Key Takeaway
All Boro's 2013 psychological-testing claim failed because its letter and unrelated testimony did not answer the insurer's case-specific peer review.
This article is part of our ongoing medical necessity coverage, with 171 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 lost All Boro Psychological Services because its evidence answered the wrong question. General support for psychological testing did not answer the peer review of this patient’s tests.
Historical note: All Boro Psychological Services (February 19, 2013) affirmed dismissal on the particular rebuttal submitted, not a ban on every medical-necessity letter or all prior testimony.
Last reviewed: September 2026.
What the opposition missed
The Second Department’s Appellate Term affirmed dismissal on February 19, 2013. The medical-necessity letter did not meaningfully engage with the insurer’s psychologist. Dr. Franklin Porter’s earlier testimony described the utility of tests in an unrelated trial rather than their necessity under this case’s facts.
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The problem was the response’s substance, not its label. The court did not reject all medical-necessity letters or all testimony from earlier cases. Read All Boro’s reasoning.
Jason’s original comment
Jason’s February 2013 comment follows unchanged. The Quality Psychological comparison is retained as his historical reference; this short opinion does not identify or decide that other case.
Prior trial testimony was plainly insufficient to rebut the peer review. Also, a letter of medical necessity was found not to be sufficient to rebut defendant’s prima facie showing. Compare: Quality Psychological, P.C. v. Mercury.
Connect to the Encyclopedia
- Medical necessity: case directory and related decisions
- Elmont Open MRI: why the purpose of treatment records mattered
- Shirom: an earlier peer review did not reach the later bills
- Healing Art: medical necessity was outside the moving papers’ issues
- Promed Orthocare: substitute testimony and a preserved objection
For review of a particular no-fault dispute, contact the firm with the denial, relevant records and procedural history.
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.
171 published articles in Medical Necessity
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Apr 25, 2010Frequently Asked Questions
Common Questions About This Topic
4 answers from the firm's New York personal-injury and employment-law practice. Click any question to expand.
What did the court rule in All Boro Psychological Services v Progressive Northeastern?
The Second Department's Appellate Term affirmed dismissal. The letter did not answer the psychologist's conclusions, and the prior testimony concerned the general utility of tests in another case.
How does this affect no-fault insurance claims in New York?
The case distinguishes general support for a test from evidence addressing its necessity for the patient and services in dispute. It does not decide every possible rebuttal.
What is a peer review report in no-fault insurance?
Here, the insurer relied on a psychologist's review of whether the disputed testing was necessary. The appeal concerned the adequacy of the provider's response.
What evidence is needed to successfully rebut a peer review report in New York?
All Boro identifies what its evidence lacked: a meaningful answer to the reviewer's case-specific conclusions. It does not prescribe an exhaustive affidavit checklist or guarantee that different evidence will succeed.
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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.
