As I stated in an earlier blog, PIP only pays for services if there was initial treatment within fourteen (14) days of the crash then the following occurs:
1. The filed services are on the referral form of a MD, DO, DC and
2. The filed services are consistent with the underlying medical diagnosis rendered in the initial visit.
Number #2 is extremely important, as I stated earlier, some symptoms of an injury related to car crashes do not manifest themselves on the same day or the day after a crash. For example, the body may tear something as the body continues to use that body part (ie: knee, shoulder, neck or back) and that tear can get bigger and it can take several days or even weeks for the person to realize that this is not a temporary condition and that they need to seek medical help. Thus, medically speaking, many of these conditions don’t even show up for a day or two after the crash due to the fact that there may be other conditions that are temporally more severe. There may be conditions that they consider to be minor compared to some other serious conditions. An example of this is soft tissue swelling, as the tissue swells it becomes more and more painful and normally it takes several days for the swelling to reach its fullest point and as it subsides, scar tissue may build up in any of the damaged areas. This scar tissue buildup takes time and while the injured person may get some temporary relief while the swelling goes down, it could get worse as the scar tissue builds up around the nerves. Thus, the creators of this bill were quite aware of the medical aspects of what happens to people who are injured thus they created this section of the bill as a way to prohibit people from receiving benefits they normally would receive and have received since the early 1970’s.
This section that I’m referring to is section 566 of the Bill which states:
“Upon referral by a provider described in subparagraph 1., follow up services and care consistent with the underlying medical diagnosis rendered pursuant to subparagraph 1, which may be provided, supervised, ordered, or prescribed only by a licensed physician or chiropractic physician.”
To read Part 5 click here.