The Medical Record Has to Show More Than a Pain Score
Chronic pain can continue long after an accident, even when there is no single X-ray, MRI, or laboratory test that measures exactly how much someone hurts. In a New York personal injury claim, medical documentation can help establish what caused the pain, how long it has lasted, what physical limitations remain, and how those limitations affect work and daily life.
Chronic pain is also extremely common. According to the National Center for Health Statistics, 24.3% of U.S. adults reported chronic pain in 2023, while 8.5% experienced high-impact chronic pain that frequently limited life or work activities.
At Giampa Law, we represent accident victims throughout the Bronx, Westchester County, and New York City whose injuries continue affecting them well beyond the initial accident. When pain becomes an ongoing part of someone's life, the records need to show more than the fact that it hurts.
- Chronic Pain Can Be Documented: Imaging, physical examinations, range-of-motion measurements, neurological testing, treatment records, work restrictions, and other evidence can help document the injury and its functional effects.
- The Serious-Injury Threshold Does Not Apply to Every Claim: New York's statutory serious-injury requirement is particularly important in personal injury claims governed by the state's motor-vehicle no-fault law. Ordinary premises-liability and other negligence claims are different.
- New York Changed Its Auto-Injury Law in 2026: For actions and proceedings commenced on or after May 26, 2026, the former 90/180-day serious-injury category is no longer part of Insurance Law § 5102(d).
- A Treatment Gap Is Not Automatically Fatal: New York courts may consider an unexplained cessation of treatment, but the law does not require unnecessary medical care simply to create a continuous record.
- Causation Matters as Much as Pain: Medical evidence should address whether the accident caused or aggravated the condition rather than merely documenting that pain exists.
Why Can Chronic Pain Be Difficult to Document?
Pain is experienced by the patient, so there isn't a machine that simply produces a numerical measurement of how much someone is hurting. Imaging may reveal an underlying injury, but the pain itself isn't something an MRI can photograph.
That distinction becomes important when an insurance company disputes whether an accident caused ongoing symptoms or whether those symptoms create meaningful physical limitations.
A person may have severe back pain, nerve symptoms, headaches, or restricted movement even when imaging doesn't reveal a dramatic fracture or other obvious injury. On the other hand, an MRI may identify a herniated or bulging disc without proving by itself that the finding caused the person's pain or resulted from the accident.
The strongest documentation therefore connects the diagnosis, objective findings, symptoms, physical limitations, treatment, and medical opinion on causation.
Does Every New York Personal Injury Claim Have to Meet the Serious-Injury Threshold?
No. This is an important distinction.
New York's Insurance Law § 5104 restricts recovery for noneconomic loss in certain personal injury claims governed by the state's motor-vehicle no-fault system unless the injured person sustained a "serious injury" as defined by Insurance Law § 5102(d).
The current serious-injury categories include:
- Death
- Dismemberment
- Significant disfigurement
- A fracture
- Loss of a fetus
- 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
New York eliminated the former 90/180-day category in 2026. The change applies to actions and proceedings commenced on or after May 26, 2026.
Someone bringing a premises-liability claim after a fall, by contrast, does not have to establish a "serious injury" under § 5102(d) merely to recover for pain and suffering. Medical documentation still matters because the person must prove causation and damages, but the statutory no-fault threshold isn't the same issue.
What Counts as Objective Medical Evidence in a New York Car Accident Claim?
New York's highest court addressed this issue in Toure v. Avis Rent A Car Systems, Inc.
In cases involving the significant-limitation or permanent-consequential-limitation categories, a medical expert may support the claim with quantified evidence, such as measured loss of range of motion, or with a qualitative assessment that has an objective basis and compares the injured person's limitations with normal function.
That means a note stating only that a patient reports "8/10 back pain" generally provides different evidence from an examination documenting measurable loss of motion, weakness, altered sensation, abnormal reflexes, muscle spasm, nerve dysfunction, or another clinically identified limitation.
Imaging can also matter, but it should be connected to functional evidence. The Court of Appeals has explained that proof of a herniated disc by itself does not necessarily establish a serious injury without objective medical evidence showing resulting physical limitations.
1. Document the Initial Injury: Emergency room records, early examinations, imaging, symptoms, diagnoses, and medical history help establish what happened after the accident and create an initial link between the event and the injury.
2. Measure the Functional Effects: Doctors may document range of motion, strength, sensation, reflexes, gait, work restrictions, activity limitations, neurological findings, and other evidence showing what the injury prevents the patient from doing.
3. Document What Persists: Later examinations, treatment records, specialist evaluations, prognosis evidence, and explanations for any treatment changes can show whether symptoms and limitations resolved, improved, or became chronic.
Which Medical Records Can Help Support a Chronic Pain Claim?
No single test automatically proves chronic pain or establishes the value of a claim. Several types of medical evidence may work together to explain the condition.
- Diagnostic Imaging: MRIs, CT scans, X-rays, and other imaging may identify fractures, disc injuries, nerve compression, structural abnormalities, or other physical findings relevant to the symptoms.
- Range-of-Motion Testing: Measured limitations can provide quantitative evidence of how an injury affects movement when the testing is properly performed and documented.
- EMG and Nerve-Conduction Studies: These tests can identify certain forms of nerve dysfunction and may support a diagnosis involving radiculopathy or another neurological condition when medically appropriate.
- Physical Examination Findings: Strength deficits, sensory changes, reflex abnormalities, gait changes, muscle spasm, tenderness, and other findings may help provide clinical context.
- Treatment Records: Physical therapy, pain management, injections, medication, surgery, rehabilitation, and other treatment can document how providers responded to persistent symptoms.
- Specialist Evaluations: Orthopedists, neurologists, physiatrists, pain-management physicians, and other appropriate specialists may provide additional evaluation of the diagnosis, causation, prognosis, and functional limitations.
- Work Restrictions: Medical restrictions on lifting, standing, sitting, driving, walking, or other activities can help connect the injury to lost work or diminished earning ability.
The usefulness of any particular record depends on the injury. Someone with nerve damage may have a very different medical file from someone experiencing chronic pain after a shoulder, knee, or spinal injury.
What If an MRI Shows Degenerative Changes?
Preexisting or degenerative findings can make causation more complicated, but they don't automatically mean an accident caused no injury.
A person may have had an asymptomatic or manageable condition before an accident and experience substantially different symptoms afterward. The legal and medical question can become whether the accident caused a new injury, aggravated an existing condition, or whether the symptoms are primarily attributable to something unrelated.
That distinction should be addressed by qualified medical professionals rather than assumed from the words "degenerative changes" on an imaging report.
New York courts consider causation closely. When a defendant produces evidence suggesting that symptoms stem from degeneration, a prior injury, or another medical condition, the injured person's medical evidence may need to address that alternative explanation directly.
Can a Gap in Treatment Hurt a Chronic Pain Claim?
It can, but a treatment gap doesn't automatically defeat a claim.
In Pommells v. Perez, the New York Court of Appeals explained that an unexplained cessation of treatment can become relevant to the seriousness and causation of an injury.
The court was equally clear about something else: an injured person does not have to continue unnecessary treatment merely to create a medical record.
There may be legitimate reasons treatment stops. A doctor may conclude that further therapy will provide little additional benefit. Insurance may stop paying. A recommended treatment may be medically inappropriate. Other circumstances can also affect continued care.
When treatment ends or significantly changes, having the reason reflected somewhere in the record can help explain what otherwise appears to be an unexplained gap.
The important lesson isn't "keep treating forever." It's that the medical history should accurately explain the course of the injury and why treatment occurred, changed, or ended.
Can a Pain Journal or Daily-Life Evidence Help?
Yes, although this type of evidence serves a different purpose from objective medical findings.
A contemporaneous record can help someone remember when pain interfered with sleep, work, household responsibilities, exercise, driving, childcare, or other activities. Family members, coworkers, and friends may also have observed changes in mobility, activity level, mood, or independence.
This evidence can help explain how the injury affects everyday life, but it does not replace medical proof when medical causation, permanency, or New York's motor-vehicle serious-injury threshold is disputed.
The most useful records are accurate rather than exaggerated. A journal that says every day was a "10 out of 10" may raise different questions than one that realistically records good days, bad days, activities attempted, symptoms experienced, and limitations that followed.
What Damages Can Chronic Pain Affect?
When another person's negligence causes an injury that results in chronic pain, the condition may affect several parts of the damages analysis.
- Past and Future Pain and Suffering: The nature, duration, severity, and expected permanency of physical and emotional suffering can affect noneconomic damages.
- Medical Expenses: Continued physician care, rehabilitation, medication, injections, surgery, or other reasonably necessary treatment may create past or future economic losses.
- Lost Earnings: Pain and physical restrictions may cause missed work during treatment or recovery.
- Lost Earning Capacity: A lasting injury may reduce someone's ability to perform the same occupation, work the same hours, or earn the same income in the future.
The ways an injury interferes with hobbies, family activities, mobility, independence, and other parts of everyday life can also be considered when evaluating pain and suffering. Under New York law, however, "loss of enjoyment of life" is generally treated as part of conscious pain and suffering rather than as a separate, duplicative damages award.
How Long Do You Have to File a New York Personal Injury Claim?
Many New York negligence claims are subject to a three-year limitations period under CPLR § 214, but that rule should not be treated as universal.
Different claims can carry much shorter deadlines or additional procedural requirements. For example, when a claim is brought against a municipality or another qualifying public corporation, General Municipal Law § 50-e generally requires a notice of claim within 90 days. Medical malpractice has a different limitations statute, and other claims may involve tolling rules or specialized deadlines.
Chronic pain can make timing particularly important because the long-term impact of an injury may not be clear during the first weeks after an accident. That does not mean the filing period waits for pain to become chronic.
Giampa Law Can Help Build the Record Behind Your Injury
A chronic pain claim shouldn't depend on a single pain score or a few lines buried in a medical chart. The records should show what happened, what doctors found, how the condition progressed, what treatment was provided, and how the injury continues to affect the person's life.
Our New York personal injury lawyers can obtain medical records, review the accident history, identify missing evidence, investigate how the injury occurred, and work with the appropriate medical evidence when causation or long-term limitations are disputed. Our case results include substantial recoveries for injured people and families throughout New York.
If an accident left you living with chronic pain, contact Giampa Law for a free consultation. We can review the medical history, explain which New York rules apply to your type of claim, and help determine what evidence may be needed. You pay no attorney's fee unless we win your case.
"I cannot say enough about the people who work here. From the lawyers to the secretaries. They are all truly the best!" - H.K., ⭐⭐⭐⭐⭐