How is pain and suffering evaluated?
Pain and suffering is not reliably calculated by multiplying medical bills by a fixed number. In a New Jersey injury claim, the evaluation should address the nature of the injury and its actual effects, together with the evidence and legal issues that determine whether damages can be recovered.
Your recovery deserves an explanation that shows how the injury has affected your life. A number on a treatment bill cannot describe difficulty sleeping or the effort required to get through an ordinary workday. Those experiences need to be understood in context, supported by the available evidence.
An insurer may use an internal evaluation system or compare other claims. That does not make its initial figure the legal value of your case. I would want to understand the assumptions behind the offer and whether the information supplied fairly presents your condition.
Medical expenses answer a different question
The cost of treatment can help show what care was provided, but cost and suffering do not rise in a fixed proportion. The same treatment may be billed differently by different providers. Coverage arrangements can also affect the amount that appears on a statement.
For that reason, choosing treatment to increase a claim would be the wrong approach. Medical decisions belong with you and your providers. Our work is to understand the care that was medically appropriate and explain the injury accurately, rather than treat a larger bill as a shortcut to a larger recovery.
New Jersey's model jury instructions recognize pain, disability and loss of enjoyment of life as matters requiring a fair evaluation of the evidence. They do not establish a universal price list for an injury. That is an important distinction when an online calculator gives an apparently precise answer after asking only a few questions.
Explain the activities that matter to you
I would ask what a normal week looked like before the accident and what is different now. The useful answer is usually specific. A person who can still complete a task may need more time, assistance or rest afterward. Saying only that the task remains possible can miss the practical effect of the injury.
The account should not focus exclusively on the worst day. Some conditions vary. Explain the better days too, along with the frequency and duration of difficult periods. That gives the insurer or a jury a more complete understanding than a statement suggesting every day has been identical.
This is not a request to make ordinary life into a performance for the claim. It is a way to identify meaningful changes and the records or witnesses that may help explain them. A family member's observation can be useful, but it should remain that person's actual observation.
Duration and prognosis affect the evaluation
An injury that resolves over time presents different questions from a lasting limitation. Early in treatment, the long-term picture may not yet be clear. A prognosis should come from appropriate medical evidence, not from a lawyer's prediction that symptoms will certainly disappear or remain forever.
If future care is recommended, we need to understand the recommendation and its basis. If the provider is still deciding what is needed, that uncertainty should be acknowledged. A responsible evaluation can explain which facts are established and which require further development.
An older condition does not automatically defeat the claim. It may require a careful comparison of your condition before and after the accident. Medical evidence can help distinguish a new injury from an aggravation and explain the additional harm caused by the event.
The right to recover and the amount are related questions
In some New Jersey motor-vehicle cases, the limitation-on-lawsuit option creates an additional legal threshold for noneconomic damages. Whether it applies depends on the people and coverage involved. Satisfying that threshold and proving the amount of damages are separate tasks, even though some of the medical evidence overlaps.
Responsibility for the accident also matters. A disputed liability question may affect settlement discussions even when the injury itself is well documented. Coverage limits and collectability present another practical issue. The available insurance is not a medical assessment of what you experienced.
I would explain those factors individually so that a settlement recommendation is understandable. A client should know whether a particular concern involves proof of the injury, a legal requirement or the amount of insurance available. Combining everything into a vague statement that the case is difficult is not helpful.
An offer should be tested against the developed record
When an offer arrives, we can compare it with the evidence rather than react only to the amount. Has the insurer reviewed the current records? Does its position account for the continuing limitations? Is a factual misunderstanding influencing the evaluation? Those questions help identify a useful response.
A supported presentation may include a clear chronology and appropriate medical opinions. More pages are not always better. The important information should be understandable and connected to the damages being claimed.
You are entitled to a candid discussion of an offer and the alternatives. I cannot promise that an insurer or jury will select a particular number. I can explain how the evidence supports the claim, where uncertainty remains and what further work could improve the basis for a decision.
Sources and Further Reading
About Michael B. Fusco
Michael B. Fusco is a New Jersey personal injury attorney certified by the Supreme Court of New Jersey as a Civil Trial Attorney. Read Mike’s biography and credentials.
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General Information
This article provides general information, not legal advice for a particular situation. Laws and policy terms must be applied to the actual facts. Reading this article or contacting the firm does not, by itself, create an attorney-client relationship.