In any injury case, your claim is going to be worth more if the injuries are more serious or more severe. However, proving that your injuries are “serious” is a requirement for car accident cases. If you can’t prove your injury is “serious,” you can’t sue for a car crash or get pain and suffering damages.
New York law considers injuries “serious” if they include any of the injuries listed in I.S.C. Law § 5102(d). If you can provide medical records showing your injury meets these standards, it should qualify for a lawsuit, but many of these injury terms require additional proof from a lawyer about the seriousness, extent of the injury, and their effect on activities of daily living.
Call our NYC car accident lawyers at The Carrion Law Firm for a free review of your car accident case at (718) 841-0083.
What is a “Serious Injury” in a NYC Car Accident Case?
New York uses a no-fault car insurance system. You are expected to use your own insurance to get coverage after an accident, regardless of who caused the accident. However, your insurance only covers medical bills and a portion of lost earnings – and only up to your policy limits. To get pain and suffering or to file against the defendant driver, you need to have “serious injuries.”
As mentioned, this term is defined in § 5102(d) and includes a specific list of injuries/issues:
- Death
- Lost fetus
- “Significant disfigurement”
- Dismemberment/amputation
- Any broken bone
- Permanent loss of an organ or member (i.e., any body part, even if you wouldn’t call it “amputation”)
- Permanent loss of a bodily function
- Permanent loss of a body system
- “Significant limitation or use of a body function or system”
- Disability lasting 90 of the following 180 days.
Most of these are self-explanatory: if your injury involves a broken bone, amputation, or loss, it should be considered “serious.” Others are a bit less straightforward because of terms like “significant” that might need additional definitions.
Who Decides if an Injury is “Serious”
When there are questions of whether an injury fits the category or not, the court decides them. Generally, the way this would come up is that you would file your claim, and the defense would try to say that you cannot sue them because your injuries do not meet the serious injury threshold.
This leads to briefing and evidence submitted by both sides to argue about whether your injury fits the definition of “serious” or not. From there, the judge makes the decision, as this is all before a jury is selected.
There are past precedents in New York law that deal with what exactly “significant” or “disfigurement” means, and some even deal with whether a “fracture” includes damage to cartilage (no) or teeth (yes).
What Evidence is Needed to Show Your Injuries Are “Serious”?
In some cases, medical records showing your injury fits the category will be enough. For example, if you have records showing a broken leg, you should qualify as having a “fracture.” However, anything where you need to show a limitation or disfigurement or that something is “significant,” you will need more medical evidence.
Often, this requires having a doctor examine you and present their findings to the court. They can explain just how serious the injuries are, what limitations they place on your daily tasks, and so forth.
90/180 Days Rule
New York law’s descriptions sometimes fall short of including certain injuries because they are not permanent or do not cause a “significant” enough impact on your body. In many of these cases, the 90/180 days rule can still get them covered as “serious” injuries.
Under the definition of serious injury, there is a catch-all category that allows you to sue for any injury that is serious enough to interfere with your activities of daily living for 90 of the following 180 days after your accident. This could potentially turn something like multiple strains or tears – non-permanent injuries – into “serious injuries” for purposes of a lawsuit.
This allows for lawsuits even for temporary injuries, but it requires a close medical evaluation. You will almost certainly need doctors’ reports and perhaps testimony from your physician to prove your injuries meet this threshold.
Note that the 90 days do not need to be consecutive. Some people have good and bad days after an injury; as long as 90 of the 180 days after the accident see significant enough limitations, your case is serious enough to sue for.
What Happens When My Injuries Meet the Serious Injury Threshold in NYC?
If your injuries do not meet the serious injury threshold, then you are stuck filing a claim with your own insurance only. You cannot sue the at-fault driver for your car accident injuries or file an insurance claim against them.
Once your case does meet the serious injury threshold, you can sue, you can claim full damages for lost earnings against the at-fault driver, and you can get non-economic damages like pain and suffering paid.
What Cases Does the Serious Injury Threshold Apply To?
Under § 5104, a “covered person” cannot sue for a car accident unless they have “serious injuries.” “Covered person” usually includes anyone covered under a no-fault policy, including the driver, passengers, and pedestrians/cyclists they hit.
That means that you cannot sue or seek pain and suffering in a car accident unless you meet the “serious injury” standard. However, this restriction does not apply to any other accidents outside of car accidents.
Can I Get Higher Damages with More Serious Injuries?
Generally, injury cases pay more for more serious injuries. This is by no means an excuse to talk up or exaggerate your injuries to get higher damages, but it is a reality of injury claims.
Of course, with car accidents, you cannot get pain and suffering without serious injuries, so that automatically makes these claims worth more when pain and suffering damages are available. Otherwise, the “seriousness” of your injuries is usually taken into account in a few ways.
More serious injuries cost more to treat, leading to higher medical bills. They also might keep you from work longer, resulting in higher lost wages. They also hurt more, thus more “severe” injuries generally lead to higher pain and suffering damages.
Call Our NYC Car Accident Lawyers Today
Call The Carrion Law Firm at (718) 841-0083 for a free case evaluation with our NYC personal injury attorneys.