Our personal injury lawyers regularly see medical reports prepared by orthopaedic surgeons who say that a client’s injury is an “acceleration or exacerbation of a pre-existing condition” that has effectively become symptomatic several years earlier than it otherwise would have done as a result of their accident. Recently, I have seen similar opinions whereby a shoulder and knee condition was brought forwards by 2-3 years accidents. The most common examples relate to back pain and in a recent case a spinal surgeon advised that a client in their forties would have suffered back pain in 12 months time, had it not been for the accident.
So what impact does an accelerated pre-existing condition have on a claim?
In these cases, a client may only claim for the injuries and consequential losses during the period of acceleration (or “exacerbation” which means worsening) and not for the rest of their lives. The compensation for a 2 year acceleration period is much less than if the injury caused by the accident is permanent. A person unable to continue working at the age of 40 due to an injury would received compensation for 2 years of lost earnings in a 2 year acceleration case but up to 30 years’ lost earnings if the injury was caused by the accident and would not otherwise have occurred, making a huge difference in the value of the two scenarios.
Our injured clients find these opinions difficult to accept, particularly as they had no symptoms before the accident and were living normal, active lives. In these cases we have to explain why the doctors have reached their conclusions.
We always instruct orthopaedic surgeons, (usually with specialist knowledge about the area of the body concerned) to prepare medical reports in cases like these to ensure that the clients will obtain the most accurate and reports possible.
What will the surgeons look at?
The surgeons will examine the clients before preparing their reports and also read their medical notes and look at radiology discs with the records containing X-Rays, MRI scans and other test results to look for evidence of a pre-existing condition. For example, occasional visits to the GP with back pain tend to suggest that a person has a deteriorating spine, even though they may have been pain-free for many years before the accident. Radiology obtained before the accident often shows clear and indisputable evidence of arthritis, ruptured and worn discs between vertebrae and other conditions that would have caused pain in the future. I understand that just about everyone over the age of 30 will have some evidence of spinal deterioration that will be detected on a scan. Without pre-accident radiology, opinions are still given by doctors, but they will be more confident and precise where they have seen scans and X-Rays.
Having seen the evidence, the medical expert will then give an opinion as to the period of acceleration caused by the accident. Their opinions are not based on factual data, but their own experiences of similar cases and patients who have presented to them during their clinical practice.
Opinions do, of course, vary and we regularly obtain second medical reports for clients who are not happy with the first one.
As we grow older, we are more and more likely to be suffering from physical deterioration whether we know it or not, so do not be surprised if, in the event of your suffering an orthopaedic injury, your medical expert includes the words “acceleration” or “exacerbation in their report.