The Shoulder
The Shoulder
69
Insurancecurious-tern-711

Insurance keeps saying my herniated disc was 'pre-existing' — I'm 34 and had zero symptoms before

Really frustrated and need to hear if anyone else has dealt with this.

Back in the spring I was a passenger in a friend's car when we got rear-ended hard by a delivery van that blew through a red light. I walked away shaken but didn't think I was seriously hurt. A few weeks later my neck and left arm started getting worse — not better — so I finally went to a doctor.

After an MRI they found two herniated discs in my cervical spine. My doctor referred me to a specialist and after months of PT, injections, and two different opinions, the recommendation is now surgery.

Here's the thing: the at-fault driver's insurance keeps sending letters suggesting my discs were already deteriorating before the crash and that the accident just "revealed" a condition I already had. They're basically saying the crash didn't cause my injury — time did.

I'm 34. I was a recreational runner. I had zero neck or arm symptoms before this happened. I never filed a prior injury claim. Never missed work for back or neck pain. Nothing.

My treating doctor says the trauma from the impact is consistent with causing this kind of disc damage, but the insurance adjuster keeps pushing back with their own "independent" medical examiner who disagrees.

Has anyone fought through this kind of argument from the insurance company? How did it go? Did having strong medical records from before the accident help? Did you end up needing a lawyer?

I feel like I'm being gaslit into thinking my body just randomly fell apart at 34 on its own. Any insight appreciated.

13replies

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13 replies

  • 14
    wise-newt-327

    Oh man, I went through almost the exact same thing. I was in my late 20s when I got hit, and they tried the same degenerative disc argument on me. What helped me was that I had a physical for a new job about eight months before the accident where everything came back completely normal. My lawyer used that to show I had no pre-existing neck issues. Do you have any recent medical records from before the crash — checkups, sports physicals, anything? Those can be gold.

    • 15
      gentle-tern-128

      From a medical standpoint, what you're describing — symptoms that ramped up over weeks after impact rather than immediately — is really common with cervical disc injuries. The inflammation and nerve irritation can take time to fully declare themselves. That delayed onset doesn't mean it wasn't caused by the crash, and any spine specialist worth their license knows that. Make sure your surgical recommendation and your doctor's causation opinion are clearly documented in your medical records.

    • 7
      careful-survivor257

      Curious whether you did this on your own or had help with it.

    • 2
      level-late-shift825

      Adding this: keep copies of every email. It mattered for me.

  • 20
    swift-heron-329

    That "independent" medical examiner they hired? Not independent at all. Insurance companies use the same handful of doctors over and over who are known for writing reports that favor the insurer. It's practically a cottage industry. Don't let them frame their paid expert as some neutral third party — your own treating physician who actually examined you repeatedly carries way more weight.

  • 14
    quiet-hare-949

    I used to work on the claims side, so let me be real with you: the degenerative changes argument is one of the first things adjusters are trained to look for on any MRI involving the spine. It's a cost-containment tactic. What changes the calculus internally is when the claimant has a strong documented history showing no prior symptoms, a credible treating physician, and — especially — when surgery is on the table. That last part escalates things quickly. Get a lawyer involved before you sign or say anything else.

    • 1
      quiet-dreamer904

      Seconding this. The same approach worked for me last year.

  • 9
    swift-lynx-891

    A few practical things worth knowing: First, most people have some disc changes visible on MRI by their mid-30s — that's actually pretty normal and doesn't mean you were symptomatic or that a crash can't make it dramatically worse. Courts and juries understand the difference between a vulnerable spine and a pre-existing disability. Second, the legal concept you'd want a lawyer to look at is called the "eggshell plaintiff" rule — basically, the at-fault party takes you as they find you, even if your spine was more susceptible to injury than average. Not legal advice, just context.

    • 4
      honest-passenger675

      Thanks for sharing. Hope things are getting a little easier for you.

  • 18
    hearty-heron-031

    Not legal advice, but I'll say this: the pre-existing condition defense is common and it's also very beatable with the right medical evidence and expert support. The key is usually getting your treating physician to write a clear causation opinion — specifically linking the trauma of the accident to your current diagnosis — and ideally having records that establish your baseline health before the crash. If surgery is now recommended, this claim has gotten serious enough that you really shouldn't be navigating it without an attorney. Most PI lawyers handle these on contingency so there's no upfront cost.

    • 9
      kind-optimist655

      Curious whether you did this on your own or had help with it.

  • 6
    warm-owl-860

    Stop talking to the insurance adjuster. Seriously. Every conversation you have with them without representation is a chance for them to get something on record that they'll use against you later. You've got a surgery recommendation and a disputed liability question — that's a lawyer situation, full stop.

  • 5
    sharp-newt-697

    The fact that they're pushing back this hard kind of tells you they know the claim has value — if they thought they had a slam-dunk defense they'd just deny it outright. The pushback is frustrating but it also means there's something worth fighting for here. Hang in there.