Chronic ailments and No-Fault Benefits

Written by Steven Matz on . Posted in .

“Can I get no-fault benefits if an auto accident makes an “old” injury worse?”

Yes, but you have to prove to your auto insurance company that the accident, as opposed to the pre-existing injury, is what is causing your need for treatment and any disability you claim.

We see many cases where, for example, someone with a history of back or neck pain gets into an auto accident that seems to make the old problems worse. It can be difficult for your doctor (and later, your lawyer) to prove that the recent trauma from the accident has made you feel worse. One way this is done is to compare your medical records from before the accident to what your records say now. There might be an old MRI or “CAT” Scan that was taken when you started having problems years ago. This could be compared to updated studies taken since the accident. If you had been doing fairly well before the accident, despite having underlying problems, and now your new studies show worsening of your condition, it seems reasonable to suggest that the accident made your old problems worse.

As we have said in previous parts of this series of articles, you can expect your insurance company to ask the same questions, because the insurance company may be responsible to pay for your medical care, work time lost, and other benefits that are provided under No-Fault. The company may send you for an evaluation by a doctor it chooses, who will usually say that the accident had nothing to do with your complaints. That takes the insurance company “off the hook” for paying your expenses. You probably will need a lawyer to fight that battle for you, since the law gives the insurance company the right to do that—you have to prove they are wrong!

One more thought to keep in mind: you have to be able to show that a single auto-related incident caused your problems. Claiming that years of climbing in and out of your truck caused you to have sore knees, for example, is not the kind of case that no-fault benefits were designed to cover.

Source: MCL 500.3105; 125 Mich App 123

Written By Steven Matz

Steven J. Matz is a founding shareholder of Matz Injury Law. The firm’s concentration is on personal injury litigation, with an emphasis on traumatic brain injury. Mr. Matz earned a Bachelor of Arts degree with high distinction and highest honors in 1974 from the University of Michigan and a Juris Doctor degree in 1977 from The George Washington University National Law Center. Mr. Matz lectures and publishes in a number of areas, including ethics, marketing, trial tactics, and head injury. Mr. Matz has served on the Michigan Association for Justice Executive Board and currently serves the Michigan Attorney Discipline Board as a Hearing Panel Chairman and Master. He is also a member of the State Bar Committee for Character and Fitness.
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The maximum contingency fee permitted by law is actually 33 1/3%. Michigan court rules require that the attorney fee be computed on the net sum recovered after deducting all disbursements properly chargeable to the enforcement of the claim.

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