Key Takeaway
PSW Chiropractic affirmed a provider's trial judgment in 2011. The majority deferred to credibility findings; the dissent read the evidence differently.
This article is part of our ongoing medical necessity coverage, with 170 published articles analyzing medical necessity issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
The provider kept its trial judgment in PSW Chiropractic Care v Maryland Casualty. The Appellate Term, Second Department majority deferred to the trial court’s assessment of the insurer’s medical witness. Justice Golia dissented.
Historical note: PSW Chiropractic (2011) affirmed a provider’s nonjury-trial judgment through deference to the trial court’s credibility assessment; the dissent’s contrary view did not become the holding.
Last reviewed: September 2026.
The majority and dissent read the trial differently
Medical necessity was the only issue at the nonjury trial. The insurer’s witness had performed two IMEs and testified that further chiropractic treatment was unnecessary. The September 16, 2011 majority found support in the record for the trial court’s conclusion that the insurer had not met its burden.
Free Consultation · No Fee Unless We Win
Does this apply to your situation?
Every case is different. Get a free, confidential case review from an experienced attorney who can tell you exactly where you stand.
The dissent emphasized that the provider called no witness and offered no testimony contradicting the insurer’s doctor. It would have credited that doctor and dismissed the complaint. That was the dissent’s proposed result, not the court’s judgment.
The disagreement was about how to read this trial record. A challenge to credibility does not by itself decide another case. The older expansion’s claim of a broader pattern involving Maryland Casualty was unsupported and has been removed.
Jason’s original comment
Jason’s September 2011 reaction follows unchanged. His description of the IME is criticism; the majority deferred to the trial court and did not supply the detailed defects that phrase might suggest.
Interesting dissent, but if the IME was that bad, this should have stopped at Civil Court.
Connect to the Encyclopedia
- Medical necessity and peer review: topic hub
- Amato: the 2010 trial ruling and its 2013 reversal
- Jason’s 2016 question about substitute IME testimony
- Amherst: identify the missing medical information
- Park Slope: a rebuttal that missed the peer review’s reasoning
For review of a particular no-fault dispute, contact our office.
Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
About This Topic
Medical Necessity Disputes in No-Fault Insurance
Medical necessity is the most common basis for no-fault claim denials in New York. Insurers hire peer reviewers to opine that treatment was not medically necessary, shifting the burden to providers and claimants to demonstrate otherwise. The legal standards for establishing and rebutting medical necessity — including the sufficiency of peer review reports, the qualifications of reviewing physicians, and the evidentiary burdens at arbitration and trial — are the subject of extensive case law. These articles provide detailed analysis of medical necessity litigation strategies and court decisions.
170 published articles in Medical Necessity
Keep Reading
More Medical Necessity Analysis
MUA is dangerous
Mollo's 2020 MUA ruling turned on competing expert testimony. Read the actual trial result without treating an expert's safety concerns as a universal rule.
Mar 17, 2021
Another Medical Necessity?
DRD Medical defeated the insurer's motion in 2020. Compare the court's finding of a factual dispute with Jason's original criticism of the affidavit.
Apr 27, 2020
Witness Credibility in Personal Injury Cases: Standards for Medical and Expert Testimony in New York
Understanding witness credibility standards in NY personal injury law. Expert analysis of medical testimony, expert witnesses & courtroom credibility.
Apr 10, 2019
Another Geffner sighting
Court decision requiring medical experts to demonstrate proper qualifications when testifying outside their specialty area in NY personal injury cases.
Dec 30, 2014
Malella and priority of coverage discovery disallowed
Court rejects insurer's discovery attempts to find primary coverage and investigate fraudulent incorporation in NY no-fault case, ruling demands improper.
Jun 27, 2012
Analysis or reference to scientific data is necessary to defeat a motion based upon the lack of causal connection between lead paint and attendant poisoning
New York Court of Appeals ruling demonstrates that expert testimony in toxic exposure cases requires scientific data and analysis, not mere speculation, to establish causation.
Jun 22, 2010Was this article helpful?
Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
If you need legal help with a medical necessity matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.
