Rehabilitation and Long-Term Care Compensation in New York: What Injury Victims Can Recover

In New York, injury victims can recover rehabilitation and long-term care costs. That includes medical and therapy expenses, home care or assisted living, lost wages, and future care needs. No-fault insurance covers the first $50,000 per person. Those whose injuries meet the serious injury threshold can pursue more, including pain and suffering, through a lawsuit.

That short answer names the five buckets of compensation this article covers. They are medical and rehabilitation expenses, home care and assisted living, lost wages and earning capacity, pain and suffering, and future care costs. The first three are largely economic, and up to a point your own auto insurance covers them. The last two depend on whether your injury clears New York's serious injury threshold. That covers both pain and suffering and lawsuit-based future care beyond what no-fault pays. The threshold changed in a significant way in 2026, and we cover the new rules in detail below.

At The Orlow Firm, we've handled catastrophic injury cases across Queens and New York City for over 40 years. That includes spinal cord injuries, traumatic brain injuries, amputations, and severe fractures that leave people needing care for years or a lifetime. Cases like these are exactly where the questions in this article become urgent. The difference between what no-fault covers and what a full recovery looks like can be hundreds of thousands of dollars.

Injuries That Typically Require Rehabilitation or Long-Term Care

Not every injury leads to a long-term care claim. The ones that do tend to be severe. They also tend to satisfy New York's stricter serious injury categories almost by definition. Understanding that overlap helps explain why documentation matters so much.

• Traumatic brain injury (TBI): Cognitive, behavioral, and physical impairments that often require years of rehabilitation and support. A lasting TBI can qualify as a permanent consequential limitation or significant limitation of a body function.
• Spinal cord injury: Partial or complete paralysis frequently means permanent loss of use of a body organ, member, function, or system. That is one of the threshold categories.
• Amputation: The loss of a limb or digit is treated as dismemberment, a threshold category in its own right. It typically triggers ongoing prosthetic and rehabilitation needs.
• Severe burns: Beyond acute treatment, burns often require reconstructive surgery. They can leave significant disfigurement, another threshold category.
• Complex or multiple fractures: Fractures are a listed threshold category, and severe ones can require multiple surgeries and extended physical therapy.
• Severe soft-tissue injuries: These can meet the threshold when they produce a permanent or significant functional limitation supported by objective medical evidence. But proving permanence is harder here than with the categories above.

The common thread is that rehabilitation and long-term care claims skew toward the most serious injuries. That is good news for meeting the threshold. It also means insurers fight these claims hardest.

What's Covered: Medical and Rehabilitation Expenses

New York is a no-fault state. After a motor vehicle accident, the first layer of coverage for your medical and rehabilitation bills comes from your own auto insurance policy. That holds regardless of who caused the crash. This is called "basic economic loss," and it is capped at $50,000 per person under Insurance Law § 5102(a). (NY Insurance Law § 5102)

Within that $50,000, no-fault pays for reasonable and necessary medical care. That includes hospital stays, doctor visits, physical therapy, occupational therapy, speech therapy, medication, medical equipment, and home healthcare. For someone recovering from a serious injury, those costs add up quickly.

There is an important nuance the original version of this article missed, and it matters. The $50,000 is an aggregate cap. It is a single pool shared across three things. Those are your medical and rehabilitation bills, your lost-wage benefits, and a separate "other expenses" category of up to $25 per day. Every dollar spent on one reduces what is left for the others. So a badly injured person who is also out of work can exhaust the $50,000 far faster than they expect. Both the medical bills and the wage replacement draw from the same account.

Once no-fault is exhausted, the picture changes. If your injury meets the serious injury threshold (discussed below), you can pursue the at-fault party for what no-fault didn't cover. That includes the remaining medical and rehabilitation costs, plus future care. Proving those costs requires solid documentation. That means medical bills and receipts, treatment records, prescriptions and therapy plans, and expert medical opinions establishing that ongoing care is necessary rather than optional.

Home Care and Assisted Living

For injuries that cause lasting disability, day-to-day support is often the largest single cost. Compensation in this category can include home health aide fees, professional caregiver services, and assisted living or nursing facility charges. It can also cover medical equipment and home modifications such as wheelchair ramps, grab bars, and accessible bathrooms.

These costs are recoverable, but they carry a heavy documentation burden. You generally need medical records plus an expert evaluation. The evaluation has to show that the care is medically necessary, not merely convenient, and that its cost is reasonable. Insurers know this and lean on it.

The most common friction point is the argument that professional care isn't necessary because a family member could provide it instead. Insurers routinely dispute whether a paid aide is required when a spouse, adult child, or parent is available. Overcoming that argument usually takes a physician's or life care planner's opinion. That opinion explains why professional, trained care is medically appropriate for the injury in question.

Lost Wages and Loss of Earning Capacity

If your injury keeps you from working, no-fault provides wage replacement, but on limited terms. It pays 80% of your gross lost earnings, capped at $2,000 per month. That runs for up to three years after the accident or until the $50,000 aggregate is exhausted, whichever comes first. Remember that this wage benefit draws from the same $50,000 pool as your medical care, so heavy medical spending shortens how long wage benefits last.

For someone with a serious, long-term injury, those limits fall well short of the real financial loss. Beyond no-fault, an injured person who meets the threshold can pursue the at-fault party for the full value of lost earnings. They can also pursue loss of earning capacity, which is the reduced ability to earn a living over a lifetime because of a permanent impairment. These claims are also coordinated with any Social Security Disability or workers' compensation benefits the person receives.

Proving a lifetime earning loss isn't done with pay stubs alone. Attorneys typically retain a vocational expert to assess how the injury limits the kind of work the person can still do. They also retain a forensic economist to project the dollar value of that limitation over the person's remaining working years. Those same experts play a central role in calculating future care costs, which we turn to below.

Pain and Suffering — Updated for New York's 2026 Law Change

Pain and suffering is compensation for non-economic harm. That means the physical pain, emotional distress, and loss of enjoyment of life that come with a serious injury and the long rehabilitation that follows. For someone spending months or years regaining function, this is often the largest component of a claim.

Two rules govern whether you can recover it. First, no-fault does not cover pain and suffering. You can recover it only through a lawsuit against the at-fault party. Second, in a motor vehicle case you face a further limit. You can bring that lawsuit for non-economic damages only if your injury meets New York's "serious injury" threshold under Insurance Law § 5104. (NY Insurance Law § 5104)

Here is where the law recently changed, and it is the single most important update in this article. As of a 2026 amendment to New York law, effective May 26, 2026, the serious injury threshold no longer includes the old "90 out of 180 days" temporary-disability category. For years, an injured person could satisfy the threshold another way. They could show they were substantially unable to perform their usual daily activities for at least 90 of the 180 days following the accident. That path has been eliminated for lawsuits commenced on or after that date. (Rivkin Radler — NY's New Motor Vehicle Accident Amendment; Wilson Elser — New York's 2026 Tort Reform)

Under the current text of Insurance Law § 5102(d), "serious injury" now means one of the following:

• Death
• Dismemberment
• Significant disfigurement
• 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

Every one of these requires objective medical evidence of a permanent injury or a significant functional limitation. The temporary-injury option is gone.

For people with rehabilitation and long-term care claims, this cuts both ways. On one hand, the injuries that drive these claims tend to fit the remaining permanent-and-significant categories comfortably. Think spinal cord damage, TBI, amputation, and severe fractures. On the other hand, the change raises the stakes on proof. It is no longer enough to show that treatment dragged on for weeks or months. You now have to document, with objective medical evidence, that the impairment is permanent or significantly limiting. Showing that recovery took a long time is not enough. Thorough documentation of lasting impairment, starting from day one, matters more than it ever has.

Award size, when the threshold is met, turns on several factors. Those include severity, the duration and intensity of rehabilitation, and the injury's impact on daily life. The quality of the medical and expert documentation supporting all of it matters too.

Future Care Costs and the Life Care Plan

For a catastrophic injury, most of the true cost lies in the future. That means years of therapy, equipment that wears out and must be replaced, home health aides, medication, and periodic surgeries. New York law allows recovery of these future costs, but they have to be projected and proven, not guessed at. That is the job of a life care plan.

A life care planner is often a nurse or rehabilitation specialist. They review the injured person's medical condition and build a detailed, itemized projection of every future need. That covers ongoing physical and occupational therapy, home health aide hours, replacement schedules for wheelchairs and prosthetics, home modifications, and lifetime medication. The plan is grounded in the treating physicians' prognoses, so it reflects that specific person's condition rather than a generic estimate.

A forensic economist then converts the life care plan into a single present-value dollar figure. This involves applying inflation assumptions, often a separate and higher rate for medical costs, which historically rise faster than general inflation. The economist then discounts the future stream back to today's dollars. The result is a defensible number a jury or an insurer can evaluate. Where the injury also reduces earning capacity, the vocational expert's analysis from the lost-wages section feeds into this same lifetime projection.

There is a New York-specific rule that surprises many people expecting a single large check, and it belongs in any honest explanation of future-care recoveries. Under CPLR Article 50-B, if a personal injury judgment awards more than $250,000 in future damages, that portion is generally not paid as a lump sum. Instead the court converts it into a structured, periodic judgment. That is an annuity-style schedule of payments, with a statutory escalation, funded to deliver the future care over time rather than all at once. (CPLR § 5041) This doesn't reduce the value of the award, but it changes the form it takes. It matters for anyone planning around a large future-care recovery.

The stakes in these cases are real. In one matter our firm handled, a construction worker fell 12 feet off a ladder and suffered neck, back, elbow, and shoulder injuries requiring neck and back surgery. He recovered $3,375,000. In another, an 83-year-old pedestrian was struck by a vehicle and left with multiple fractures, the kind of elderly injury that often means home care or assisted living. That client recovered $1,200,000. Both fact patterns turn on exactly the extended-rehabilitation and future-care questions this article addresses.

Prior results do not guarantee a similar outcome.

Filing a Claim for Rehabilitation and Long-Term Care Compensation

The practical path to recovering these costs follows a fairly consistent sequence:

1. Get medical treatment and report the injury. Prompt, documented care is both good for your health and the foundation of your claim.
2. Notify your no-fault insurer promptly. New York's no-fault rules impose short filing deadlines. You generally must submit the initial application within 30 days of the accident, so don't delay.
3. Understand what no-fault covers, and where it stops. Track your medical bills and wage losses against the $50,000 aggregate so you know when you're approaching the cap.
4. File a lawsuit if your injury meets the serious injury threshold. This is how you reach compensation no-fault won't pay: pain and suffering, future care beyond the cap, and full earning-capacity losses.
5. Work with the right experts. Life care planners, forensic economists, vocational experts, and treating physicians build the proof for future and non-economic damages.
6. Mind the deadline. Most personal injury lawsuits in New York must be filed within three years of the accident under CPLR § 214. (CPLR § 214) Claims against a municipality (a city bus, for example) have much shorter deadlines.

Common Challenges in These Claims

Rehabilitation and long-term care cases are among the most contested claims there are. The recurring sticking points include:

• Proving the need for long-term care. Insurers demand objective medical evidence that ongoing care is necessary, not just that the person would benefit from it.
• Estimating future costs. Projecting decades of care invites disputes over the life care plan's assumptions and the economist's inflation and discount rates.
• No-fault's limits. The $50,000 aggregate cap is quickly outpaced by a serious injury, forcing the case toward litigation to recover the rest.
• Meeting the serious injury threshold. After the 2026 change, this now requires objective proof of a permanent or significant limitation. The temporary-disability shortcut is gone.
• Documentation gaps. Delays in treatment or thin medical records give insurers room to argue the injury isn't as serious, or as lasting, as claimed.
• Disputes over home-care necessity. As noted earlier, insurers frequently argue family could provide care that the injured person actually needs from trained professionals.

New York City Context

New York City doesn't have its own injury-compensation laws. The no-fault system and the serious injury threshold are New York State law, applied the same way in the Bronx as in Buffalo. What sets the city apart is cost. Medical care, rehabilitation, home health services, and daily living all cost more in NYC. That makes these claims larger and more heavily contested than in lower-cost parts of the state. A life care plan built around Manhattan or Queens healthcare rates produces bigger numbers, and insurers scrutinize them accordingly. The law is the same; the stakes are higher.

Sources & Official Resources

New York Laws Cited

1. NY Insurance Law § 5102 — Definitions (Basic Economic Loss & Serious Injury)
2. NY Insurance Law § 5104 — Right of Recovery for Non-Economic Loss
3. CPLR § 5041 — Article 50-B, Structured Judgments for Future Damages
4. CPLR § 214 — Statute of Limitations for Personal Injury Actions

No-Fault Filing Requirements 5. NYS Department of Financial Services — No-Fault Insurance FAQs

2026 Tort Reform (Serious Injury Threshold Amendment) 6. New York State Senate — 2026-2027 Budget Bill S9008-C (Part EE)

Helpful Resources 7. NYS Courts — Civil Court Self-Help, Personal Injury

Contact The Orlow Firm

Are you or a loved one facing extended rehabilitation or long-term care after a serious injury? The 2026 changes to New York's serious injury threshold make it more important than ever to document the permanence of your condition from day one. Understanding what you can recover, and building the medical and expert proof to support it, is where a full recovery is won or lost.

The Orlow Firm has helped seriously injured people and their families throughout Queens and New York City for over 40 years. We handle exactly these high-stakes catastrophic injury and long-term care claims.

Call (646) 647-3398 for a free consultation. We work on contingency — you pay nothing unless we win.

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This article provides general information and is not legal advice. Every case is different. Contact an attorney to discuss your specific situation.