The buzz on the street over the last few years is that “surgery” is necessary to breach the serious injury threshold. On the no-fault side, this has translated into insurance carriers seeing many more surgery cases than in years past. It seems that surgery might not even save the threshold case as seen below:
Rodriguez v Grant, 2010 NY Slip Op 01780 (2d Dept. 2010)
“The affirmed magnetic resonance imaging report of Dr. Raymond Rizzuti merely revealed the existence of a tear of the anterior cruciate ligament and medial meniscus in the plaintiff’s left knee. A tear in tendons, as well as a tear in a ligament, is not evidence of a serious injury in the absence of objective evidence of the extent of the alleged physical limitations resulting from the injury and its duration.”
So does this relate to a service lacking medical reasonableness based upon the absence of objective evidence of the nature and extent of the underlying injury? This raises a really interesting question about what this means for certain no-fault medical necessity surgery cases.
