2012 /2013 PIP LAW
Initial Services and Care
In order to receive Personal Injury Protection (PIP) benefits, an injured person
MUST seek initial services and care
within 14 days
of the motor vehicle accident. Initial services and care may be provided
by, supervised, ordered
OR prescribed by: MD, DO, Dentist, Chiropractor, or provided in a hospital,
provided by a facility that owns/is owned by a hospital, Ambulance/EMTs
Failing to seek treatment within 14 days will result in a complete forfeiture
of a patient's PIP benefits.
Follow Up Services and Care
May be obtained upon a referral from any of the 7 providers (listed above)
of initial services and care
Treatment MUST be "consistent with the underlying medical diagnosis
It is anticipated that there will be a lot of litigation regarding "underlying
medical diagnosis" and "care consistent with" this diagnosis.
May be provided by, supervised, ordered OR prescribed ONLY by: MD/DO/Dentist/Chiropractor,
A Physician's Assistant (PA) or an Advanced Registered Nurse Practitioner
(ARNP) working under MD/DO/Dentist/Chiropractor
, a hospital/ambulatory surgical center, an entity wholly owned by MD/DO/Dentist/Chiropractor
and their spouse/parent/child/sibling, an entity that owns/ is owned by
a hospital, a Physical Therapist (PT)
IF the referral is made to the PT by MD/DO/Dentist/Chiropractor, or a Certified
Health Care Clinic
The patient will be eligible for
$10,000.00 if an MD/DO/PA/ARNP has determined that the injured person had an
Emergency Medical Condition (EMC).
The patient will be eligible for a maximum of
$2500.00 if any of the providers who rendered initial care or follow up care determines
that the injured person did not have an
Emergency Medical Condition.
Emergency Medical Condition Defined (Fla. Stat. 627.732(16)
"Emergency medical condition" means a medical condition manifesting
itself by acute symptoms of sufficient severity, which may include severe
pain, such that the absence of immediate medical attention could reasonably
be expected to result in any of the following:
(a) Serious jeopardy to patient health.
(b) Serious impairment to bodily functions.
(c) Serious dysfunction of any bodily organ or part.
According to the Statute, a Chiropractor
determine if an Emergency Medical Condition exists, but
determine that an Emergency Medical Condition
The Statute does not say where in the course of treatment the EMC must
be determined. It does not reference whether EMC is established in either
the initial care or follow up care, nor does it say that an initial treating
provider or follow up provider must be the one to determine that an EMC existed.