Pre-Existing Condition Cases for Plaintiffs: The Concessions That Beat the Natural Progression Defense

Michael Cowen, Partner & Trial Attorney | Cowen Law

Michael Cowen is the founding partner of Cowen Law, a Texas trial firm with offices in San Antonio and College Station that concentrates on 18-wheeler and commercial motor vehicle cases involving death and catastrophic injury. A nationally recognized authority in trucking and company vehicle accident litigation with nearly three decades of experience, he has tried more than 120 jury trials and handled thousands of personal injury cases, achieving numerous multimillion-dollar verdicts and settlements. Board certified in both Personal Injury Trial Law and Truck Accident Law, Mr. Cowen has built a national reputation for teaching plaintiffs’ lawyers how to maximize case value — including how to confront the “pre-existing condition” and “natural progression” defenses that insurers deploy against injured clients with prior medical histories.

• Education & Credentials

Mr. Cowen earned his J.D. from the University of Texas at Austin School of Law in 1995 and his B.A. from Texas A&M University in 1991. He has been Board Certified in Personal Injury Trial Law by the Texas Board of Legal Specialization since 2001 and Board Certified in Truck Accident Law since 2019. He is licensed to practice in Texas, New Mexico, and Georgia, and is admitted before numerous federal courts, including the U.S. District Courts for the Southern, Eastern, and Western Districts of Texas, the Southern and Eastern Districts of New York, the Northern District of Illinois, the District of New Mexico, and the Western District of Oklahoma, as well as the U.S. Court of Appeals for the Seventh Circuit and the United States Tax Court.

• Recognition & Leadership

Mr. Cowen has been repeatedly recognized as a Texas Super Lawyer and by Best Lawyers, and has been named among the Best San Antonio Lawyers by San Antonio Scene (2015–2016, 2021) and its Top 50 Personal Injury Plaintiff Lawyers (2017–2019). His trial results have earned placement on TopVerdict.com’s Top 20 Verdicts in Texas (2020) and Top 100 Verdicts in Texas (2017). He is the author of Big Rig Justice: A Comprehensive Guide to Maximizing Value in Truck Accident Cases, along with Building Towers of Evidence Captured by Cell Phones, Secret to Winning 8-Figure Injury Cases, and Maximizing Trucking Commercial Motor Vehicle Cases, and he hosts the Trial Lawyer Nation podcast, where he interviews the country’s leading trial lawyers on strategy, case value, and courtroom persuasion.

• Professional Involvement

Mr. Cowen serves on the Board of Governors of the American Association for Justice (AAJ), where he is Co-Chair for Membership, and sits on the Boards of Directors of the Texas Trial Lawyers Association (where he serves on the CLE Committee), the Attorney Information Exchange Group (AIEG), where he is active on the Trucking Committee, and the Academy of Truck Accident Attorneys (ATAA), where he has served as Chair and is Board Certified. He is a member of the New Mexico Trial Lawyers Association, the San Antonio Trial Lawyers Association, the Trucking Litigation Group, and the San Antonio Bar Association, serves on the faculty of Trial School, and sits on the Executive Board of Von’s Vision at Texas A&M. Since 2018 he has founded and hosted Cowen’s Big Rig Boot Camp, an annual event that draws attorneys from across the country to learn his proven strategies for winning truck accident cases.

• Experience

Mr. Cowen’s courtroom record includes a $26 million wrongful death settlement, a $17.5 million product liability recovery, and a $14 million personal injury result, among many other seven- and eight-figure outcomes for clients with catastrophic injuries. A sought-after national lecturer since 2017, he has presented at the ATAA Annual Symposium, Trial Lawyers University, the AAJ Annual Convention, Texas Trial Lawyers Association seminars, State Bar of Texas CLE programs, and the Kentucky Justice Association Trucking Seminar on topics ranging from cell phone forensics and negligent training to trucking regulations and remote trial preparation. Having spent nearly thirty years proving up damages for injured plaintiffs in front of juries — many of them clients with prior injuries, degenerative findings, or documented medical histories — he is uniquely positioned to show practitioners which concessions to make, which to refuse, and how to turn a pre-existing condition from a liability into the foundation of a winning damages case.

SESSION 1 – Building the Aggravation Record Before the Demand Goes Out | 12:00pm – 1:00pm

This session equips plaintiff personal injury attorneys to build a litigation-grade aggravation record before the demand letter goes out in cases involving pre-existing conditions. Attorneys will learn how to establish a defensible pre-accident baseline, obtain causation-specific medical documentation, deploy the concession strategy that neutralizes the natural progression defense, and structure the demand to force a real response. Attendees leave with a pre-demand checklist covering doctrine, medical records, treatment continuity, and demand framing for aggravation cases.

BREAK | 1:00pm – 1:10pm

SESSION 2 – Deposing the Defense Medical Expert on Natural Progression and Apportionment | 1:10pm – 2:10pm

This session teaches plaintiff attorneys how to systematically depose a defense medical expert in a pre-existing condition case, focusing on natural progression opinions and percentage apportionment claims. Attendees will learn how to expose selective record review, lock down financial bias, set up Daubert challenges, and sequence concessions that undermine the defense’s causation narrative. Attorneys who complete this session will be able to structure a complete deposition outline targeting the four major vulnerabilities in a typical IME report.