Key Takeaway
Medical experts must address preexisting conditions when establishing causation in personal injury cases, or risk dismissal for speculative testimony.
This article is part of our ongoing 5102(d) issues coverage, with 89 published articles analyzing 5102(d) issues 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.
When pursuing a personal injury claim in New York, establishing causation between an accident and claimed injuries is fundamental to recovery. However, this becomes significantly more complex when a plaintiff has preexisting medical conditions. The Boone v. Milano case demonstrates how failure to properly address the relationship between preexisting conditions and accident-related injuries can doom a plaintiff’s case.
In personal injury litigation, medical experts frequently encounter situations where accident victims have prior health issues. The key challenge lies in differentiating between injuries caused by the accident versus those stemming from preexisting conditions. When medical professionals fail to provide adequate explanations for this distinction, courts may find their testimony too speculative to create genuine issues of fact.
This case illustrates a common pitfall that can lead to summary judgment dismissal - when plaintiffs’ own medical evidence undermines their claims by failing to establish clear causation. The outcome serves as a reminder that thorough medical documentation and expert testimony must specifically address preexisting conditions to survive defendants’ motions for summary judgment.
Jason Tenenbaum’s Analysis:
Boone v. Milano— N.Y.S.2d —-, 2012 WL 2137382 (3d Dept.,2012)
“However, Rosa failed to account for why plaintiff’s preexisting physical maladies were not the source of the injuries and limitations that she now claims were caused by this accident. As such, Rosa’s affirmation does not create a factual issue that required denial of defendants’ motion for summary judgment, and plaintiff’s claims that she suffered a permanent consequential limitation as well as a significant limitation of a body organ, member, function or system were properly dismissed ( see Franchini v. Palmieri, 1 N.Y.3d 536, 537 ; Cirillo v. Swan, 95 A.D.3d 1401, ––––, 2012 N.Y. Slip Op 03493, *2 [2012]; Foley v. Cunzio, 74 A.D.3d 1603, 1604–1605 ).”
Key Takeaway
Medical experts must specifically explain why accident-related injuries are not attributable to preexisting conditions. When doctors fail to address this critical distinction, their testimony becomes speculative and insufficient to defeat summary judgment motions. Even when threshold dismissals occur, proper causation analysis remains essential for any remaining claims.
Legal Update (February 2026): Since this 2012 post was published, New York’s no-fault insurance regulations under Insurance Law Article 51 have undergone multiple amendments, particularly regarding medical documentation requirements and causation standards. Additionally, appellate decisions have continued to refine the threshold for establishing medical causation in cases involving preexisting conditions. Practitioners should verify current regulatory provisions and recent case law developments when addressing causation issues in no-fault and personal injury matters.
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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.
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Frequently Asked Questions
What is the serious injury threshold under Insurance Law §5102(d)?
New York Insurance Law §5102(d) defines 'serious injury' as a personal injury that results in death, dismemberment, significant disfigurement, a fracture, loss of a fetus, permanent loss of 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 that prevents the person from performing substantially all of their daily activities for at least 90 of the first 180 days following the accident.
Why does the serious injury threshold matter?
In New York, you cannot sue for pain and suffering damages in a motor vehicle accident case unless your injuries meet the serious injury threshold. This is a critical hurdle in every car accident lawsuit. Insurance companies aggressively challenge whether plaintiffs meet this threshold, often relying on IME doctors who find no objective limitations. Successfully establishing a serious injury requires detailed medical evidence, including quantified range-of-motion findings and correlation to the accident.
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About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
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.
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