy visits, full-time work without restrictions and a normal activity level.

Records after the crash show the change: the first emergency or urgent care visit, when symptoms began, which body parts hurt and how treatment progressed. A treating physician who saw the patient before the collision can describe baseline function in a way an imaging report cannot. Those accounts supply the clinical context that the American Journal of Neuroradiology review says imaging findings need.

Long breaks in care cut against this timeline, because they give an adjuster room to argue that something else caused the later symptoms. The page on treatment gaps after car accidents covers how those breaks are read.