What Does The PIP 14-Day Rule Mean For An EMC?

 In PIP Claims & Collections

 14 DAY RULE

The 14 -day treatment rule pertains solely to initial treatment.  A person injured in a car accident must seek medical treatment with 14 days of the motor vehicle crash. Treatment with a walk-in clinic, a hospital, chiropractor, and the like is acceptable.  Document your file to ensure there is record of the actual treatment.  You cannot be certain an insurance carrier has record of treatment despite your timely mailing of the bills. If you have record of the treatment on your billing ledger and a copy of the bill along with treatment notes, you will be one step ahead!

WITH WHOM MAY THE INJURED PARTY TREAT:

  1. Walk-in Clinic, Hospital
  2. MD, DO, PA
  3. Chiropractor

EMERGENCY Medical Condition – EMC

The EMC Statute is a confusing and frustrating piece of legislation.  It is unclear what triggers $10,000.00 of PIP benefits vs. what reduces recovery to $2,500.00 in PIP.  As vague as it is, this much is true, an EMC can be rendered at any point.  The initial treating physician need not opine whether the Claimant suffered from an EMC.  The 14-day rule ONLY has relevance in the world of initial treatment.  EMC’s are fluid and can be rendered at any point a doctor believes the patient suffered from a condition brought on by an accident.

WHO CAN RENDER AN EMC:

  1. MD, DO, PA
  2. Advanced Registered Nurse Practitioner.

ACCORDING TO THE CURRENT STATUTE

  1. A chiropractor CANNOT render an EMC determination.  Benefits would exhaust at $2,500.00.
  2. However, a chiropractor CAN state that a patient has NOT suffered from an emergency medical condition.
    1. If you are scratching your head in disbelief you are in good company.   A challenge to this circular rule has been certified to the appellate courts and a decision has not been rendered at this point in time.  If a chiropractor can render initial treatment, diagnose a patient and the like, why can  he/she not opine as to an EMC condition being present?  This is the by-product of a law enacted one minute prior to resetting it altogether.

LaBovick, LaBovick & Diaz PIP team has years of experience litigating both the old and new PIP statute.  We have innovative litigation strategies to ensure full recovery of all PIP benefits due and owing.  We likewise have  PI and Workers Compensation teams that work closely with us to ensure all parties are reimbursed correctly.  Remember, 14 days solely refers to initial treatment.  EMC determinations can be rendered at any time! Do not get tricked, Call LaBovick, LaBovick & Diaz!

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