I waited to see a doctor after my accident. Do I still have a claim?

Do I still have a claim if I waited to see a doctor?

You may still have a claim, but waiting can affect PIP (personal injury protection) medical benefits, which need initial care from a listed provider within 14 days after the crash. In a claim against the other driver, jurors are told to decide: was that driver negligent and, if so, was that negligence a legal cause of your injury?

The 14-day words in Florida's PIP law are about PIP medical benefits, not the questions of negligence (careless conduct) and legal cause that jurors are told to decide in a claim against the other driver. No one can promise how a delay will be weighed, but a lawyer can go over your dates and records with you.

For PIP medical benefits, initial care counts only if it is lawfully provided, supervised, ordered or prescribed by one of these providers, or provided in one of these places:

• A medical or osteopathic physician (licensed under chapter 458 or 459)
• A dentist
• A chiropractic physician
• An advanced practice registered nurse (APRN) registered under section 464.0123
• A hospital, or a facility that owns, or is wholly owned by, a hospital

A licensed provider of emergency transportation and treatment may also provide initial care.

For more on crash claims, see car accident lawyers in Melbourne.

What does Florida law say about a gap in treatment?

The PIP 14-day rule: section 627.736

The 14-day rule is in section 627.736, Florida Statutes, paragraph (1)(a), which covers PIP medical benefits. It pays those benefits "if the individual receives initial services and care pursuant to subparagraph 1. within 14 days after the motor vehicle accident." Subparagraph 1 is the list of initial care providers shown above. For the full 14-day rule, see I feel fine after a car accident. Do I still need to see a doctor, and how soon?

The same paragraph pays for follow-up care only "Upon referral by a provider described in subparagraph 1." (one of the initial care provider types listed above) and only if it is "consistent with the underlying medical diagnosis" from that initial care. All of this still depends on getting initial care within 14 days after the crash from a listed provider type.

What jurors are told to decide

Florida's standard civil jury instructions are the instructions Florida judges read to jurors. The Florida Bar publishes them, and they are not a statute. In a negligence claim, jurors are told the issues are whether the defendant (the person being sued) was negligent and, if so, whether that negligence was a legal cause of the loss, injury or damage to the injured person.

Jurors are told that negligence is a legal cause of loss, injury or damage if it "directly and in natural and continuous sequence produces or contributes substantially to producing" it, "so that it can reasonably be said that, but for the negligence," the loss, injury or damage "would not have occurred." Put simply, jurors are told to ask whether the negligence, directly and in natural and continuous sequence, produced the injury or contributed substantially to producing it, so that it can reasonably be said the injury would not have happened without it.

Jurors are also told that if the greater weight of the evidence does not support the injured person's claim, the verdict should be for the defendant, and that "greater weight of the evidence" means "the more persuasive and convincing force and effect of the entire evidence in the case."

What you tell your doctor: section 90.803

Section 90.803, Florida Statutes, part of Florida's evidence code, says the hearsay rule does not make certain statements inadmissible (kept out of evidence). Subsection (4) covers statements "made for purposes of medical diagnosis or treatment by a person seeking the diagnosis or treatment" that "describe medical history, past or present symptoms, pain, or sensations," among other things, "insofar as reasonably pertinent to diagnosis or treatment." In plain words, what you tell a provider about your medical history and symptoms to get diagnosed or treated is not kept out by the hearsay rule, so far as it is reasonably pertinent to diagnosis or treatment.

Pain and suffering: section 627.737

Under section 627.737(2), Florida Statutes, in a lawsuit against the owner or driver of a PIP-insured vehicle, damages for pain, suffering, mental anguish and inconvenience are recoverable only if the injury meets the statute's list, which includes a "Permanent injury within a reasonable degree of medical probability," other than scarring or disfigurement. For more, see Can I sue the other driver after a Florida car accident if I have PIP?

What does a delay change, and what stays the same?

Your first visit was late, but within 14 days

Say your first visit to a listed provider type was six days after the crash. PIP medical benefits need initial care within 14 days after the crash from a listed provider type, so that day 6 visit can still meet the condition.

Your first visit came after day 14

Unless a licensed provider of emergency transportation and treatment gave you initial care within 14 days, PIP medical benefits may not be available, because the law ties them to initial care within 14 days after the crash from a listed provider type. For how medical bills get paid, see Who pays my medical bills after a car accident in Florida?

You started care, then stopped for a while

This is a gap in treatment. For PIP, follow-up care is paid only upon referral by an initial care provider and only if it fits the diagnosis from that initial care. For a claim against the other driver, at trial jurors are told to decide legal cause on the greater weight of the entire evidence.

What stays the same

• The questions jurors are told to decide in a claim against the other driver: negligence and, if so, legal cause.
• The pain and suffering threshold in section 627.737(2), explained above.

More questions about late or missed treatment

Will PIP pay if my first doctor visit was after 14 days?

It may not, depending on when and where you first got care. As the law is written, PIP medical benefits pay only if you got initial care from a listed provider type within 14 days after the crash. For the full rule, see I feel fine after a car accident. Do I still need to see a doctor, and how soon?

Does a gap between doctor visits hurt my claim?

No one can promise how a gap will be weighed. For PIP, follow-up care is paid only upon referral by an initial care provider and only if it fits the initial diagnosis. For a claim against the other driver, jurors are told to decide legal cause on the greater weight of the entire evidence.

Can I still sue for pain and suffering if I waited?

You may, depending on your injury. In a lawsuit against the owner or driver of a PIP-insured vehicle, pain and suffering damages are recoverable only if the injury meets the list in section 627.737(2), explained above, such as a "Permanent injury within a reasonable degree of medical probability," other than scarring or disfigurement. For more, see Can I sue the other driver after a Florida car accident if I have PIP?

Will waiting lower what my claim is worth?

This page does not predict what any claim is worth. If a claim goes to trial, jurors are told to decide it on the greater weight of the entire evidence, as explained above. For the factors that go into value, see How much is my personal injury case worth?

What should I do now if I waited to see a doctor?

• Get checked now if you have not been.
• If you are still within 14 days after the crash, initial care from a listed provider type can still meet the condition for PIP medical benefits.
• Tell your provider about the crash and every symptom, past and present, truthfully. What you say about your symptoms to get diagnosed or treated is not kept out by the hearsay rule, so far as it is reasonably pertinent to diagnosis or treatment.
• Get follow-up care on a referral from your initial care provider. PIP medical benefits pay for follow-up care only upon a referral from a listed provider type, and only if it fits your initial diagnosis.
• Keep your records: visit summaries, referrals, bills, receipts and letters from insurers.

For the full list of steps after a crash, see What should I do right after a car accident in Florida?

Your deadline to file a lawsuit

Under section 95.11, Florida Statutes, a lawsuit for an injury caused by negligence must be filed within two years. That two-year rule applies only to claims that arose after the 2023 change took effect on March 24, 2023, and under section 768.28, Florida Statutes, a negligence lawsuit against a Florida state or local government agency must be filed within 4 years after the claim arises, except medical malpractice and wrongful death claims, which follow the deadlines in section 95.11(5). Before you can sue a government agency, a written claim generally must be presented within 3 years after the claim arises (2 years for wrongful death) and then denied, or left without a final decision for the time the law allows. Older claims follow different rules, explained in How long do I have to file a personal injury claim in Florida?

Talk to a Melbourne car accident lawyer

Douglas R. Beam, P.A. is a personal injury law firm in Melbourne, Florida. If you waited to see a doctor and have questions about your claim, you can talk with us in a free consultation.

Call us at (321) 723-6591, or send us a message through our website. Our office is at 25 West New Haven Avenue, Suite C, Melbourne, FL 32901.

Sources

• Section 627.736, Florida Statutes
• Section 627.737, Florida Statutes
• Section 90.803, Florida Statutes
• Section 95.11, Florida Statutes
• Section 768.28, Florida Statutes
• Chapter 2023-15, Laws of Florida
• Florida Standard Jury Instructions in Civil Cases (The Florida Bar)