What Parents Need To Know About NICA Compensation After A Birth Injury

OB/GYNs and other physicians involved with pregnancy and birth are hit with some of the highest rates of medical malpractice claims in all of medicine. To ease the financial burden on health care providers and the insurers that provide them with malpractice coverage, lawmakers enacted the Florida Birth-Related Neurological Injury Compensation Plan in 1988. The statute provides an alternative compensation program for parents when an infant suffers certain types of birth injuries, so they can obtain necessary funds to support their disabled child.

Unfortunately, in their effort to protect obstetricians, lawmakers put the parents of children with disabilities in an extremely difficult position. They must work with administrators at the Neurological Injury Compensation Association (NICA) to fulfill these financial needs, and the challenges can be overwhelming. A Miami birth injury lawyer can explain the relevant issues in more detail, but some important information should also be useful.

Overview of NICA and the Law 

When an infant is born with a serious, permanent disability because of malpractice, parents may qualify to bring a birth injury claim against the negligent health care provider. However, when legal action is unavailable or impractical, NICA offers another option. The plan pays for all costs associated with medically necessary and reasonable health care services, including:

• Surgery
• Physical therapy
• Specialized care, either through at-home care or in an assisted living facility
• Assistive devices, such as wheelchairs, hospital bed, and adaptive equipment

Note that the plan does NOT cover expenses that are typically covered by health insurance or public benefits. Plus, you cannot recover amounts for pain and suffering, emotional distress, and other non-economic damages.

Eligibility for NICA 

To qualify, your child must have been born alive; NICA does not apply to fatal birth injury claims. Additional requirements for the program include:

• The infant must have weighed more than a specified minimum threshold at birth
• Only brain trauma and spinal cord injuries caused by oxygen deprivation or mechanical injury are covered
• The delivery must have been conducted by a physician in a hospital
• The child suffers from permanent, substantial impairment, physically and mentally

NICA Controversy 

As a program primarily focused on protecting doctors and insurers, there are substantial pitfalls for parents of disabled children. Before recent changes to NICA, the vast majority of plan administrators had backgrounds in health care and the insurance industry. Even after the overhaul, parents have numerous complaints about NICA representatives’ lack of personal experience in dealing with the needs of the disabled. Many also state that they are treated as liars and fraudsters when seeking reimbursement. 

Consult with a Florida Birth Injuries Attorney to Learn More 

Parents are right to be concerned about dealing with exclusive remedies and NICA administrators when all they want is to support their disabled child. For more information on this compensation plan and other legal remedies for birth injuries, please contact Freidin Brown, P.A. in Miami or Fort Myers, FL. We can schedule a no-cost consultation to assess your situation and advise you on the applicable laws.

Resource:

leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0766/Sections/0766.303.html