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I had mva approx 6 mnths ago, have had to have urgent spinal cord surgery since then but insurance say its pre existing cond.

New York, NY |

My car was rear ended whilst I was stationary about 6 months ago, I went to Drs 3-4 days later as I had back, neck and shoulder soreness, dx as bruising from mva. Approx 3 wks later, was cleaning and reached under a bed and got electric shock sort of pain down back of arm and fingers went dead, went of to Drs again and was referred for an urgent CT. CT showed a large mass between and around C2/3, C3/4 & C5/6. Sent for MRI which showed a badly herniated disc and 2 smaller bulges which was causing severe spinal cord compression, Specialist said it was an impressive injury caused by impact and was suprised my symptoms so few. Said ok to work etc but to take it very easy and if symptoms worsened to go immediately to A&E as I could end up paralized. Symptoms got worse and signed off for 5mth

I was advised to do nothing, no lifting, cleaning, driving, exercising etc due to the risk of becoming paralized, my symptoms got worse particularly the electric shock pains in my arms which were bad when I walked. My Neurosurgeon booked me in for surgery 3 months after accident but insurance company refused to fund op so it then got delayed another 2 months and still insurance company saying it was a pre existing condition that caused the problem and not the accident. I am so frustrated as I knew nothing of the condition (osteo arthritis) I have had a problem with my shoulder in the past but it has been dx as tendernitis and I had no reason to believe otherwise, my faith was in my Dr as they know what they are talking about. They say it has been there for a long long time but have not said how long. What should I do?

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Attorney answers 10


You can have a pre-exisitng condition that is aggravated by trauma. It sounds like the insurance company is playing insurance company games. You need to retain a lawyer NOW!


You should consult with a personal injury attorney immediately who may be able to help. If the doctor relates your disk problem and the surgery to the accident, you would have a viable claim against the owner and operator if te vehicle that struck you in the rear. No Fault companies are notorious for denying medical claims and treatment as "not causally related" or "pre existing" even if you never had a problem before. As long as they have a doctor to justify the denial, they do. It Is possible to file an appeal of the denial, or you could commence a lawsuit to seek payment of the bills and for your injury, pain and suffering.

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What's your question? Do you have a lawyer? If not, then get one right away!



Question is where do I stand?

Yefim Rubinov

Yefim Rubinov


You are standing no where if you don't have a lawyer. If everyone is telling you that, then it must true


You have t asked a question which strongly suggests you ate looking for direction. The wisest decision you can make is to speak with a qualified personal injury litigation attorney asap. Do t be foolish. Good luck.

Personal injury cases only; I'm good at it; you be the Judge! All information provided is for informational and educational purposes only. No attorney client relationship has been formed or should be inferred. Please speak with a local and qualified attorney. I truly wish you and those close to you all the best. Jeff

Jeffrey Mark Adams

Jeffrey Mark Adams


Sorry for poor grammar; answered while in transit. One point regarding what has been posted, you cannot arbitrate or appeal the denial of no-fault benefits while you have a lawsuit, or the possibility of a lawsuit, pending. Prevailing on the no-fault claim will have no collateral effect. Losing the no-fault claim will bar a claim for personal injuries. Interview a few lawyers and look to retain the one you are most comfortable with and confident in. Be well.


If you don't have an attorney, get one now. Even if you had a pre existing condition the law protects you if the condition was activated/aggregated causing the need for surgery. What insurer is refusing to pay for the surgery, no fault? A lawyer should be able to clear this up quickly.

This answer is not intended as legal advice, nor as a substitute for legal advice received from an attorney during a consultation. Your rights and obligations may vary depending upon facts not disclosed in your question. Therefore, you should contact an attorney immediately so that your interests are properly protected.


You need a personal injury lawyer. You have several options including trying to get the surgery on a lien or filing for no-fault arbitration against the insurance company. Hopefully the car that hit you has a large insurance policy or you have a large SUM policy.

I am a former federal and State prosecutor and now handle criminal defense and personal injury/civil rights cases. Feel free to check out my web site and contact me at (212) 577-9797 or via email at I was named to the Super Lawyers list as one of the top attorneys in New York for 2012. No more than 5 percent of the lawyers in the state are selected by Super Lawyers. The above answer is for informational purposes only and not meant as legal advice.


You owe it to yourself to contact a lawyer, whether myself or one of my colleagues. If you appreciate the time spent preparing this answer, kindly consider marking it BEST ANSWER or HELPFUL. Also, please be sure to read my disclaimer below. Good luck to you.

Dean P. Murray
The Murray Law Firm
560 Sylvan Avenue
Englewood Cliffs, NJ 07632
T: (201)875-2600
F: (201)549-8700

Mr. Murray's response is NOT legal advice and does NOT create an attorney-client relationship. You should NOT rely on this response. Mr. Murray's response was generated without conducting a full inquiry as would occur during a face to face attorney-client consultation. It is likely that the response above may be made less accurate, or become entirely inaccurate, as you, i.e. the questioner, disclose additional facts that should only be discussed during a private consultation with an attorney. I strongly recommend that you consult an attorney who is licensed to practice law in your state (or, in the case of immigration law, and attorney in ANY state), whereupon all relevant facts will be discussed. All responses posted by Mr. Murray on are intended as general information for the education of the public, and not for any specific individual.


You need to retain personal injury counsel ASAP. Call my law partner Mark Kosofsky toll free 1-877-996-6849. All he does is personal injury cases.


A personal injury lawyer will argue aggravation of previous injury. Retain a personal injury lawyer with a low contingency fee, less than 30%, so you are left with the lion's share of the settlement, not your lawyer. Good luck.

Only 29% Contingency Fee! Phone: 215-510-6755


Your dilimena is not unique. Most people with spinal injuries from car accidents have degenerative spinal conditions. I'll take that one step further..., most people have degenerative spinal conditions. This the same game that all the insurance companies play. They send you to some Dr. who graduated last in his class for a three minute medical exam. Unless you walk in missing a limb, they either find nothing wrong with you or determine your condition to be pre-existing. Your options are 1) contest the no fault insurance company's finding ( through arbitration) ; 2) if you have private insurance, forget no fault and put it through your own insurance or 3) see if you can find a reputable surgeon who will perhaps take a lien against your personal injury case. Possibly a fourth option would be to borrow money against the case to have the surgery. What are the limits of insurance coverage on the vehicle that struck you? You have two of the four elements to make a strong case: 1) good liability; 2) significant damages. If you have 3) a defendant with a large insurance policy then the insurance company will most likely make a substantial offer on your case rather than go to trial on issue 4) which is proximate cause ( that the accident was a substantial contributing cause of your damages). My office handles such cases. Good luck to you.

This communication does not create an attorney/client relationship. My firm is a second generation family firm successfully handling personal injruy and medical malpractice cases for over 35 years. "Let Our Family Help Your Family" 516 466-7900

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