Very interesting discussion on Perl

Santos v Traylor-Pagan, 2017 NY Slip Op 05502 (1st Dept. 2017)

“Plaintiff failed to raise a triable issue of fact as to whether his carpal tunnel syndrome was causally related to the accident (Perl v Meher, 18 NY3d 208, 217-218 ). This Court, in Rosa v Mejia (95 AD3d 402, 404 ), opined that the decision in Perl did not abrogate the need for at least a qualitative assessment of injuries soon after an accident. This Court then affirmed the dismissal of a plaintiff’s case where the plaintiff had presented no admissible proof that she saw any medical provider for any evaluation until 5½ months after her accident (id.). Plaintiff here was treated on the date of the accident and released from the emergency room at Westchester Medical Center, where he was diagnosed with a right elbow laceration, which was treated with three sutures. He never had any further medical treatment until he first saw an orthopedist 13½ months after the accident, and then allegedly had a few months of physical therapy, although there are no details of any such therapy in the record. He did not see a neurologist about his carpal tunnel syndrome until almost four years after the accident

I always read Perl for the proposition that issues regarding qualitative evaluation and “causation” following the accident were questions of fact for the jury.  I think the Second Department reads Perl the same way as they have not kicked a case on contemporaneous treatment issues since Perl.  Remember, the crux of this case is that causation is not established without contemporaneous treatment.  In the no-fault world, the same argument could hold since the burden on summary judgment for lack of causation is the same in the 5102(d) and first-party benefit sense.

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Legal Update (February 2026): Since this 2017 post discussing Perl v Meher and causation standards for delayed-onset injuries, New York courts have continued to refine the application of causation requirements under Insurance Law § 5102(d), and the Court of Appeals may have issued additional precedential decisions affecting the qualitative assessment standards for injuries manifesting months or years after an accident. Practitioners should verify current judicial interpretations of causation requirements and any updates to the serious injury threshold analysis.