Electronic Signatures on Physician Reports Are Admissible in New York: Ramirez v Miah

The admissibility of electronically signed medical documents has been a contentious issue in New York personal injury litigation. For years, courts grappled with whether electronic signatures on physician reports met the stringent requirements for admissible evidence. The legal landscape has been particularly complex when dealing with medical affidavits and reports that form the backbone of personal injury claims.

Earlier precedents, including the Vista Surgical Supplies case, took a more restrictive approach to electronic signatures on medical documentation. This created significant challenges for attorneys and their clients, as the increasing digitization of medical practices meant that more physician reports and medical records were being created and signed electronically. The question became whether these electronically signed documents could satisfy New York’s State Technology Law requirements while maintaining the integrity needed for courtroom admissibility.

The Decision: Ramirez v Miah

Ramirez v Miah, 2018 NY Slip Op 07472 (2d Dept. 2018)

“We disagree with the Supreme Court’s determination that the electronic signature on the plaintiff’s physician’s affirmed report was insufficient to render the report admissible pursuant to State Technology Law §§ 302(3) and 304(2)(see Forcelli v Gelco Corp., 109 AD3d 244, 250-251; Naldi v Grunberg, 80 AD3d 1, 12-13; cf. Vista Surgical Supplies, Inc. v Travelers Ins. Co., 50 AD3d 778).”

We have evolved from Vista.

The Statutory Framework: ESRA and the State Technology Law

The statutes the Second Department cited are part of New York’s Electronic Signatures and Records Act (ESRA), codified in the State Technology Law. Section 302(3) defines an “electronic signature” broadly — an electronic sound, symbol, or process attached to or logically associated with an electronic record and executed or adopted by a person with the intent to sign the record. Section 304(2) supplies the operative rule: an electronic signature has the same validity and effect as a signature affixed by hand.

Read together, the provisions mean that the medium of a signature is not, by itself, a basis to reject a document. The question is the same one courts have always asked of handwritten signatures: did the signer adopt the document with intent to sign it? The authorities cited in Ramirez trace that principle through New York case law — Forcelli v Gelco Corp., which gave effect to electronic communication in the settlement context, and Naldi v Grunberg, which did so under the statute of frauds — while distinguishing the older, more restrictive Vista Surgical Supplies line by the “cf.” signal.

Why Physician Reports Are Where This Fight Happens

In personal injury litigation, affirmed physician reports do heavy lifting. Under New York practice, a physician’s report must be properly affirmed or sworn to be considered on a dispositive motion, and these reports are routinely the core evidence on both sides of serious injury threshold motions, damages disputes, and no-fault medical necessity litigation. A successful challenge to the signature on a report can knock the document out of evidence entirely — which is why signature objections became a standard arrow in the motion-practice quiver.

As medical practices digitized, more reports issued from electronic medical record systems bearing electronic signatures. Under the restrictive Vista-era approach, that workflow created genuine admissibility risk: a substantively unimpeachable report could be rejected over the form of its signature. Ramirez removes much of that risk for litigants in the Second Department, holding that an electronic signature on an affirmed physician report does not render the report inadmissible.

Why This Matters

For personal injury practitioners: signature-format objections to electronically signed physician reports are now substantially weaker. Counsel offering such a report should be prepared to tie it to State Technology Law §§ 302(3) and 304(2) and to Ramirez; counsel opposing one should focus on genuine foundation problems — intent to sign, authentication, or the affirmation language itself — rather than the bare fact that the signature is electronic.

For medical providers: reports generated and signed within electronic medical record systems can support litigation and no-fault claims without a wet-ink counterpart, provided the signature is genuinely the physician’s act. Providers should still maintain consistent signing practices, because how a signature came to appear on a document remains fair game for inquiry, as the related cases on stamped signatures and signatures placed at the signor’s direction show.

For clients: the decision reflects a court system catching up to how documents are actually created. The merits of a medical report — not the technology used to sign it — decide its weight.

Related Resources

• Medical necessity and peer review requirements in NY no-fault cases — where signed medical reports are most heavily litigated
• The firm’s Legal Encyclopedia — plain-language explainers on New York personal injury and no-fault doctrine
• Personal injury practice
• A signature placed at the direction of the signor
• Electronic signatures unconditionally accepted
• And why do you think the signature was stamped?
• Defective notarization