What is New York State’s Serious Injury Threshold for Personal Injuries?

serious injury threshold

Victims of car accidents are often surprised to find out that not every injury they have suffered warrants a personal injury lawsuit. New York state has a serious injury threshold that they impose on personal injury cases. If a negligent or reckless driver has injured you, you will be able to obtain compensation by filing a claim with an insurance company for benefits under New York no-fault law. However, if you intend to sue the defendant in court via a personal injury lawsuit, your injury must meet the “serious injury” requirement. Learn more about it below, courtesy of our team at Stanley Law!

Serious Injuries in New York 

Section 5102(d) of New York Insurance Law sets forth what categories of injuries qualify as “serious injuries.” If you would like to bring a personal injury lawsuit against the negligent or reckless defendant who caused your injuries, you will need to prove that one of the following types of injuries has occurred: 

  • Death
  • A severe disfigurement
  • Dismemberment
  • A fracture
  • Permanent loss of use of a body organ, member, function, or system
  • The loss of a fetus
  • A significant limitation of use of a body function or system
  • Permanent consequential limitation of use of a body organ or member A “medically determined injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person’s usual and customary daily activities for not less than 90 days during the 180 days immediately following the occurrence of the injury or impairment.”

Most of these categories are straightforward, such as bone fractures, the loss of a fetus, and death. The last four categories are more complicated, however. For example, there is some room to argue about the definition of severe disfigurement or dismemberment. When judges make rulings in specific cases, those rulings become case law. An experienced personal injury lawyer will be able to examine previous rulings and help you determine whether your injury fits within one of the categories listed above. 

Regardless of your type of injury, you will need to obtain a comprehensive medical evaluation. New York courts demand evidence as to the nature and extent of your injury. You must have a doctor objectively verify your injuries through diagnostic testing. There is some variance regarding which type of injuries meet the requirements above. However, courts will not consider your injury serious if you do not have proof. You will need to obtain proof in the form of a medical test confirming your limitations, pain, and how your injury affects you on a day-to-day basis. Courts want to ensure that you meet the 90/180 rule. According to this rule, personal injury victims can only file a lawsuit if they can provide medical evidence that they cannot perform significant daily activities for at least three out of the first six months after their accident. 

Proving a Serious Personal Injury Case in New York 

After becoming injured, the best thing you can do is to speak to an experienced personal injury lawyer in New York. Your lawyer will be able to help you understand whether your case qualifies as a serious injury or not. Even if your case does qualify as a serious injury and you bring a personal injury lawsuit, the defendant will likely argue that your injury should not have qualified as a serious injury. The insurance company for the defendant or the at-fault driver’s defense lawyer will try to prove that you are not injured enough to bring a personal injury lawsuit. Their goal is to get your case dismissed. 

Providing a simple statement from your physician that you have been seriously injured is not enough to prove your case in New York. If your injury falls within one of the last four categories in the list mentioned above, the defense will likely try to prove that you do not meet the definition of seriously injured. Your attorney will be able to help you obtain clear evidence demonstrating the connection between the accident and your injury. The evidence must explain the methods through which your medical provider arrived at his or her conclusion and list, in detail, their specific medical findings regarding your injury. Typically, the more detail your doctor provides, the better your chances of success. 

Following Your Doctor’s Orders is Crucial 

When it comes to personal injury lawsuits in New York, following your doctor’s orders is crucial. If there have been any gaps in your medical treatment, or you have missed doctors’ appointments, the defendant will likely exploit these occurrences to show that you were not severely injured. New York courts often question the reliability of a medical expert’s opinion if the expert did not continuously treat the plaintiff after the accident occurred. It is best to be evaluated by your doctor after the accident and continue treatment with that doctor. 

If your doctor refers you to specialists, such as an orthopedic surgeon or a physical therapist, you must follow up with the specialist. If you do not, the defense will try to argue that you were not injured enough to require a specialist, and your case should be barred. If you have a pre-existing condition or some other type of medical trauma that occurred after your accident, your claim can

become even more complicated. The defendant will likely try to argue that your subsequent accident caused your injuries, and he or she is not financially liable for your injuries. You will need to provide medical evidence that clearly shows that the injury you suffer from is the result of the accident caused by the defendant. 

Contact a New York Personal Injury Lawyer Today 

Proving that you have experienced a serious injury in court is challenging. Whether you are disputing your claim with an insurance company or with the at-fault person’s defense lawyer, you need your attorney on your side advocating for your rights. Contact the New York personal injury lawyers at Stanley Law Offices today to schedule your free initial consultation.