Inconsistency between chiropractor report and MRI reports spells the end of personal injury plaintiff's claim

In New York personal injury litigation, plaintiffs must satisfy specific thresholds to recover damages beyond basic economic losses. Under Insurance Law § 5102(d), plaintiffs must demonstrate they suffered a “serious injury” as defined by statute. This threshold requirement serves as a crucial gatekeeping mechanism, preventing minor injury claims from proceeding to trial.

The serious injury threshold can be satisfied through various categories, including 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 or impairment of a non-permanent nature that prevents the injured person from performing substantially all material acts constituting their usual and customary daily activities for not less than ninety days during the one hundred eighty days immediately following the occurrence of the injury or impairment. Each category requires objective medical proof demonstrating the nature and extent of the alleged injury.

One of the most challenging aspects of meeting the serious injury threshold involves presenting consistent, objective medical evidence. When a plaintiff’s medical providers reach conflicting conclusions about the same injury, it creates significant problems for the case. This is particularly true when treating physicians’ findings are inconsistent with diagnostic imaging results. Courts view objective diagnostic tests like MRI and CT scans as particularly reliable evidence because they provide independent verification of claimed injuries, unlike subjective patient complaints or clinical examination findings that may be influenced by secondary gain motives or provider bias.

The intersection between no-fault threshold issues under § 5102(d) and traditional personal injury claims under § 5106 creates complex litigation dynamics. Medical inconsistencies can be fatal to a plaintiff’s case, as demonstrated in situations where a plaintiff’s own hospital records defeated his threshold motion. The causation element required for both threshold satisfaction and ultimate liability creates overlapping proof requirements that amplify the impact of medical contradictions.

Case Background: Komina v Gil

In Komina v Gil, the plaintiff sought to recover damages for injuries allegedly sustained in an automobile accident. The plaintiff underwent MRI examinations of the lumbar and cervical spine regions, which were interpreted by a radiologist. These MRI studies reportedly showed normal spine images with no evidence of disc bulging or herniation—findings that would ordinarily negate claims of spinal injury from trauma.

Despite these normal imaging results, the plaintiff’s treating chiropractor conducted physical examinations and reached conclusions suggesting spinal injury. The chiropractor’s examination findings apparently included positive orthopedic tests, range of motion limitations, or other clinical indicators of injury. However, the chiropractor failed to provide any explanation for why these clinical findings diverged so dramatically from the normal MRI results. This unexplained inconsistency became fatal to the plaintiff’s case when defendants moved for summary judgment.

Jason Tenenbaum’s Analysis:

Komina v Gil, 2013 NY Slip Op 04744 (1st Dept. 2013)

“Furthermore, plaintiff’s chiropractor made no attempt to explain the conflicting findings of the tests he performed during plaintiff’s physical examination and the MRI reports of plaintiff’s radiologist, which found normal lumbar and cervical spine images with no evidence of disc bulging or herniation, and defendants are thus entitled to summary judgment on this basis”

Do not kid yourself – there is cross over between 5102(d) and 5106 litigation.

Legal Significance: The Duty to Reconcile Conflicting Medical Evidence

The First Department’s decision in Komina establishes an important evidentiary principle: treating physicians cannot simply ignore contradictory objective test results. When clinical examination findings conflict with diagnostic imaging, the treating provider must offer some medical explanation for the discrepancy. Failure to provide such an explanation undermines the credibility of the clinical findings and may result in summary judgment for defendants.

This requirement reflects sound medical practice and evidentiary principles. MRI technology provides objective visualization of anatomical structures, revealing disc herniations, bulges, tears, and other pathology with considerable precision. When an MRI shows normal anatomy, it strongly suggests that any symptoms the patient experiences do not arise from structural spinal damage. A chiropractor who finds positive examination findings despite normal imaging should explain whether the symptoms arise from muscle spasm, ligamentous injury, facet joint dysfunction, or other conditions that might not appear on standard MRI sequences.

The court’s willingness to grant summary judgment based on this inconsistency demonstrates the significant weight appellate courts place on objective diagnostic tests. Subjective patient complaints and clinical examination findings carry less evidentiary weight when they conflict with imaging studies. This hierarchy of medical evidence reflects judicial skepticism toward injuries that cannot be objectively verified, particularly in the litigation context where secondary gain motives may influence symptom reporting.

The decision also reinforces the connection between threshold motions under Insurance Law § 5102(d) and ultimate liability under § 5106. While these provisions address different aspects of personal injury claims—threshold satisfaction versus proof of negligence and causation—both require consistent medical proof linking the accident to objectively verifiable injuries. An inconsistency that defeats the threshold motion typically also undermines the causation element necessary for ultimate recovery.

Practical Implications: Medical Proof Strategy in Personal Injury Cases

For plaintiff’s counsel, Komina underscores the critical importance of reviewing all medical records before filing suit or opposing summary judgment motions. When imaging studies show normal findings, practitioners must either obtain supplemental medical opinions explaining how injury can exist despite normal imaging, or seriously reconsider the viability of the case. Proceeding to litigation with unexplained contradictions between clinical findings and imaging results invites summary dismissal.

Treating physicians should be educated about the importance of addressing imaging results in their narrative reports. A simple statement acknowledging the normal MRI findings and explaining that the patient’s symptoms likely arise from soft tissue injury, muscle spasm, or other conditions not visualized on MRI can prevent the type of fatal inconsistency that doomed the plaintiff’s case in Komina. Physicians who perform examinations without reviewing imaging studies, or who reach conclusions inconsistent with imaging without explanation, create evidentiary problems that competent defense counsel will exploit.

Defense attorneys should carefully review all plaintiff medical records for inconsistencies between clinical findings and diagnostic test results. When such inconsistencies exist and remain unexplained, summary judgment motions become highly viable. The motion papers should highlight the contradiction, cite the specific MRI findings showing normal anatomy, and contrast those findings with the treating provider’s claims of injury. Demonstrating that the plaintiff’s own medical proof is internally contradictory often proves more persuasive than relying solely on defense medical examinations.

The case also illustrates the litigation risk in relying primarily on chiropractic evidence in serious injury cases. While chiropractors can provide competent testimony regarding spinal injuries, their clinical findings carry less weight when they conflict with imaging studies interpreted by radiologists. Plaintiffs with normal MRI results may need supporting opinions from physicians who can explain the mechanism of injury and reconcile clinical findings with imaging results to survive threshold motions.

Key Takeaway

Medical consistency is paramount in personal injury cases. When treating physicians cannot explain why their clinical findings contradict objective diagnostic tests like MRI results, courts will often grant summary judgment for defendants. This case illustrates how objective signs of continuing disability must align with imaging studies to survive legal challenges.

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Legal Update (February 2026): Since this post’s publication in 2013, New York’s serious injury threshold standards under Insurance Law § 5102(d) may have been refined through subsequent appellate decisions and regulatory updates. Practitioners should verify current judicial interpretations of medical evidence consistency requirements and threshold motion standards, as courts have continued to develop precedent regarding the admissibility and weight of conflicting medical reports in serious injury determinations.

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