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My Doctor Says My Injury is Serious: Is That Enough to File a Car Accident Lawsuit?


Since New York is a no-fault state in terms of auto accident cases and claims, it can be difficult for injury victims who have been harmed because of another driver’s negligent or reckless behavior to understand their eligibility for filing a lawsuit. New York law only allows an injury victim to file a lawsuit against that at-fault driver once they have met the “serious injury threshold.” You might be wondering: If my doctor says my injury is serious, is that enough to file a car accident lawsuit? Generally speaking, a healthcare provider’s assessment of an injury as “serious” may not meet the definition that is required by New York law, but it may be possible to obtain additional information from your healthcare provider to show that her or his assessment of your injury as “serious” does meet the definition required by New York Law.

Understanding No-Fault Auto Accidents and PIP Insurance to New York

The “serious injury threshold” requirement exists because New York is a no-fault state. Our New York auto accident lawyers want to provide you with more information about what this means before we discuss the possible difference between your doctor’s assessment of a “serious” injury and state law definition of a “serious” injury.

The first thing to know is that, regardless of the severity of your injury or who is at fault for the collision, New York law assumes that you will seek compensation initially by filing an auto insurance claim through your own personal injury protection, or PIP, coverage. Nearly all auto accident victims with injuries have medical records from a recent medical assessment after the crash that links the injuries to the collision. Yet many injury victims want to file a lawsuit against the at-fault driver, especially when the other driver’s fault is clear due to drunk driving or distracted driving, for example. In order to do so, they must meet the serious injury threshold.

How New York Law Defines a Serious Injury

According to New York Insurance Law § 5104, a “serious injury” is not defined as a traumatic injury that a healthcare provider identifies as “serious,” but rather as an injury that:

“[R]esults in death; dismemberment; significant disfigurement; a fracture; loss of a fetus; permanent 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; or 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 ninety days during the 180 days immediately following the occurrence of the injury or impairment.”

In many situations, your healthcare provider must also describe the types of injuries listed above as “serious,” in which case your healthcare provider’s assessment would allow you to file a lawsuit since it would be in line with New York law definition of a serious injury. Yet a healthcare provider’s description of a serious injury as such is not necessarily enough. For example, a doctor might describe, in some cases, a sprain or a strain that is temporary as a “serious” injury based on the patient’s pain description or medical history, even if the injury would not meet the serious injury threshold under New York law.

Seek Advice From a New York Car Accident Attorney

You should never assume that your doctor’s description of your injury as serious means that you can file an auto accident lawsuit. Instead, you should seek advice from our New York car accident lawyers who can help to determine whether your injuries meet the serious injury threshold such that you can sue the at-fault driver. Contact Leitner Varughese Warywoda PLLC today to learn more.

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