Understanding Aggravation of Pre-Existing Injuries in New York Personal Injury Law

The landmark case of Ortiz v Boamah, 2019 NY Slip Op 01129 (1st Dept. 2019), provides crucial insights into how New York courts handle cases involving the aggravation of pre-existing injuries. This area of personal injury law is particularly complex because it requires distinguishing between conditions that existed before an accident and new symptoms or worsening caused by the traumatic event.

The Ortiz v Boamah Case: Setting Legal Precedent

In Ortiz v Boamah, the court addressed a fundamental issue in personal injury law: when can a plaintiff recover damages for injuries that aggravate pre-existing conditions? The case demonstrates how causation issues play out in New York’s statutory no-fault world and provides guidance for both plaintiffs and defendants in similar situations.

The Defense’s Prima Facie Case

The defendants in Ortiz established their initial burden by submitting the plaintiff’s medical records and an orthopedist’s report. The court noted: “Defendants submitted plaintiff’s medical records and the affirmed report of an orthopedist who, following examination and review of the medical records, found that plaintiff had preexisting conditions and no evidence of injuries caused by trauma.”

This demonstrates the standard approach defendants use to challenge injury claims: establishing that the plaintiff’s conditions existed before the accident and arguing that no new trauma-related injuries occurred.

The Plaintiff’s Response: Proving Aggravation

The court provided clear guidance on what plaintiffs must show to overcome a pre-existing injury defense: “An explanation that the plaintiff was previously asymptomatic and the accident aggravated an underlying pre-existing condition, rendering the plaintiff symptomatic, is sufficient to raise an issue of fact as to causation.”

This standard requires plaintiffs to prove two key elements:

• They were asymptomatic before the accident
• The accident caused their pre-existing condition to become symptomatic

Legal Standards for Aggravation Claims in New York

The Asymptomatic Standard

New York law recognizes that many people have underlying degenerative conditions that cause no symptoms until triggered by trauma. The key legal principle is that defendants must “take their victims as they find them” – commonly known as the “eggshell skull” rule.

In Ortiz, the plaintiff’s neurosurgeon provided crucial testimony: “although plaintiff has chronic degenerative spinal stenosis and spondylolisthesis, she had no prior history of back pain and leg pain.” This testimony established that while the conditions existed, they were not causing symptoms before the accident.

Medical Expert Requirements

Successful aggravation claims require qualified medical experts who can:

• Document the pre-existing condition
• Establish the plaintiff’s asymptomatic status before the accident
• Explain how the trauma aggravated the condition
• Provide causation opinions within a reasonable degree of medical certainty

In Ortiz, the neurosurgeon opined that “it is not unusual for such a chronic pathology to become aggravated by a relatively mild-to-moderate trauma” and concluded “within a reasonable degree of medical certainty, that the motor vehicle accident aggravated plaintiff’s latent asymptomatic age related degenerative spine conditions.”

Common Types of Pre-Existing Conditions That Can Be Aggravated

Spinal Conditions

Degenerative spinal conditions are among the most common pre-existing injuries that become symptomatic after accidents:

• Degenerative disc disease – Natural wear and tear that may be asymptomatic until triggered
• Spinal stenosis – Narrowing of the spinal canal that can be aggravated by trauma
• Spondylolisthesis – Vertebral slippage that may worsen after an accident
• Arthritis – Joint degeneration that can become symptomatic following injury

Joint Problems

Many accident victims have underlying joint issues that become problematic after trauma:

• Degenerative joint disease in knees, shoulders, or hips
• Previous injuries that had healed but left vulnerability
• Cartilage damage from prior wear and tear

Soft Tissue Conditions

Pre-existing soft tissue problems can also be aggravated:

• Previous muscle strains or tears
• Scar tissue from prior injuries
• Chronic pain conditions

Proving Aggravation: Evidence and Documentation

Medical Records Analysis

Successful aggravation claims require thorough analysis of:

• Pre-accident medical records – To establish baseline condition and symptom status
• Emergency room records – Immediate post-accident documentation
• Treatment records – Ongoing medical care and symptom progression
• Diagnostic imaging – MRI, CT scans, and X-rays showing changes

Expert Medical Testimony

In Ortiz, the plaintiff presented testimony from both a neurosurgeon and chiropractor. The court found this sufficient because “each of whom independently opined that because she had no history of symptoms or medical treatment for her spine before the accident, her injuries were caused, or at least aggravated by the motor vehicle accident.”

Multiple expert opinions strengthen aggravation claims by providing corroborating medical evidence.

Challenges in Aggravation Cases

Insurance Company Tactics

Insurance companies often aggressively defend against aggravation claims by:

• Conducting extensive medical record reviews going back years
• Arguing that current symptoms are part of natural disease progression
• Challenging the credibility of treating physicians
• Using independent medical examinations to contradict treating doctors

Burden of Proof Issues

Plaintiffs must clearly establish:

• The existence of pre-existing conditions
• Their asymptomatic nature before the accident
• The causal relationship between the accident and symptom onset
• The extent of aggravation versus natural progression

Working with Personal Injury Attorneys on Aggravation Cases

Aggravation cases require specialized legal expertise because they involve complex medical and legal issues. When consulting with a personal injury attorney, it’s crucial to:

• Provide complete medical history, including all pre-existing conditions
• Document your symptom-free status before the accident
• Maintain detailed records of symptom onset and progression
• Comply with all medical treatment recommendations

Building Strong Aggravation Claims

Successful aggravation cases typically involve:

• Comprehensive medical documentation
• Multiple expert medical opinions
• Clear testimony about pre-accident activity levels
• Documentation of functional limitations caused by the accident

Frequently Asked Questions About Aggravation of Pre-Existing Injuries

Can I recover damages if the accident made my arthritis worse?

Yes, if you can prove that your arthritis was asymptomatic before the accident and became symptomatic or significantly worse due to the trauma. You’ll need medical expert testimony establishing the causal relationship between the accident and your increased symptoms.

What if I knew about my pre-existing condition but had no symptoms?

Knowledge of a pre-existing condition doesn’t bar recovery if you were asymptomatic. The key is proving that the accident triggered symptoms or worsened your condition beyond what would have occurred naturally.

How do courts distinguish between natural progression and accident-related aggravation?

Courts rely heavily on medical expert testimony comparing your condition’s expected natural progression with the actual symptoms and timing following the accident. Expert witnesses must explain how the trauma accelerated or worsened your condition.

Do I need multiple doctors to prove aggravation?

While not strictly required, having multiple medical experts strengthens your case. As shown in Ortiz, independent opinions from different specialists provide more compelling evidence of causation.

What damages can I recover for aggravation of pre-existing injuries?

You can recover damages for the aggravation caused by the accident, including additional medical expenses, increased pain and suffering, lost wages due to worsened symptoms, and reduced earning capacity if the aggravation affects your ability to work.

The Role of Different Types of Accidents

Motor Vehicle Accidents

Car accidents frequently cause aggravation of spinal conditions due to the sudden forces involved in collisions. The rapid acceleration and deceleration can trigger symptoms in previously asymptomatic degenerative conditions.

Slip and Fall Accidents

Premises liability cases often involve aggravation of joint conditions when falls cause additional stress to already-compromised joints or spine.

Workplace Injuries

Under workers’ compensation, the aggravation doctrine allows recovery even when workplace activities worsen pre-existing conditions, provided the work activities contributed to the aggravation.

Protecting Your Rights in Aggravation Cases

Immediate Actions After an Accident

1. Seek immediate medical attention – Don’t delay treatment due to concerns about pre-existing conditions
2. Be honest about your medical history – Disclosure protects your credibility
3. Document symptom changes – Keep detailed records of how your condition worsened
4. Follow treatment recommendations – Compliance strengthens your case

Long-term Case Management

• Maintain consistent medical care
• Keep detailed symptom diaries
• Preserve all medical records
• Avoid gaps in treatment that could undermine your claim

Conclusion

The Ortiz v Boamah case demonstrates that New York law provides meaningful protection for accident victims whose pre-existing conditions are aggravated by traumatic events. The key to success in these cases is establishing that you were asymptomatic before the accident and providing credible medical testimony that the trauma caused or accelerated your symptoms.

Aggravation cases require sophisticated legal and medical analysis to overcome insurance company challenges. With proper documentation, expert medical testimony, and experienced legal representation, accident victims can recover fair compensation for the aggravation of their pre-existing conditions.

If you’ve been injured in an accident and believe it has worsened a pre-existing condition, it’s important to seek legal counsel immediately. The earlier you address these complex issues, the better positioned you’ll be to prove your case and recover the compensation you deserve.

Call 516-750-0595 for a free consultation with our experienced Long Island personal injury attorneys. We understand the complexities of aggravation cases and can help establish the causal connection between your accident and worsened condition while protecting your rights throughout the legal process.