90/180 Prong of the Serious Injury Law
Section 5102 of the Insurance Law defines one category of “serious injury” as “a medical determined injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person’s usual and customary activities for not less than ninety days during the one hundred eighty days immediately following the occurrence of the injury or impairment.” In lay terms, proving a serious injury under this category requires evidence of (1) a medically determined injury (2) which is causally related the accident and (3) prevents you from performing the majority of your usual and customary activities (4) for at least 3 of the first 6 months following the injury. For those whose injuries have kept them out of work for 3 months or longer, proving a serious injury under the “90/180” category is straightforward. For those who are unemployed, it is a bit more difficult, as you must provide evidence that your injuries greatly limited your daily activities, such as household chores, sports, exercising, caretaking, and socializing, to name a few examples. For those who returned to work shortly after their accident, it is nearly impossible to prove a serious injury in this manner (though there are other categories of “serious injury” which may apply). All of this certainly doesn’t mean you should stay out of work to benefit your case – your absence must be “medically directed”.