Soft tissue injuries are the most common result of a car accident and the most aggressively disputed. There is no fracture on the X-ray and no bleeding on the CT scan, so the insurance company treats the claim as exaggerated by default.
That posture ignores what these injuries actually do to people. Muscles, tendons, ligaments, and nerves hold the body together, and when they are torn or inflamed, the result can be months of pain, permanent range of motion loss, and an inability to do work you have done for twenty years.
What Counts as a Soft Tissue Injury
Whiplash is the classic example. A rear-end impact snaps the head forward and back, straining the cervical muscles and ligaments beyond their normal range. Symptoms often do not appear for 24 to 72 hours: neck stiffness, headaches originating at the base of the skull, shoulder pain, dizziness, and difficulty concentrating.
Sprains and strains involve stretched or torn ligaments and muscles or tendons respectively. In the spine these are covered further on our back sprains and strains page.
Tears of the rotator cuff, meniscus, ACL, or labrum are soft tissue injuries that frequently require surgery. These are not minor, and the fact that they fall under the same general heading as a mild strain is one reason the category gets dismissed unfairly.
Contusions and myofascial injury produce deep bruising and persistent muscular pain that can outlast the visible signs by months.
Why Insurers Fight These Claims
Adjusters apply a predictable set of arguments.
“The imaging is normal.” Standard X-rays show bone. They are not designed to show ligament or muscle damage. MRI is better but does not capture everything, and a normal study does not mean nothing was injured.
“Minor impact, minor injury.” Property damage photographs get used as a proxy for human injury. Modern bumpers are designed to absorb energy and resist visible deformation, and the correlation between vehicle damage and occupant injury is weaker than insurers suggest.
“You waited to treat.” A delay between the accident and the first medical visit is the most damaging gap in a soft tissue case, precisely because these symptoms emerge late. Getting evaluated within days protects both your health and your claim.
“You stopped treating.” Gaps in care get characterized as recovery. If you paused treatment because of cost, childcare, or work, that reason belongs in the record.
“It was preexisting.” Prior injuries and degenerative findings get raised, though New York permits recovery for aggravation of a preexisting condition.
The documentation described in what evidence you need for a personal injury claim is what defeats these arguments.
The New York Threshold Problem
This is where soft tissue claims face their hardest obstacle. In a motor vehicle case, you cannot recover for pain and suffering unless your injury qualifies as a serious injury under Insurance Law § 5102(d). Fractures qualify automatically. A cervical strain does not.
Soft tissue claimants generally must proceed under the permanent consequential limitation or significant limitation categories, which require objective medical findings, not just reported pain. Quantified range of motion measurements, positive orthopedic testing, and a physician’s opinion on permanence become essential.
This got harder in 2026. The Legislature deleted the category covering a medically determined non-permanent injury preventing substantially all usual daily activities for 90 of the 180 days after the accident. That provision was the primary pathway for soft tissue claimants with significant but recovering injuries. Its removal means proving permanence or significant limitation is now the only route. Our guide to how pain and suffering is calculated in New York explains the surviving categories.
Note that No-Fault benefits still cover medical treatment and lost wages regardless of the threshold. The threshold governs only the lawsuit for pain and suffering.
What Protects a Soft Tissue Claim
Get evaluated promptly, even if you feel functional. Describe every symptom at every visit, including the ones that seem minor, because symptoms omitted from the record effectively did not happen. Follow the treatment plan and document any reason you cannot. Keep your own notes on what you can no longer do at work and at home.
And expect the insurer to look for reasons to devalue the claim, as our page on dealing with insurance companies describes.
Talk to a New York Personal Injury Attorney
Soft tissue cases turn on medical proof and credibility, both of which are built from the first appointment forward. Buttafuoco & Associates has handled these claims across New York since 1981. If you were hurt in a crash, speak with our New York car accident lawyer today. Contact us for a free case review. You owe no attorney’s fee unless we recover for you.