serious injury threshold attorney New York

In New York, a person injured in a motor vehicle collision cannot recover for pain and suffering unless the injury satisfies the serious injury threshold defined at N.Y. Insurance Law 5102(d). No-fault benefits pay for treatment and a portion of lost earnings without regard to fault, but they stop there. The threshold is the gate to everything else, and it is where the majority of contested motor vehicle cases in this state are actually decided. Law Offices Of SRIS, P.C. handles these disputes. Call (888) 437-7747.

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The Statutory Categories

Section 5102(d) defines serious injury through a list. Death, dismemberment, significant disfigurement, fracture, and loss of a foetus are relatively self-proving. The categories that generate litigation are permanent loss of use of a body organ, member, function or system; permanent consequential limitation of use of a body organ or member; significant limitation of use of a body function or system; and the category covering a medically determined injury that prevents the person from performing substantially all of their usual and customary daily activities for a defined portion of the period immediately following the accident.

Why Imaging Alone Does Not Decide It

A herniated or bulging disc appearing on an MRI does not by itself establish serious injury. Courts have said so repeatedly, and defence carriers rely on it. The reason is that degenerative changes are extremely common in people with no symptoms at all, so the existence of a finding proves little about whether this collision caused this person’s loss of function. What carries the argument is objective measurement of limitation, recorded by a treating provider, connected in the record to the accident.

What Objective Evidence Looks Like

Range of motion measured with an instrument and expressed against the normal value, repeated at intervals so a trajectory is visible. Positive results on recognised clinical tests. Findings of muscle spasm observed rather than reported. Electrodiagnostic studies where indicated. A narrative from a treating physician that ties the measured deficits to the collision and offers an opinion on permanence. Notes recording only that a patient complained of pain will not carry the burden however sincere the complaint.

The Gap in Treatment Problem

Cessation of treatment is the defence argument that succeeds most often. When no-fault benefits are cut off after an insurer-arranged examination, many people stop treating because they cannot pay. The record then shows a gap, and the defence argues the injury resolved. New York courts have accepted that a cessation can be explained, but the explanation has to be in the record. Documenting why treatment stopped, at the time it stops, is one of the most valuable things an injured person can do.

The 90/180 Category

This category requires a medically determined injury of a non-permanent nature that prevented the person from performing substantially all of their usual and customary daily activities during a defined portion of the period immediately following the accident. It is proved differently from the permanence categories: with contemporaneous disability notes, employment records showing time out of work, and specific evidence about what the person could not do. A general statement of being unable to do much is insufficient.

Pre-Existing Conditions

Where a person had prior injuries or degenerative findings, the defence will attribute everything to them. The answer is not to conceal the history, which is always discovered and is far more damaging once found, but to address it directly through a physician who compares the prior condition to the present one and identifies what changed. New York law permits recovery for the aggravation of a pre-existing condition, provided the aggravation is proved.

How the Motion Is Decided

Threshold disputes are usually resolved on a summary judgment motion. The defendant moves with the report of a physician who examined the plaintiff and found normal range of motion and resolved injuries. The burden then shifts, and the plaintiff must raise a triable issue with competent medical evidence in admissible form, addressing both the measured limitation and any gap or pre-existing condition the defence raised. Cases are lost at this stage on evidentiary defects rather than on the merits of the injury.

Frequently Asked Questions

What is the serious injury threshold?

A statutory standard at N.Y. Insurance Law 5102(d) that must be met before a person injured in a motor vehicle collision can recover for pain and suffering. No-fault benefits are available regardless, but they do not cover pain and suffering.

Does a herniated disc meet it?

Not automatically. Courts have held that imaging findings alone are insufficient, because disc changes are common in people without symptoms. Objective measured limitation connected to the collision is what establishes the threshold.

What if I stopped treatment?

It is the most common defence argument, but a cessation can be explained, including where benefits were cut off and treatment became unaffordable. The explanation needs to be documented at the time rather than reconstructed later.

I had a prior back injury. Is my claim gone?

No. New York permits recovery for aggravation of a pre-existing condition where the aggravation is proved. Disclose the history early so it can be addressed by a physician rather than discovered by the defence.

What is the 90/180 category?

A category for a medically determined non-permanent injury that prevented substantially all usual daily activities during a defined portion of the period right after the accident. It is proved with contemporaneous disability documentation and specific activity evidence.

How long do I have to sue?

A personal injury action generally must be commenced within three years of the collision under N.Y. C.P.L.R. 214(5). Claims involving a public entity or authority carry much earlier notice requirements.

About Mr. Sris

Mr. Sris, Owner and Founder of Law Offices Of SRIS, P.C., has practiced since 1997. He is a former prosecutor, and that experience shapes how he builds a record and reads the other side’s file. He is admitted in Virginia, Maryland, the District of Columbia, New Jersey, and New York. His background at George Mason University in accounting and information systems applies to the documentary and financial side of an injury claim, from billing records to wage loss. Mr. Sris and the firm’s Of Counsel attorneys handle New York matters together, with the division of work set at the start of the engagement.

Speak With Mr. Sris

Request a consultation. Reach our location at (888) 437-7747. Bring the police or incident report, the name of every provider who has treated you, your no-fault claim number if one was opened, and any correspondence from an insurer. That material lets the first conversation move past intake.

No attorney fee unless we recover. Clients may be responsible for case expenses.

Last updated: August 25, 2026

This page provides general information about New York personal injury law and does not create an attorney-client relationship. Case results depend on a variety of factors unique to each case. Results may vary.

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