Causation on a degeneration

Overcoming Preexisting Condition Defenses in Personal Injury Cases

When defendants claim that a plaintiff’s injuries stem from preexisting medical conditions rather than the accident in question, the legal landscape becomes more complex. In personal injury litigation, establishing causation is crucial—plaintiffs must demonstrate that their current symptoms and limitations directly result from the defendant’s negligent actions, not from underlying health issues that existed before the incident.

The challenge becomes particularly acute when dealing with degenerative conditions or genetic disorders that may have been present but dormant prior to an accident. Defense attorneys frequently argue that any documented preexisting conditions broke the chain of causation, absolving their clients of liability. However, as the Goodwin v Walter case demonstrates, plaintiffs can successfully counter these defenses with proper medical evidence and expert testimony.

This case illustrates the strategic importance of thorough medical documentation in personal injury cases, especially when preexisting conditions are involved.

Jason Tenenbaum’s Analysis:

Goodwin v Walter, 2018 NY Slip Op 06643 (4th Dept. 2018)

“We further conclude, however, that defendant submitted evidence establishing that plaintiff’s injuries were caused by a preexisting condition, i.e., ankylosing spondylitis, a genetic condition. Thus, “plaintiff had the burden to come forward with evidence addressing defendant’s claimed lack of causation” (Pommells v Perez, 4 NY3d 566, 580 ). Plaintiff raised a question of fact by submitting the affidavit of her treating chiropractor and the affirmation of her primary care physician. Plaintiff’s primary care physician asserted that plaintiff’s preexisting condition was “asymptomatic” prior to the accident, and both the primary care physician and the treating chiropractor asserted that, after the accident, plaintiff had a quantified limited range of motion in, inter alia, her neck (see Terwilliger v Knickerbocker, 81 AD3d 1350, 1351 ).”

Legal Significance: The Burden-Shifting Framework in Causation Disputes

Goodwin v Walter illustrates the burden-shifting framework governing causation challenges in New York personal injury litigation. When defendants establish through competent medical evidence that a plaintiff’s injuries stem from preexisting conditions rather than the accident at issue, they satisfy their prima facie burden on summary judgment. This shifts the burden to plaintiffs to raise triable issues of fact demonstrating that the accident, not the preexisting condition, caused or materially contributed to their current symptoms and limitations.

The decision clarifies that plaintiffs can meet this burden by presenting evidence that preexisting conditions were asymptomatic before the accident but became symptomatic afterward. This temporal distinction proves critical because it establishes a causal connection between the traumatic event and symptom manifestation. When medical evidence shows a patient had a degenerative condition or genetic disorder that produced no symptoms or functional limitations before an accident, but documented restrictions appeared immediately thereafter, courts recognize this sequence as sufficient to create factual disputes precluding summary judgment.

The ruling also demonstrates the importance of quantified objective findings in causation disputes. Plaintiff’s medical providers did not merely state that treatment was necessary or that the plaintiff experienced pain. Instead, they documented specific, measurable limitations in range of motion that could be objectively verified through standardized examination protocols. These quantified restrictions provide concrete evidence of functional impairment attributable to the accident rather than the natural progression of a preexisting condition.

Furthermore, the decision shows how defendants’ strategic success in establishing preexisting conditions paradoxically creates burdens they must ultimately overcome at trial. By proving the existence of ankylosing spondylitis, the defendant shifted the burden to the plaintiff—but the plaintiff met that burden by demonstrating the condition was asymptomatic pre-accident. This dynamic illustrates why defense counsel must carefully evaluate whether to emphasize preexisting conditions or focus on other defenses, as the former approach can create burden-shifting complications.

Practical Implications: Documenting Asymptomatic Preexisting Conditions

For plaintiff’s counsel, this decision provides a roadmap for defeating causation challenges based on preexisting conditions. The key elements involve: establishing through credible medical testimony that any preexisting condition was asymptomatic before the accident; documenting the onset of symptoms immediately following the accident; and providing objective, quantified evidence of current functional limitations. Medical providers treating plaintiffs with known preexisting conditions should carefully document baseline asymptomatic status in initial evaluations to establish this critical temporal distinction.

Obtaining affirmations or affidavits from primary care physicians proves particularly valuable because these longstanding treating doctors can attest to the patient’s pre-accident condition based on years of medical history. When a primary care physician who treated a patient for years states that a degenerative condition existed but produced no symptoms until after a traumatic event, courts credit such testimony as reflecting genuine knowledge of the patient’s medical trajectory rather than litigation-driven opinions.

For defense counsel, the decision counsels caution in relying exclusively on preexisting condition defenses. While establishing that plaintiffs have degenerative disorders or genetic conditions shifts the burden, plaintiffs can often meet that burden by documenting asymptomatic status pre-accident. Defendants should therefore combine preexisting condition evidence with additional proof such as minor impact, gaps in treatment, inconsistent symptom complaints, or medical literature showing that the type of trauma sustained could not exacerbate the specific preexisting condition at issue.

Finally, both sides should recognize the importance of contemporaneous medical records in causation disputes. Pre-accident records showing the plaintiff treated for the condition and complained of symptoms undermine claims of asymptomatic status. Conversely, records showing regular medical care without symptom complaints support asymptomatic assertions. Discovery strategies should therefore focus on obtaining complete medical histories extending well before the accident date to establish or refute claims of symptom onset timing.

Key Takeaway

The key to overcoming preexisting condition defenses lies in demonstrating that the condition was asymptomatic before the accident and became symptomatic afterward. Medical professionals must provide clear documentation showing measurable changes in the plaintiff’s condition, such as quantified limitations in range of motion, that can be directly attributed to the traumatic event rather than the natural progression of the preexisting condition.

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