Q: Is my child covered?
A: If your physician is a participating physician, your child may be eligible for NICA benefits. Expecting parents should ask their physician for a NICA brochure. Florida law defines the birth-related neurological injuries for which NICA coverage is provided, and the final decision on whether a child is covered is made by an Administrative Law Judge. Pease use the link provided on this website to review Sections
766.301-766.316, Florida Statutes.
Q: How do I know if my obstetrician is a participating physician?
A: Generally, all participating physicians and hospitals are required by law to inform obstetrical patients by providing a brochure which explains the program. You can see a list of current
participating physicians on this website. Information for earlier years is available from NICA.
Q: Do we have to consult a lawyer?
A: Consulting a lawyer is a personal decision, which we encourage you to make only after a thorough review of your individual circumstances. You are not required to have a lawyer to file a claim for benefits. NICA will provide the form and help you fill it out and file it with the Division of Administrative Hearings. You may fill out the petition on-line on this website and print it out, or just print a copy and fill it out. The completed form must be filed with the Division of Administrative Hearings. If you need assistance filling it out, contact NICA for further information at 1-800-398-2129 or
contact us on this website.
Q: How much does it cost to file a petition for benefits?
A: There is a $15 filing fee, payable to the Florida Division of Administrative Hearings.
Q: What about medical records?
A: Although the petition is filed with the Division of Administrative Hearings, the Medical records must be filed with NICA. It is the parent's responsibility to provide them. You may obtain these records from the hospital where the child was born and from your physician. Records for both the mother and the child must be sent to the NICA. When preparing records for submittal, be sure to ask for and include Fetal Heart Monitor records. Again, you may contact NICA for assistance and further information at 1-800-398-2129.
Q: Will the doctor know that I have filed a NICA petition?
A: Yes. When the Division of Administrative Hearings receives a petition, copies are mailed to NICA, to the Agency for Health Care Administration-Consumer Services Unit, to the Department of Financial Services, to the hospital where the child was born, and to the physician who is named in the petition.
Q: How does being accepted by NICA help me?
A: NICA provides assistance with medical care, co-pays, equipment, therapy, nursing care, medications, handicap modifications, transportation, and supplies that are medically necessary and are not covered by another source, such as insurance or Medicaid. This coverage continues throughout the child's lifetime and depending on the child's circumstances, may provide services not available through other sources. For children who require diapers and/or baby food after age two, NICA will provide these supplies.
Q: Is there a time limit on filing a claim?
A: Yes. The petition must be filed by the child's fifth birthday.
Q: Who can file a petition?
A: The child's legal parent or guardian must file the petition.
Q: How do I file a claim?
A: Choose the form on this website which fits your situation, fill it out on line and print it, or print it out and fill it in. If you have difficulty understanding the form or need assistance, contact NICA at the toll free number, (800) 398-2129, and we will assist you in completing a petition. Once the petition is completed and signed it should be forwarded to:
Ann Cole
Division of Administrative Hearings
1230 Apalachee Parkway
Tallahassee, Florida 32399-3060
A $15.00 filing fee, payable to: Division of Administrative Hearings, is due with the petition. Remember to send copies of medical records for both the mother and child to NICA. It is very important that you ensure the fetal monitor strips are included in the medical records. Call NICA if you need assistance at 1-800-398-2129.
Q: Who decides if a child qualifies for NICA?
A: All petitions are filed with the Division of Administrative Hearings. An Administrative Law Judge (ALJ) at the Division of Administrative Hearings has sole authority to determine whether a child qualifies for the Plan. The ALJ issues an order finding that the claim is compensable.
Q: If my child does not qualify for NICA is there anywhere else I can get help?
A: Please see our
Helpful Resources page. We have listed many sources of information and assistance, and there may be others that we have not listed.
