Preserving the "Chain of Causation" in Personal Injury Cases

How you seek medical treatment for an injury following an automobile accident can significantly affect your ability to seek damages from the responsible parties. New York requires evidence of a “serious injury” in order to bring a personal injury lawsuit. A key element of this is showing a “chain of causation” between the accident and the alleged injury.

Holmes v. Brini Transit, Inc.

Here is a recent example of this principle in action. The plaintiff in this case suffered injuries to both his knees after he was rear-ended by the defendants' vehicle. The injuries required separate surgeries on each knee during 2009. The plaintiff then sued the defendants, alleging he sustained “permanent injury” to his knees.

Before Bronx Supreme Court, the defendants presented expert testimony from an orthopedist who examined the plaintiff in 2010 and found a “normal range of motion” in the affected knees. Defendants also presented evidence of prior knee surgery the plaintiff had before the 2009 accident, which suggested a preexisting degenerative condition not attributable to the collision with the defendants' vehicle. Despite this evidence, Supreme Court denied the defendants' motion to dismiss the plaintiff's complaint alleging permanent injury.

But the Appellate Division, First Department, reversed in a December 2014 decision. The appeals court said the plaintiff's failure to seek any additional medical treatment after his 2009 surgeries “interrupt[ed] the chain of causation and render[ed] the finding of permanency speculative.” The plaintiff claimed he stopped treatment when his benefits under New York's no-fault law expired. That was not good enough for the First Department, because “he failed to explain why he could not continue treatment through his other health insurance.”

New York's Court of Appeals explained the “chain of causation” rule in a 2005 opinion. New York's highest court said that “even where there is objective medical proof [of a serious injury], when additional contributory factors interrupt the chain of causation between the accident and claimed injury—such as a gap in treatment, an intervening medical problem or a preexisting condition—summary dismissal of the complaint may be appropriate.”

When it comes to a “gap in treatment,” the Court of Appeals said when a plaintiff ceases all medical care following an injury, he or she must offer a “reasonable explanation” in order to avoid dismissal of their complaint. That said, “A plaintiff need not incur the additional expense of consultation, treatment or therapy, merely to establish the seriousness or causal relation of his injury.” All the courts require is some explanation as to why there may be a serious injury despite a gap in active medical care.

Maintaining Your Personal Injury Claim

Maintaining the chain of causation is just one part of a successful personal injury lawsuit. That is why, if you have been injured in a motor vehicle accident, it is important you speak with a qualified New York personal injury attorney who can advise you on the best way to proceed with your case. Contact our office today if you have any questions.