Your client is 52, has a desk job, and had never treated for neck pain a day in her life until a rear-end collision at a stoplight. The MRI comes back and the report reads like a horror show: multilevel disc desiccation, foraminal narrowing, osteophyte complexes. The adjuster sees it before you do, and the offer reflects one theme repeated in every letter and every deposition: it was already there. This is the single most common liability-conceded defense in soft-tissue and disc cases, and it works on juries who think a crash either breaks a healthy body or does nothing at all.
The doctrine is on your side. The question is whether you build the record to use it.
The eggshell plaintiff takes the crash as it finds him
Every jurisdiction recognizes some version of the rule that a defendant takes the plaintiff as found. A tortfeasor who negligently injures a person with a fragile or degenerating spine is liable for the full harm caused, even if a healthier person would have walked away. The corollary that wins cases is the aggravation principle: when a collision lights up a dormant, asymptomatic degenerative condition and makes it painful and disabling, the defendant answers for that aggravation.
The pattern jury instruction is your best friend here, and you should be quoting it from voir dire forward. Most states give some form of it. Get it read to the venire, get your causation expert to track its language, and put it in your closing verbatim. Jurors resist the idea that a middle-aged plaintiff with arthritis deserves anything. The instruction tells them the law disagrees.
Aggravation versus causation is the real fight
The defense rarely disputes that degeneration exists on the film. It disputes that the crash did anything to it. So the case is not really about causation in the abstract; it is about aggravation of a preexisting condition. Your job is to separate the asymptomatic radiographic finding from the symptomatic clinical injury.
Degeneration is common and often silent. Radiology literature has shown for years that large percentages of pain-free adults have disc bulges and desiccation on imaging they never knew about. Use that. The presence of degenerative change tells you nothing about whether your client hurt before the collision. What changed was function: she could work, sleep, and turn her head before, and she cannot now. That before-and-after delta is the aggravation, and it is compensable whether or not the underlying spine was pristine.
Build the proof: imaging, treaters, and a causation expert
Three pillars carry an aggravation case.
- Comparative imaging. If any prior films exist, get them and put them side by side with the post-collision study. A new disc herniation, an acute annular tear with high-intensity zone, or a measurable change in disc height between a pre-crash and post-crash MRI is close to unimpeachable. Even absence of prior imaging helps: if she never had a reason to get scanned, that supports an asymptomatic baseline.
- The treating physician. Your treater saw the client during the acute phase and can testify to onset, mechanism, and the temporal relationship between the crash and the symptoms. Treaters are more credible than hired experts precisely because they were caring for the patient, not the case. Prepare them to explain "lighting up" in plain language.
- A causation expert. Bring a physiatrist, orthopedic surgeon, or radiologist who can read the films, apply the mechanism of injury, and testify that the trauma aggravated a preexisting but dormant condition to a reasonable degree of medical probability. This witness answers the defense radiologist head-on.
Get ahead of the prior records, do not hide from them
Defense counsel will subpoena every prior medical record your client ever generated, so subpoena them first. You want to know about the old gym injury, the chiropractic visits, the pain-management note buried in a primary-care chart before the defense ambushes you with it in deposition. If there is prior treatment to the same body part, meet it directly: quantify how it resolved, how long she was symptom-free, and how the current presentation differs. A candid "yes, she tweaked her back in 2019, treated for three weeks, and had zero symptoms for five years until this crash" beats a concealment the defense reveals for you. Some of this overlaps with the workups you already run in workers-comp aggravation claims, where prior-condition apportionment is a daily fight.
The apportionment problem
Even accepting aggravation, the defense pivots to apportionment: how much of the disability belongs to the crash versus the natural progression of degeneration. This is where many good cases lose money. Some states require the plaintiff to segregate the aggravation from the underlying condition; others place the indivisibility burden on the defendant and let the plaintiff recover the whole where the harm cannot be neatly divided. Know your rule cold, and have your expert address it directly rather than leaving the jury to guess. Reviewing how courts have split these questions in comparable verdicts and settlements helps you value the exposure before mediation.
Neutralizing the defense IME
The defense radiologist or IME doctor will label everything chronic and degenerative and pronounce the crash a non-event. Cross him on what he does not know: he never treated the plaintiff, never took a history, saw her once or never, and cannot say she was symptomatic before the collision because there is no record of it. Pin him on the asymptomatic-degeneration literature. Make him concede that a dormant condition can be rendered painful by trauma, because any honest physician will. Then hand the jury the instruction that seals it. The same discipline that wins the biggest auto-accident disputes applies here: control the medicine, own the timeline, and let the doctrine do the closing.