Imaging and Specialist Referrals: Protect the Full $10,000 PIP Benefit After a Car Accident

The initial examination, with orthopedic and neurological testing and range-of-motion measurements, decides what leaves the office. Point tenderness over bone, a limb that will not bear weight, weakness, a lost reflex, or spreading symptoms each trigger an order. X-ray answers the fracture question. MRI shows the disc and the nerve. CT is used where bone detail matters. The order goes to an outside imaging center, and the report comes back into your file.

A disc herniation that is not responding, a nerve injury with weakness, a joint that may need surgery, or a head injury goes to the outside provider best placed to manage it: an orthopedic surgeon, a neurologist, a pain management specialist, or the emergency department.

Florida is a no-fault state. Personal Injury Protection pays 80% of reasonable medical expenses up to $10,000 with initial treatment within 14 days of the crash, and only $2,500 without an emergency medical condition determination. Under section 627.736, Florida Statutes, an EMC is determined only by an MD, DO, PA or APRN. A chiropractor is not on that list. This office does not make EMC determinations; it refers patients out for them.

That referral is how the full benefit is protected. If the examination shows an injury that fits the EMC definition, Dr. McNamara-Krauss refers you to a qualified outside provider, and that finding goes into your file. Without it, your treatment here and anywhere else is capped at $2,500 of PIP. With it, the $10,000 limit applies. See PIP and EMC for attorneys and the 14-day rule. This is general information, not legal advice.

When imaging is ordered, you leave with the order and the name of an outpatient imaging center, and the report is sent to us. Treatment that does not depend on the result, such as laser on an area with no red flags, often starts the same visit. Treatment that does, such as decompression over a suspected herniation, waits for the report.

For an EMC referral, you see the outside provider for an examination and their determination is returned to us. For a specialist referral, that provider takes over the part of your care in their scope, and Dr. McNamara-Krauss continues the chiropractic plan around it. We do not promise a timeline for outside providers.

Some injuries do not wait for an office referral. Dr. Carol McNamara-Krauss is a Florida-licensed chiropractic physician (DC), license CH5281. She refers, and does not treat, head injuries and concussion. If you hit your head, lost consciousness, or have confusion, vomiting, a worsening headache, chest pain, new bowel or bladder changes, or spreading numbness, go to an emergency department first.

The nearest emergency departments are Broward Health North on Sample Road in Deerfield Beach and Broward Health Imperial Point in Fort Lauderdale. Delray Medical Center is the trauma center to the north. Bring your discharge papers to your first visit here.