A trial judge's misapprehension of medical evidence in multiple material respects, even where each individual error might be explained away, can cumulatively vitiate a serious injury determination by specific error. An applicant's stoicism and continued capacity to work should not count against them in assessing whether pain and suffering consequences meet the statutory threshold of seriousness. Constant pain requiring daily analgesic medication that has not responded to conservative treatment and has reached the point where surgery is warranted, combined with material inhibition of daily activities, is capable of meeting the 'more than significant or marked and at least very considerable' threshold.
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