This is a lawyer blog but nonetheless this is a common question that I receive at the law firm.
There are many options as it comes to treatment for back pain stemming from a car accident. While this is primarily a medical question, there are some legal issues that come into play under Florida law.
First, generally in a car accident, the primary insurance is your PIP insurance. PIP pays 80 percent of the medical bills (although generally they are reduced to a fee schedule that is tied to medicare rates) up to $10,000. Unlike other insurance, doctors generally do not have contracts with PIP automobile insurance companies. Thus, essentially you can go to any doctor that you would like. The only exception to this is that under a recent law change that kicked in on January 1, 2013, PIP insurers do not have to pay for acupuncture treatment (some argue this is unconstitutional and that issue has yet to be heard in the courts).
The most common treatment that i see individuals go to following a car accident are:
1) Hospital – many people start at the hospital where they can get x-rays and many other tests such as CT scans, MRIs and so forth. Obviously the hospital is suited to handle the most catastrophic accident to the most basic back problem. Further, the hospital may offer referral to specialists based on your injury and pain level.
2) Urgent Medical Centers – there is a moving trend towards Urgent Medical Centers, for non-catastrophic injuries. Again, there are many tests available there like x-rays. Some of these urgent medical centers will treat back problems and offer physical therapy afterwords, for example.
3) Primary Care Doctor/Internist – this is a common choice amongst people with health insurance. The primary care doctor can refer out for x-rays and refer the injured person to specialists, for physical therapy, and even for diagnostic tests like MRIs.
4) Chiropractors – this is likely the most common choice that I see here at the law firm. Chiropractors specialize in spinal injuries, so back problems are something these doctors see regularly. Further, chiropractors seem to be more “user friendly” offering better office hours than most medical doctors. Chiropractors are not medical doctors and are not allowed to write prescriptions for medications in Florida. Chiropractic is a more holistic medical approach, which may people prefer. Much but not all of the physical therapy offered at a medical doctors office or a physical therapy office is offered at a chiropractor.
5) Orthopedic surgeons/doctors – generally, orthopedic doctors specialize in bones, muscles and joints. Many of these doctors are sports type orthopedics which specialize in extremities, like knees and shoulders. There are some that focus on spinal problems, orthopedic spine surgeons. Many of these office offer physical therapy or they can refer clients our for physical therapy. Certainly someone with a more advanced spinal injury would be a good fit for a orthopedic, spine specialist. Many clients get referred to orthopedic doctors after they have seen other doctors, like chiropractors or primary care doctors.
6) Neurosurgeons – generally, these doctors focus on brain and spine injuries requiring surgery, and usually it is one or the other. Neurosurgeons who focus on spinal problems again are common for people with more advanced/complicated spinal problems, that are not resolvable by more conservative means like physical therapy.
7) Pain Specialist doctors – these doctors commonly are anesthesiologists who later focus on chronic pain problems including back and neck problems. The offer a variety of treatment, usually that are less intrusive than spinal surgery but more advanced than chiropractic or physical therapy. Such treatments and procedures include spinal injections, cortisone injections, epidural injections under Fluoroscope and various other procedures.
8) Physiatrist – these doctors are rehabilitation doctors that offer various types of therapy and rehabilitation. They handle the most complex spinal injuries to more basic physical therapy.
9) Neurologist – these doctors are trained in neurological disorders, including brain, spine and peripheral nerves; thus. lower back injuries are within their expertise.
10) Acupuncturist – these practitioners penetrate the skin with needles to stimulate certain points on the body. Interestingly, under a 2013 Florida law, automobile insurers do not have to pay for acupuncture treatment (although I expect this law to be challenged on constitutionality). Nonetheless, this is a treatment course that some clients prefer.
11) Physical therapy – these are health care providers that offer various therapy modalities to help with all types of injuries, including back injuries. Sometimes, the physical therapist works at the doctor’s office and other times the physical therapist works for a physical therapy office and you take the prescription from the doctor and have the therapy outside of the doctor’s office.
The above represents the most common types of doctors and treatments that clients with back problems go to. It is helpful to do your own research based on symptoms and to discuss any referrals with your primary care doctor.
