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Back injuries produce a diagnostic problem that few other injuries share. An MRI ordered after a collision will almost always reveal something, and the question is never whether a finding exists. It is whether the finding explains the pain and whether the collision caused it. That distinction is where these claims are contested, and a claimant who does not understand it will be caught off guard when the insurer produces the imaging as evidence against them.
Why the Imaging Argument Arises
Degenerative changes in the spine are extremely common in people with no symptoms whatsoever. A systematic review of imaging findings in 3,110 asymptomatic individuals, published in the American Journal of Neuroradiology, found that disc degeneration was present in 37 percent of asymptomatic 20-year-olds and rose to 96 percent of 80-year-olds. Disc bulges were present in 30 percent of asymptomatic people at age 20 and 84 percent at age 80. The authors concluded that many of these features are likely part of normal aging and unassociated with pain, and that imaging findings must be interpreted in the context of the patient’s clinical condition.
Defense counsel uses the first half of that finding and ignores the second. The argument runs that because degeneration existed before the collision, the collision caused nothing. The answer is that the presence of a degenerative finding says little on its own, and that the relevant comparison is between the claimant’s function before the incident and after it.
Aggravation of a Pre-Existing Condition
A defendant takes the claimant as found. Someone with asymptomatic degeneration who was working full time and sleeping normally before a collision, and who cannot do either afterward, has a compensable injury even though the underlying condition predates the crash. What must be proven is the change, not the absence of prior findings.
This makes the pre-incident record valuable rather than dangerous. Employment attendance, prior imaging showing the same findings without complaints, and testimony about activity levels all establish the baseline. Disclosing that history at the outset is safer than allowing the defense to produce it later as though it had been concealed, and the same principle governs prior injuries and your claim in Virginia matters.
The Range of Injuries
Soft tissue strains involve muscle and ligament and typically resolve within weeks, though a minority do not. Disc injuries involve displacement of material that can compress a nerve root, producing radiating pain, numbness, or weakness in a limb rather than pain confined to the back. Radiating symptoms are what separate bulging and herniated disc claims from ordinary strains, because they indicate nerve involvement rather than muscle. Vertebral fractures are visible on imaging and rarely disputed on causation, though their long-term consequences often are.
Spinal cord damage is categorically different. A complete injury eliminates function below the level of the lesion. An incomplete injury preserves some sensation or movement. Injuries at the cervical level affect all four limbs, while thoracic and lumbar injuries affect the lower body. Claims involving paralysis are built around lifetime care requirements rather than treatment already received, and the lifetime figures in catastrophic injuries are established through a care plan rather than from bills already incurred.
Treatment Progression and the Record
Spinal claims usually follow a sequence: conservative care first, then injections, then surgical consultation if symptoms persist. Insurers read this progression closely. A claimant who was discharged from physical therapy after four visits and returned eight months later will face the argument that something else intervened.
Timing matters at the outset as well. Back pain that begins the morning after a collision is medically ordinary, but a claimant who waited three weeks to seek care has created a gap that must be explained. Treatment timing affects both causation and value, and a reason for the delay documented at the time is worth far more than an explanation offered months afterward.
What These Claims Are Worth
Valuation depends on permanence, on whether surgery has occurred or is recommended, and on the effect of the injury on the claimant’s ability to work. A laborer with a lumbar injury and an office worker with the same imaging findings may have very different claims, because earning capacity is affected differently. That gap is captured through lost earning capacity rather than through medical bills, which is why two back injury claims with identical imaging can be valued very differently. The split between economic and non-economic damages determines which part of the loss requires documents and which requires testimony. Most of these claims arise from auto collisions, where the forces involved are frequently disputed alongside the medicine.
Speak With a Washington, DC Personal Injury Attorney
Partner Adam R. Leighton, admitted in the District since 1998, concentrates his practice on medical negligence, automobile accidents, and premises liability matters and has extensive trial experience. Spinal claims require an attorney who can put a radiologist’s findings in context for a jury rather than allow the defense to present an MRI report as though it settled the question. Contact our attorneys to discuss your injury and your treatment history. Fees are contingent, and nothing is owed unless we recover.
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