The Florida Birth-Related Neurological Injury Compensation Plan (“Plan”) is an example
of provisions of Florida law that is working. Known as NICA, the Plan provides a wide range of benefits to a child who has sustained a brain or spinal cord injury caused by oxygen deprivation or mechanical injury during labor, delivery, or in the immediate post-delivery period. See:
Section 766.302(2), Florida Statutes.
Eligibility
Acceptance into the Plan is determined by an Administrative Law Judge after a petition is filed with the Florida Division of Administrative Hearings. Once accepted by an order from the judge, the child is covered for lifetime, and no other compensation from a malpractice lawsuit is available. It is an exclusive compensation plan which is only available if there has not already been a settlement in a lawsuit. Instead, there are lifetime benefits and care available through the Plan.
General Criteria:
- Injury to the spinal cord or brain
- Infant born alive
- Weight at birth must be at least 2500 grams at birth or 2000 grams in the case of multiple gestations
- The injury must have been caused by oxygen deprivation or mechanical injury during labor, delivery or resuscitation immediately after delivery
- Birth must occur in a hospital
- The child must be permanently and substantially mentally and physically impaired
- The Plan does not apply to genetic or congenital abnormalities.
- There must be a participating physician, as defined in s. 766.302(7), Florida Statutes
Benefits
Benefits include actual expenses for:
- Medical
- Hospital
- Rehabilitation/Therapy/Training
- Family residential or custodial care
- Professional residential and custodial care and service
- Drugs
- Special Equipment and facilities
- Related travel expenses
Not covered:
Expenses or reimbursement for items or services received or entitled to be received:
- Under the laws of any state or the Federal Government
- From any prepaid health plan or health maintenance organization
- Under the provisions of any insurance policy or private insurance program
For more details see the
Benefit Handbook.
