What is an NICA Claim and What are the Requirements to Recover Needed Care?

The “Florida Birth-Related Neurological Injury Compensation Act” is a law passed by the Florida Legislature in 1988. “NICA” refers to the “Neurological Injury Compensation Act,” and sometimes to the “Neurological Injury Compensation Association,” which is the agency created to administer the NICA program.

Purpose of NICA

Originally the purpose of NICA programs was not to provide benefits to families with injured children. Rather, it was intended to protect obstetricians and hospitals from liability for causing significant injuries to newborn babies as a result of negligence during labor and delivery. The statute grants all of these healthcare providers immunity from being sued in certain situations, and instead, replaces the family’s right to file a medical malpractice lawsuit with the right to recover compensation from the NICA program.

NICA Benefits

In order to recover NICA benefits the family must file an administrative claim for the benefits with the Florida Department of Administrative Hearings. They must be able to prove that the injuries occurred at (or very near) the time of birth. Families do not have to prove that the injuries were caused by the negligence of the obstetrician or any other health provider.

Requirements for NICA Benefits

To benefit from coverages of the NICA plan, each of these requirements must be met:

1) An obstetrician who attended the delivery must be a member of NICA at the time of the delivery;
2) The baby must be born alive and in a hospital;
3) The baby weighed at least 2500 grams at birth, i.e. about 5.5 pounds, at birth (2000 grams for multiple gestations);
4) The baby suffered an injury to the brain or spinal cord caused by oxygen deprivation or mechanical injury;
5) The injury occurred either during labor, delivery, or during resuscitation right after birth; and
6) The baby’s injury must include severe and permanent physical AND mental impairments (or death).

A NICA claim may enable you to recover lifetime “medically necessary and reasonable medical and hospital, rehabilitative and training, family residential or custodial care, professional residential, and custodial care and service, for medically necessary drugs, special equipment, and facilities, and for related travel.”

“Family residential or custodial care” is any treatment rendered by trained professional attendants beyond the scope of child care duties, but which is provided by family members. Family members who provide nonprofessional residential or custodial care may not be compensated under this act for care that falls within the scope of childcare duties and other services normally and gratuitously provided by family members. Family residential or custodial care shall be performed only at the direction and control of a physician when such care is medically necessary.

Is there a statute of limitations on NICA claims?

There is a special statute of limitations placed on NICA claims that allow claims to be filed within five years of the child’s birth. If the parents were to file a medical malpractice suit, the statute of limitations for filing is much more complicated. It can range from two years to eight years after the date of birth depending on the unique circumstances. If you believe that your child was injured during or before birth as the result of a surgery, medication, or other medical treatment, the injury may be the product of medical malpractice. What is the next step?

Hire a Medical Malpractice Attorney

You need to speak with a medical malpractice attorney that has experience in dealing with birth injury claims who can make sure you receive all the benefits and compensation you are entitled to. You need experienced and aggressive attorneys like Dan Newlin Injury Attorneys to ensure that you get everything that you are entitled to. Call us at 800-257-1822. We take pride in offering free consultation and we do not get paid unless we win your case!