| Auto accident attorneys in New York State know | | | | The significant limitation category has led to hundreds |
| there's something special about car accidents. Article | | | | of cases discussing when a limitation is significant, and |
| 51 of the Insurance Law says car crash victims have | | | | what the injured person has to prove to show it. |
| to show they have a serious injury before they can | | | | The defendant's attorney will often move for |
| get any money for pain and suffering. What does | | | | summary judgment to dismiss the case. After having |
| this all mean? | | | | the injured person looked at by their own doctor in |
| It means very little when it comes to medical bills, | | | | an independent medical examination (also known as |
| lost wages, and some other relatively minor items. | | | | an IME, and many of us dispute the use of the word |
| New York No-Fault law guarantees that the injured | | | | "independent"), the defense attorney submits the |
| person will be compensated in these areas. The | | | | expert's report which generally indicates the injured |
| insurance company for the car you were in should | | | | person is fully recovered. Then the plaintiff's auto |
| pay for your medical expenses and lost wages. In | | | | accident attorney responds, usually with a report |
| nearly all cases you will not need a lawyer. While we | | | | from the treating physician, describing the details of |
| are starting to see insurance companies unreasonably | | | | the injury and why it is, or was, significant. If the |
| refuse to pay in some instances, this is still rare. Also, | | | | plaintiff's response is insufficient, the case often gets |
| for most of these denials, the amount of money | | | | dismissed. To avoid this, the evidence must show |
| involved is not enough to justify the legal expense. | | | | that the injury was more than mild, minor or slight, |
| We advise our clients when it comes to any No-Fault | | | | and that this is connected to objective findings (like |
| denials, and in cases where the problem is substantial, | | | | an abnormality on an X-ray or MRI, or in many cases |
| we do represent them. Usually we fight the denial in | | | | a finding of spasm. |
| an arbitration. | | | | The category about being out of work is known |
| The auto accident serious injury threshold is a | | | | among attorneys as the 90/180 category. This refers |
| compromise, in theory at least. Since routine | | | | to the law which requires that the person be impaired |
| expenses were covered by the personal injury | | | | from substantially all of their daily activities for 90 or |
| protection line of insurance under No-Fault, liability | | | | more days out of the 180 days following the |
| expenses were supposed to be reduced on the | | | | accident. Most of the time this means three months |
| bodily injury liability line. There could be a vigorous | | | | out of work in the six months after the accident |
| debate about whether this compromise was wise or | | | | happened. Responding to a motion, the plaintiff |
| fair, but someone else can write that article. | | | | attorney must show, through medical evidence, that |
| The standard for what is a serious injury is fairly | | | | the person had to stay out of work for the three |
| complicated. There are several categories of serious | | | | months, and that this was connected to objective |
| injury. The most common that we see involve | | | | medical findings. |
| fractures, other injuries that cause a significant | | | | For both of the latter two categories, we often win |
| limitation, or a substantial amount of time out of | | | | the motion by pointing out a key flaw in the IME. In |
| work. | | | | most cases the IME doctor does not discuss much |
| You would think the fracture category would be | | | | about the past problems and treatment. We argue |
| pretty straightforward. In most auto accident cases | | | | that this means the defense did not meet their |
| it is. But there are a few kinds of fractures where it's | | | | burden on their motion. They didn't show the Court |
| not so clear. Court decisions suggest that a fracture | | | | that the limitation was not significant, or that the |
| of a bone meets the criteria. Fractured cartilage | | | | time out-of-work was inappropriate, because the IME |
| normally will not qualify, and the same is true of a | | | | doctor doesn't discuss those issues. In our |
| fractured organ. We had one case with a "liver | | | | experience, most judges understand this and keep |
| fracture." Sounds odd, but that's what the doctors | | | | the case alive. |
| called it. The case settled so we never tested that in | | | | There are other categories and a number of other |
| Court. The other issue is when is a fracture a | | | | complex issues that can come up in car accident |
| fracture? A hairline fracture counts, but a "greenstick" | | | | cases involving the serious injury threshold, but that's |
| fracture does not. | | | | a good start. |