Key Takeaway
Brooklyn Chiropractic addressed 15 claims, including 12 medical-necessity claims. A competing IME did not rebut the separate peer-review claim.
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.
This action involved 15 claims, not just 12. Twelve raised medical necessity: eleven based on an IME and one on a peer review. The court assessed what the opposition answered for each group.
Last reviewed: September 2026.
Historical note: Brooklyn Chiropractic ruled claim by claim; its conflicting examinations did not supply an answer to every denial. Read the 2013 decision.
A competing IME did not answer every claim
Brooklyn Chiropractic & Sports Therapy v A. Central, 2013 NY Slip Op 50904(U), decided May 22, 2013, found supported medical reports and timely denials for those twelve claims. The provider submitted an affirmed examination report from a different doctor, dated one day after the insurer’s examination. Its contradictory findings raised a factual dispute for the eleven IME-based claims.
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No medical evidence rebutted the peer review for the twelfth claim, which was dismissed. Two other claims were dismissed on unanswered-verification grounds; the insurer did not establish its fee-schedule defense for the final claim.
Avoid turning the dates into a deadline
The opinion says a different doctor examined the patient one day later. It does not identify a different specialty as the legal test or require examinations to occur within one day. Nor does it establish that IME-based denials receive a categorically easier rebuttal standard. The useful question is which medical conclusion the submitted evidence actually addresses.
Jason’s original 2013 note
Jason’s original 2013 comparison follows. The Hillcrest reference is his comparison, not an authority adopted in this opinion; neither a specialty rule nor a one-day deadline was announced.
This is similar to Hillcrest v. State Farm, where an IME report defeated the findings of the peer review report. Yet, note how the conflicting IME reports had not effect on the claim that was denied, based upon the peer report.
Connect to the Encyclopedia
Start with the medical necessity and peer-review encyclopedia, then compare these records:
- Ji Sung Kim: answering an IME’s medical reasoning
- Mingmen: examination findings and the opposing affidavit
- Five Boro: missing report pages and sufficient opposition
- Radiology Today: insufficient testimony at trial
For review of a particular no-fault dispute, contact the firm with the relevant reports and motion papers.
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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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.
