That the testing was necessary to rule out herniations is sufficient to warrant a trial on medical necessityOctober 20, 2013

AP Diagnostic Med., PC v Chubb Indem. Ins. Co., 2013 NY Slip Op 51647(U)(App. Term 1st Dept. 2013)

“The medical affidavit submitted by plaintiff – which detailed the assignor’s complaints of pain and the restricted range of motion of his cervical spine, and opined that the MRI was necessary to rule out disc herniations in the cervical spine – was sufficient to raise a triable issue as to medical necessity (see generally Lee v McQueens, 60 AD3d 914 [2009]; cf. CPT Med. Servs., P.C. v New York Cent. Mut. Fire Ins. Co., 18 Misc 3d 87 [2007]).”

This is the second time this Court has cited to a personal injury case to find that medical necessity or lack thereof of diagnostic testing.  Diagnostic Medicine, P.C. v Clarendon Natl. Ins. Co., 34 Misc.3d 143(A)(App. Term 1st Dept. 2012).  All I can think is that this Court on some level is requiring an objective basis to be found in rebuttal affidavits to defeat medical necessity motions.

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