In the realm of personal injury law, motor vehicle accidents occupy a unique space, especially in “no-fault” states like New York. Unlike other negligence cases, where the criteria for a lawsuit might be more straightforward, car accidents involve specific legal thresholds that must be met before you can pursue compensation.
Understanding the “Serious Injury Threshold” in New York
In New York, the ability to file a lawsuit following a motor vehicle accident hinges on whether your injuries meet the “serious injury threshold” as defined under New York State Insurance Law § 5102(d). This threshold is a critical factor in determining whether an attorney will take your case.
Unlike other negligence claims where even a minor injury or the mere “threat of imminent harm” (as in civil assault) can be grounds for a lawsuit, motor vehicle accident claims require that the injury fall into one of several specific categories. These include:
- Death
- Dismemberment
- Significant disfigurement
- Fracture
- Loss of a fetus
- Permanent loss of use of a body organ, member, function, or system
- Permanent consequential limitation of a body organ or member
- Significant limitation of use of a body function or system
- A medically determined injury or impairment of a non-permanent nature that prevents you from performing your usual daily activities for at least 90 days during the 180 days immediately following the injury.
If your injury does not fit into one of these categories, you will not be able to maintain a viable claim for pain and suffering or other damages. However, you should still file for “no-fault” coverage for your medical treatment within the required 30-day period after the accident.
Preexisting Conditions: What You Need to Know
Having a preexisting injury does not necessarily preclude you from meeting the serious injury threshold. If the accident exacerbated a preexisting condition, you might still have a valid claim. For example, in the recent New York Appellate Court case Ghosio v. Weiser (2024 NY Slip Op 00616 [224 AD3d 664]), the court ruled that a plaintiff’s prior brain injury did not prevent her from meeting the threshold for serious injury when the medical evidence showed that the car accident aggravated her condition.
It is crucial to inform your attorneys about any preexisting conditions and whether they have worsened since the accident. Proving that the aggravation of a preexisting injury qualifies as a “new injury” can be challenging, but it is vital for building a strong case.
The Importance of Immediate and Consistent Medical Treatment
One of the most common pitfalls in motor vehicle accident cases is delaying medical treatment. If you do not seek immediate care, such as going to the emergency room or seeing a doctor shortly after the accident, it becomes much harder to prove that your injuries were caused by the accident. Courts often view a quick return to work or minimal initial treatment as evidence that the injuries were minor, leading to potential dismissal of your case.
For instance, in Perez v. Ahadzi (2024 NY Slip Op 00877 [224 AD3d 556]), the court dismissed the case due to the plaintiff’s delay in seeking treatment and returning to normal activities shortly after the accident.
Furthermore, significant gaps in your treatment can severely undermine your case. New York’s highest court has held that gaps in treatment can cast doubt on the seriousness of the injuries and the reliability of the medical expert’s conclusions regarding causation (Pommells v. Perez, 4 N.Y.3d 566, 797 N.Y.S.2d 380 [2005]). If you stop physical therapy or other necessary treatments, you must provide a reasonable explanation if you expect to maintain your lawsuit for pain and suffering.
Conclusion
Being involved in a motor vehicle accident does not automatically entitle you to compensation for pain and suffering or other economic losses. To pursue a successful lawsuit, you must meet New York’s serious injury threshold. This requires immediate and consistent medical treatment, thorough communication with your attorney about your medical history, and diligent follow-up care. Consulting with an experienced attorney as soon as possible after your accident is crucial to navigate these complex legal requirements and protect your rights.