New York's Serious Injury Threshold

What Counts as a Serious Injury Under New York Law?

In New York, you cannot sue a driver for pain and suffering unless your injury fits one of the categories in Insurance Law § 5102(d).

That list used to have nine entries. As of May 26, 2026, it has eight.

The category New York deleted, the 90/180 rule, was the one that covered serious but temporary injuries. It was also the one most injured people qualified under.

What remains: death, dismemberment, significant disfigurement, a fracture, loss of a fetus, permanent loss of use, permanent consequential limitation of use, and significant limitation of use.

Five of those eight are objective and nearly self-proving. Three depend entirely on how well the medical record was built.

Which category your injury lands in is now the single biggest factor in whether a New York car accident case exists at all.

The Eight Ways to Clear the Threshold in New York

Insurance Law § 5102(d) defines serious injury as a personal injury resulting in any one of the following.^[1] You need to satisfy one, not all of them.

The first five are objective. A fracture is a fracture, and an insurer that fights one usually loses. The last three turn on the quality of the medical documentation, which is why the same injury can clear the threshold in one file and fail in another.

How a given diagnosis clears the gate is covered injury by injury, and which category it is argued under decides the proof:

• Fractures sit in an enumerated category, so the question closes as soon as the imaging shows one
• Herniated discs are argued under significant limitation of use, and they are the most contested injury in the statute
• Brain injuries run on permanent consequential limitation, which has to be proved when the scan reads normal
• Complex regional pain syndrome turns on whether the condition is objectively documented at all
• Rotator cuff tears face the degenerative-changes argument before anything else
• ACL and meniscus injuries face the same argument in a weight-bearing joint

Why Deleting the 90/180 Rule Matters So Much

Before May 26, 2026, a ninth category qualified: a medically determined injury of a non-permanent nature that prevented you from performing substantially all of the material acts constituting your usual and customary daily activities for at least 90 of the 180 days following the crash.

Part EE of the 2026 state budget deleted it. The provision applies to actions commenced on or after May 26, 2026, which means the date the lawsuit is filed, not the date of the crash, decides which version of the statute governs.^[2]

Who Loses the Most

The 90/180 category was the route for injuries that were disabling at the time and temporary in the end. A back injury that kept a warehouse worker off the job for four months and then resolved. A concussion that ended a semester. A shoulder injury treated with three months of therapy and no surgery. Under the old statute those cleared. Under the new one they have to be forced into "significant limitation of use" or they do not clear at all.

Why This Hits Working People Hardest

The categories that survived reward permanence and imaging. An injury that heals well, in someone who could not afford to keep treating, is exactly the profile that used to rely on 90/180. The reform did not change how badly those people were hurt. It changed whether the law is willing to hear about it.

The 2026 reform did not help injured people, and we are not going to pretend otherwise. What we can do is know exactly which version of the law governs your file, and make every argument the current statute still allows.

What It Means for a Case Filed Today

Documentation stopped being paperwork and became the case. Quantified range-of-motion findings, imaging read by someone who will testify, a treating physician willing to give an opinion, and an unbroken treatment record are now the difference between a claim and a closed file. That work has to start early, because it cannot be reconstructed a year later.

How Insurance Companies Attack the Threshold

Threshold litigation is its own specialty in New York, and the defense playbook is consistent. A carrier that can knock out the threshold does not have to argue about fault or damages at all, so this is where they spend their money.

• The gap in treatment. Stop physical therapy for two months and the defense will argue the injury resolved. Most gaps have ordinary explanations, insurance ran out, work schedules, childcare, but the explanation has to be in the record, not offered for the first time at a deposition.
• The defense medical examination. The carrier sends you to a physician of its choosing who measures range of motion and reports it as normal. These examinations are brief by design, and countering one takes contemporaneous measurements from your own treating providers.
• Degenerative changes. Nearly every adult spine shows wear on an MRI. The defense radiologist will call your disc herniation age-related. The counter is not to deny the degeneration; it is to show what changed after the crash.
• Unquantified findings. A chart note saying "decreased range of motion" without numbers is close to useless on a summary judgment motion. New York courts want degrees measured against a stated norm.
• Summary judgment on the threshold. The defense moves to dismiss on the papers before trial. This motion is where most weak threshold claims die, and where a well-documented one is worth substantially more the day it survives.

None of this is about whether you are actually hurt. It is about whether the file proves it in the form New York courts require.

What the Threshold Does Not Block

The threshold is often described as a wall around every New York injury claim. It is narrower than that, and knowing where it does not apply matters.

• Economic losses are not gated. Medical bills and lost earnings beyond the $50,000 no-fault cap are recoverable from the at-fault driver whether or not the threshold is met. The threshold blocks non-economic loss only.
• It only applies to motor vehicle claims. A construction fall, a sidewalk trip, a bad surgery, a dog bite, and a nursing home injury are not subject to § 5102(d) at all. There is no threshold to clear in a Labor Law 240 claim, a sidewalk fall, or a nursing home neglect claim.
• Motorcyclists are outside the no-fault system. Insurance Law § 5102(f) excludes motorcycles from the no-fault definition, which means a rider gets no PIP benefits but also does not have to clear the serious injury threshold to sue. That trade, and what it costs a rider on the medical-bill side, is worked through on our page for New York motorcycle riders.
• Wrongful death stands on its own footing. Death satisfies the threshold outright, and the 2026 non-economic cap does not reach wrongful death claims. See how New York wrongful death damages work.

Once the threshold is cleared, nothing in New York law caps what the injury is worth. Our page on pain and suffering damages in New York covers what does set the range, and what actually drives New York settlement value puts the non-economic piece next to the economic one.