The January 2024 Utah Court of Appeals opinion, Rodriguez v. Crosby, stands as a strong reminder to those seeking compensation for injuries caused by an auto accident that (1) injury victims are not entitled to seek damages for “pain and suffering” unless their medical bills exceed $3,000 or experience another specified serious injury as listed in Utah Code Ann. 31A-22-309(1); and (2) unresolved and lingering pain after an injury should be addressed with proper medical treatment, which should continue until the injuries and pain resolve or the medical provider determines that the injuries are permanent.
Issue Analyzed: In Rodriguez, the Utah Court of Appeals analyzes what type and extent of injury must be sustained by an auto accident injury victim for the injured person to be entitled to an award of general damages, also known as “pain and suffering,” pursuant to Utah Code Ann. § 31A-22-309(1), which states:
(a) A person who has or is required to have direct benefit coverage under a policy which includes personal injury protection may not maintain a cause of action for general damages arising out of personal injuries alleged to have been caused by an automobile accident, except where the person has sustained one or more of the following:
(i) death;
(ii) dismemberment;
(iii) permanent disability or permanent impairment based on objective findings;
(iv) permanent disfigurement;
(v) a bone fracture; or
(vi) medical expenses to a person in excess of $3,000.
Facts: In 2017, Plaintiff Veronica Rodriguez's child (“Child”) was involved in an auto accident and broke her wrist as a result. Child's wrist was placed in a cast for approximately six weeks, after which “no additional treatment was recommended' and she apparently understood ‘that healing was complete.'”
Three years later, in 2020, Ms. Rodriguez filed a lawsuit against the at-fault party, Krista Crosby, on behalf of her Child and sought monetary compensation as a result of Child's “pain and suffering” associated with Child's broken wrist.
Rodriguez disclosed during litigation that only $929.50 in medical expenses had been incurred to treat the Child's injury.
During discovery, Crosby retained a medical expert, Dr. Newton, “to provide testimony regarding Child's injury.” Dr. Newton examined the Child and prepared a report that contained his medical findings and expert opinions, which are summarized as follows:
- As a result of the accident, Child sustained “torus fractures with buckling but no significant angulation.” These fractures were “well healed with some residual pain symptoms” that Child subjectively reported on the date of Dr. Newton's exam.
- Child's “subjective symptoms” of pain “exceed[ed] what we would typically expect” given that “healing is complete and adequate” and Dr. Newton was unable to “define a structural diagnosis for the ongoing symptoms.”
- Dr. Newton opined that “there is a likelihood that these symptoms will eventually resolve but may require some treatment.”
- Dr. Newton emphasized “that ‘there should not be any long-term consequences' of the fractures,'” but also “recognized that ‘there is progress to be made'” given the Child's report of ongoing symptoms. Accordingly, Dr. Newton recommended that the Child undergo 6-8 sessions of physical therapy.”
In 2021—now four years after the subject motor vehicle accident and only 2.5 months prior to trial—Crosby moved for summary judgment and argued that the Rodriguez was not entitled to a general damages award because the Child's injury did not meet the statutory threshold set forth in Utah Code Ann. § 31A-22-309(1). Notably, in 2017 when the subject auto accident occurred, Utah Code Ann. § 31A-22-309(1) did not include “a bone fracture” (which is listed in the current statute as Subsection (1)(v)) as one of the listed conditions that would permit a plaintiff to seek an award of general damages. Based on this prior version of the statute that was in place when the subject accident occurred, Crosby argued that Rodriguez was not entitled to general damages because “Rodriguez failed to provide evidence to support that child ‘suffered a permanent partial disability or incurred medical expenses in an amount exceeding $3,000.00.'”
Rodriguez opposed the motion based on four arguments. Rodriguez argued: (1) that the current version of the statute should apply, which included “a bone fracture” to the list of qualifying injuries; (2) that the Child's broken wrist “constitutes ‘dismemberment'” under the statute; (3) that a jury could conclude that the Child had a “permanent impairment” as required under the statute, because the Child was complaining of ongoing pain and symptoms four years after the accident; and (4) that because Dr. Newton recommended that the Child obtain physical therapy, “it was ‘not impossible' that the Child would ‘incur at least $3,000.00 of medical expenses prior to trial.”
The trial court found Rodriguez's arguments unpersuasive and granted Crosby's motion for summary judgment. Accordingly, Rodriguez was not entitled to seek damages for “pain and suffering” at trial. Rodriguez, on behalf of her Child, appealed.
Analysis: In analyzing Utah Code Ann. § 31A-22-309(1) and what is required in order for an injured party to maintain an action for general damages, the Utah Court of Appeals specifically held as follows:
- The 2017 version of Utah Code Ann. § 31A-22-309(1) applies because Utah courts generally “operate under a statutory bar against the retroactive application of newly codified laws” unless “the newly codified law ‘is expressly declared to be retroactive” within the language of the statute. Given that Utah's “legislature did not make the statutory change at issue here explicitly retroactive,” the 2017 version of the statute applies, as that is the version that existed on the date of the accident.
- Child's broken wrist does not constitute “dismemberment” as that term is used within the statute. This determination is based on the “plain meaning of the term ‘dismemberment,” as applied to a human body,” which is defined as “the action of dividing the body into pieces or cutting off portions of the body, most commonly in reference to the removal of limbs from the body.”
- There was insufficient evidence for a jury to determine that the Child sustained a “permanent impairment.” A “permanent impairment” is “a ‘loss of function'” that may “continue throughout the life of the person suffering from it.” Juries lack the medical expertise needed to determine whether Child's injury will likely continue throughout the remainder of her life. Thus, this finding could only reasonably be made by the jury if there was evidence presented from a medical expert supporting the determination of permanent impairment. The only medical expert opinion presented was from Dr. Newton, who “repeatedly expressed his opinion that any current limitations were not permanent and that Child could expect a full recovery.” Dr. Newton further testified that according to “AMA and Utah Guidelines, a healed nondisplaced fracture does not qualify for permanent impairment.” Thus, while Dr. Newton conceded that there was “room for improvement” in Child's condition, his expert opinion that Child's injury was not permanent was the only expert testimony the jury could rely on. Accordingly, a jury could not conclude that the Child's injury qualified as a “permanent impairment.”
- The possibility that Child may incur at least $3,000 in medical expenses in the future is insufficient under the statute to entitle Rodriguez to seek general damages at trial. This conclusion was reached because (a) Rodriguez had only disclosed medical expenses of less than $1,000; (b) Rodriguez failed to present “evidence suggesting that the $3,000 threshold might be reached if child attended the remaining treatment that had been recommended” by Dr. Newton; (c) Rodriguez had failed to present evidence that Child would be obtaining the recommended physical therapy in the few weeks remaining prior to trial; and (d) Rodriguez did not request that the trial be delayed in order for her to obtain the physical therapy or learn more about its associated costs.
Have you sustained injuries as a result of an auto accident?
If so, Utah law states that you are only entitled to reimbursement for your medical expenses and other monetary costs and are not entitled to damages for pain and suffering unless your medical bills exceed $3,000 or the injury caused death, dismemberment, permanent disability, permanent disfigurement, or a bone fracture. Most personal injury victims satisfy this requirement by exceeding the $3,000 threshold. It is important that you obtain immediate treatment following an accident and continue with all recommendations for follow-up care in order to ensure that you meet this threshold and can then obtain compensation for your pain and suffering.
Further, if you obtained an initial course of treatment but your pain did not fully resolve or returned shortly after you completed your medical treatment, it is critical that you seek additional medical care to address this ongoing pain. This will benefit your physical recovery and also strengthen your claim for injury-related compensation. Attorneys at Wilcox & Mastrorocco can discuss treatment options with you and help you determine what type of medical treatment you should pursue to best resolve your ongoing pain and injury.
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