Key Takeaway
When treating physicians show conflicting findings about range of motion limitations, courts require proper reconciliation to establish medical necessity under New York's no-fault law.
Understanding Medical Evidence Conflicts in No-Fault Insurance Cases
In New York No-Fault Insurance Law cases, establishing medical necessity requires clear and consistent medical evidence. When treating physicians provide conflicting reports about a patient’s condition, courts scrutinize whether these discrepancies have been properly addressed. This becomes particularly critical when one physician finds limitations while another documents normal findings around the same time period.
The challenge intensifies when plaintiffs attempt to demonstrate ongoing medical necessity despite conflicting evidence from their own treating physicians. Courts have developed specific standards for evaluating such contradictory medical reports, especially regarding range of motion assessments that form the foundation of many personal injury claims.
Jason Tenenbaum’s Analysis:
“Dr. Thompson also failed to reconcile his findings of limitation in the plaintiff’s left shoulder in May 2009, as set forth in his affirmation, with the report of the injured plaintiff’s other treating physician, Dr. Gary Fink, who found no limitations in the injured plaintiff’s left shoulder less than one month post-accident (see Raleigh v Ram, 60 AD3d 747).”
Again, how come the Appellate Term is not applying this body of law to no-fault? If an IME shows normal range of motion and plaintiff’s own medical evidence shows normal range of motion prior to the IME, then the plaintiff who attempts to show deficiencies in assignor’s range of motion post IME shoud be unable to raise an issue of fact. Simple.
Key Takeaway
When treating physicians provide conflicting findings about range of motion limitations, the failure to reconcile these discrepancies can be fatal to a plaintiff’s case. Courts require medical professionals to address contradictory evidence from the plaintiff’s own treatment team, particularly when medical necessity reversals hinge on demonstrating ongoing functional impairment.
Legal Update (February 2026): Since this 2010 analysis, New York courts have continued to refine standards for medical evidence consistency in no-fault cases, and practitioners should verify current requirements for reconciling conflicting physician reports. Additionally, fee schedules and procedural rules governing medical necessity determinations may have been amended, potentially affecting how courts evaluate contradictory range of motion findings between treating physicians and IME doctors.
