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What Is Considered an Emergency Medical Condition?

If you have been in an accident in the Sun City Center area, and your injuries are severe enough that the lack of immediate medical care could put your well-being in jeopardy, you may have what is designated as an “Emergency Medical Condition,” or EMC. 

But how do you know if you have an EMC? That’s what we’re here for!

Learn what could be considered an Emergency Medical Condition from our medical team at Impact Medical Sun City Center.

What is an Emergency Medical Condition?

People who are diagnosed with an emergency medical condition (EMC) have injuries that are caused by acute symptoms of “sufficient severity” and if they don’t receive immediate medical treatment, their injuries could result in impairment, serious health complications, or loss of bodily function.

An EMC must:

  • Pose a serious threat to a patient’s health.
  • Possibly cause serious impairment to bodily functions or serious dysfunction of a body organ or part.

Situations where an EMC may be declared, include:

  • Bleeding that won’t stop
  • Severe difficulty breathing
  • Change in mental status
  • Unconsciousness
  • Coughing or vomiting blood
  • Head or spine injury
  • Deep or large wounds
  • Severe injuries
  • Smoke inhalation
  • Seizures
  • Severe burns
  • Severe abdominal pain

Who Can Determine an EMC?

This EMC designation is determined at the discretion of the medical provider who treats the individual following an accident. Only doctors, dentists, physician’s assistants, and registered nurse practitioners can determine if a patient has an EMC.

To make things more complicated, there isn’t an EMC form that your physician can fill out and present to your insurance company. Instead, your medical record must state that you suffered an EMC as the result of a car accident if you plan to seek compensation for your injuries.

How Does an EMC Affect Insurance Compensation?

When you are involved in a car accident in the state of Florida, regardless of fault, your Personal Injury Protection (PIP) benefits will pay for your initial medical bills, but you are required to receive treatment within 14 days of your accident.

Your insurance company will pay 80% of your initial medical bills up to the limits stated in your policy. If your doctor determines that you have an Emergency Medical Condition, you will be entitled to up to $10,000 in PIP benefits. Otherwise, your benefits are limited to $2,500.

If your doctor does not believe that the person’s injuries are an EMC, then the individual will only be eligible for $2,500 in PIP benefits.

Why Does PIP have a 14-Day Rule?

Florida’s 14-day PIP rule exists for two reasons. First, waiting to get medical attention could make injuries worse. The sooner you receive care, the sooner you can prevent complications and minimize your injuries.

Second, proving that the accident was the cause of your injuries is critical to making an insurance claim. When you receive medical care right away, the link between your injuries and the car accident is clear and can be documented to ensure easier settlements.

The 14-day rule exists to help accident victims get the treatment that they deserve while ensuring that accident claims are accurate and valid.

How Should a Doctor Report an EMC?

The bare minimum that is required by law, is for a doctor to state in their medical report that a patient “had/has an emergency medical condition.”

A treating medical provider should add the definition of an EMC to their report, but it is not required.

Don’t Wait, Get Treatment Today

If you have been in a car accident, no matter the severity of your injuries, you should seek medical care immediately to ensure that you are entitled to your insurance benefits under Florida Law.

Our compassionate team of doctors, chiropractors, and physical therapists are here to help you heal and move forward from injuries.

The road to recovery starts here. Call Impact Sun City Center today; (813) 938-5195!