New York State’s Serious Injury Threshold for Personal Injury Cases

New York State drivers may be surprised to learn that suffering an injury in a motor vehicle accident is not, by itself, enough to sue for personal injury. This is because New York is a “no-fault” state, meaning that you can file a claim for personal injury with your own auto insurance provider and receive compensation no matter who caused the accident. But what happens if you suffered a serious injury and your medical expenses exceed the compensation given by your insurance provider? If your injury meets New York State’s “serious injury” threshold, you could be entitled to more.

Under I.S.C. § 5401, the “No-Fault Law”, victims of motor vehicle accidents may sue the parties responsible if the injuries they sustained meet the “serious injury” threshold. The difficult part for most victims of a motor vehicle accident is determining whether they suffered a “serious injury” as defined by the law. There are a number of requirements needed to prove that your injury is a serious one and each requirement presents its own challenges. Keep in mind, however, that the serious injury threshold only applies to personal injury cases involving car accidents.

For help with your car accident injury case, call the New York personal injury lawyers at The Carrion Law Firm. For a free case review, call us at (718) 841-0083.

Definition of “Serious Injury” in New York Car Accident Claims

I.C.S. §5102(d) defines “serious injury” as a personal injury that results in one of the following:

  • Death
  • Loss of a body part
  • Fractures
  • Loss of a pregnancy
  • Significant scarring or disfigurement
  • Permanently losing the use of a body part or system
  • Permanent or major limitation in the use of a body part
  • Significant limitation in the use of a body function or system
  • An injury lasting for at least 90 days out of the first 180 days after the accident

Although some of these categories are obviously serious, like death or loss of a body part, others are less so. Proving that you have a “serious injury” under one of the last four categories can be challenging since there is much more room for insurance providers and attorneys to argue over the definition of each term used.

The final category is known as the “90/180 Day Rule.” Simply put, an accident victim can prove that their injury is serious if they can present medical evidence of their inability to perform significant daily activities for at least 90 days out of the first 180 days after the accident. New York courts have spent considerable time attempting to clarify these categories in order to provide plaintiffs with a clear guide to proving whether their injuries were serious.

Proving an Injury Meets the Serious Injury Threshold in a NY Injury Case

When one’s injured, it’s natural to think that the injury is serious. However, simply claiming that you believe your injury is serious will not be enough to win your case. Several requirements must be met to prove that your injuries meet the threshold for “serious injuries” in a personal injury case involving a car accident.

Quantified Injuries

One requirement is that your injuries must be “quantified.” This means that you must provide medical records stating the nature, severity and extent of your injuries, all treatments required, expected recovery time, and other details. This may include evidence showing a an observable decrease in something like range of motion, or it may include evidence of a short-term or long-term disability. the records will quantify the extent that you are disabled or the degree by which your range of motion is reduced compared to “normal functioning.” New York courts have consistently held that a medical provider’s findings, without support or testing, are not enough to establish a serious injury under NY law, and additional records supporting these claims are required.

Certified Medical Records

Your medical records must also be certified. This means that they must be submitted to the court in a form that is admissible as evidence. Generally, this comes in the form of a sworn, signed affidavit from your doctor stating that the records are authentic copies. It is important to understand that you will not be able rely on unsworn medical records to prove your serious injury claim, only those that have been certified.

Explain Gaps in Treatment

If there is a gap in your treatment at any time, you must explain it to the court. If you voluntarily refuse or stop treatment while also claiming a serious injury, you must offer some explanation as to why. Without this, the courts are unlikely to believe that your injury is, in fact, serious. The defendant will also claim that the injuries were caused by a different accident if you didn’t seek treatment close in time to your accident.

Explain Pre-Existing Conditions and Injuries

Lastly, you must explain any pre-existing injuries or conditions that you suffered prior to your serious injury claim. Basically, your medical evidence must show that the serious injury you suffered in the accident is distinct from your pre-existing condition. This can be accomplished with a report from your doctor explaining the pre-existing condition in detail.

How a Lawyer Can Help With “Serious Injury” Claims for Accidents in NY

Serious injury cases are complex and difficult to prove. Recovering from a serious injury is hard enough on its own without the added stress of collecting records, filing court documents, and arguing with insurance providers. Settlement negotiations can be tense, and you may feel pressured into accepting a settlement offer that is lower than what you deserve. Obtaining legal representation can make all the difference.

Once you have obtained legal counsel from one of our Syracuse personal injury lawyers, your only responsibility is recovering from your serious injury. Your attorney will thoroughly assess your case and acquire any medical records, witness statements, or experts needed to prove your claim. Your attorney will handle settlement negotiations on your behalf to fight for maximum compensation.

Call Our New York Personal Injury Lawyers Today

If you were hurt in an accident and sustained serious injuries, call our Albany personal injury attorneys for a free case review. Call The Carrion Law Firm at (718) 841-0083 today.