Will No-Fault Insurance Pay for My Physical Therapy Costs After a Car Accident in Harrisburg?

After a Harrisburg car crash, some victims may need physical therapy to continue their recovery, but does no-fault insurance pay for this treatment?

If you are unsure if no-fault insurance will cover your physical therapy sessions after a car crash, we encourage you to contact our experienced Harrisburg car accident lawyers. We can answer your questions and explain what medical treatments should be covered by your no-fault insurance.

At Schmidt Kramer, we are here to help you navigate the legal process so you can focus fully on your recovery. Call our office today for a free consultation with one of the qualified attorneys at our firm. If we represent you, there are no upfront legal costs to worry about. Our firm only gets paid when we win your case.

Schedule a free consultation today at 717-727-2500.

Can I Include Physical Therapy (PT) in My Harrisburg Car Accident Claim?

If you have been injured in a car accident in Harrisburg, Pennsylvania, physical therapy expenses can be included in your accident claim. These costs are considered legitimate medical expenses if they are directly related to your accident injuries. Typically, you can recover compensation for these losses through your no-fault insurance claim or a personal injury lawsuit.

When You Can Include the Costs of PT in Your Car Crash Claim

You can include physical therapy sessions in your claim if a doctor has formally prescribed or recommended them. Once you get a prescription, you should begin therapy immediately.

Be aware that any unexplained time gaps between the date of your car crash and when you begin treatment may make it difficult to recover compensation. It gives the insurance company room to question whether your injuries are related to your car crash or caused by something else.

How PT Can Help After a Car Crash

Blunt force trauma injuries are common in car crashes and may often result in more severe injuries. Even relatively minor collisions can cause significant damage to muscles, ligaments, joints and nerves. Physical therapy offers specialized rehabilitation to address immediate injuries and help prevent long-term complications.

Some of the benefits of physical therapy include:

• Reduce the risk of developing a chronic pain syndrome
• Pain management without heavy medication
• Introduce specific movements early in recovery that help tissues heal
• Restores range of motion due to whiplash, shoulder injuries and back problems
• Rebuild strength and stability
• Customized home exercise program that can be used after sessions end

Will My No-Fault Insurance Cover Physical Therapy After a Car Crash in Pennsylvania?

In Pennsylvania, whether you are eligible for physical therapy coverage after a car accident may depend on several factors, including the type of policy you have, the severity of your injuries and who was at fault.

Pennsylvania operates under a modified no-fault insurance system with two options. Full tort coverage allows you to sue for all damages, including pain and suffering, while limited tort coverage restricts your right to sue except in severe injury cases.

Your auto insurance provides first-party benefits that usually cover physical therapy. However, in Pennsylvania, the minimum requirement for insurance is $5,000 in medical coverage. Most policies cover “reasonable and necessary” medical treatment, including physical therapy. Coverage applies regardless of fault in the accident, but a physician must prescribe therapy related to accident injuries.

How Many Sessions Will Insurance Cover After a Car Crash?

The number of physical therapy sessions covered by insurance after a car accident varies widely based on several key factors. There is no universal answer, as coverage depends on your specific situation.

Some key factors in determining whether your physical therapy sessions are covered may include your insurance policy type and the medical documentation you have available.

Insurers may approve additional sessions when progress is documented, but treatment goals are not yet met. Your insurance can approve your physical therapy session for these other reasons:

• The doctor and physical therapist submit detailed justification
• The patient has severe injuries requiring longer rehabilitation
• The alternative would be more costly interventions like surgery

What Documentation Do I Need to Be Approved for Post-Accident Physical Therapy?

Securing insurance approval for physical therapy after an accident requires thorough documentation. Below are some evidence you will need to maximize your chances of approval and minimize delays in your recovery.

• Physician Referral or Prescription: A written order from your doctor prescribing PT, Diagnostic tests and the recommended frequency and duration of treatment.
• Emergency Room or Initial Treatment Records: Medical records from your first post-accident visit, imaging reports (X-rays, MRIs, CT scans) and initial examination findings and observations.
• Detailed Medical Evaluation: This includes an extensive assessment of your injuries by a qualified provider and objective findings showing functional limitations.
• Progress Documentation for Continued Care: Regular progress notes showing improvement and updated treatment plans if your condition changes.
• Accident Report: Police report, incident documentation, date, time and accident circumstances.
• Personal Injury Journal: Take daily notes on pain levels and functional limitations and record how injuries affect daily activities.
• Employment Impact Documentation: If your injuries limit you from completing tasks at work, have documents that can show lost time from work and modified duty requirements.

Car Accident Injuries Requiring Physical Therapy in Harrisburg

After a car accident, some injuries may heal naturally with rest, but some injuries may require physical therapy to ensure complete recovery and prevent any long-term complications.

Some common injuries that may need physical therapy may include:

Whiplash and Neck Injuries

The unexpected and violent back-and-forth jerking motion in a collision could cause whiplash. Symptoms of whiplash and neck injuries may include intense neck pain, stiffness, reduced range of motion and severe headaches radiating from the base of the skull.

Back and Spinal Injuries

High impact rear-end and sideswipe accidents on highways may result in victims facing back and spinal injuries such as herniated discs, spinal compression fractures, facet joint injuries, muscle strains and ligament sprains.

Shoulder Injuries

Seat belt restraints and bracing impact during an accident may lead to seat belt syndrome and other types of injuries, including:

• Rotator cuff tears or strains
• Shoulder impingement
• Labral tears
• AC joint sprains

Knee Trauma

If a victim’s knee hits a vehicle’s dashboard after suddenly braking during a car crash, it could result in serious knee injuries, such as:

• MCL and ACL sprains or tears
• Meniscus damage
• Patellar injuries
• Joint effusion
• Dislocated knees
• Dashboard knee injuries

Traumatic Brain Injuries (TBIs)

Mild to moderate TBIs from collisions can benefit from specialized physical therapy, which addresses:

• Balance disturbances
• Coordination problems
• Visual tracking issues
• Physical deconditioning during recovery

Recovering Out-of-Pocket Physical Therapy Expenses

When you pay for physical therapy out of your pocket, you need to understand your options and take strategic steps to recover these expenses. This detailed guide will help you recoup these costs.

Document Everything Meticulously

Successful recovery of out-of-pocket expenses begins with thorough documentation. Keep all receipts, payment confirmations and bank statements showing your physical therapy payments. Request itemized bills detailing each service provided, the date and associated costs. These detailed records establish evidence of what you paid and connect the treatments directly to your accident injuries.

Insurance Reimbursement Paths

Most health insurance policies have a reimbursement process for covered services you have paid for directly. Contact your insurance provider to request their specific reimbursement form. You will typically need to submit this form along with your receipts, a letter of medical necessity from your doctor and possibly your explanation of benefits. Some insurers have online portals specifically for submitting out-of-pocket expense claims.

When Another Party Is Liable

If your accident resulted from someone else’s negligence, their liability insurance should cover your medical expenses, including physical therapy. In these cases, you may initially pay out-of-pocket and recover these costs through a settlement or court judgment. Work with your attorney to include all therapy expenses in your demand letter or lawsuit. Ensure you have medical documentation connecting these treatments to the accident.

Settlement Negotiations and Physical Therapy Expenses

When negotiating a settlement, present organized records of all out-of-pocket physical therapy expenses. Include the direct costs of therapy sessions and related expenses such as transportation to appointments, medical equipment purchased for home exercises and lost wages from attending therapy during work hours. In-depth records strengthen your position during negotiations.

Small Claims Court as a Last Resort

Small claims might be an option for smaller amounts that insurance will not cover and when other parties will not pay small claims court. This process is generally more straightforward and less expensive than an entire lawsuit, making it appropriate for recovering modest out-of-pocket expenses.

Time Limits for Adding Physical Therapy to Your Injury Claim

Insurance companies often impose strict deadlines for reimbursement requests, typically 30 days to one year after the accident. Submit your claim as soon as possible to avoid missing these deadlines. If you are approaching the time limit, send the documentation you have and note that additional information will follow.

Why Insurance Companies Challenge Physical Therapy Claims

Insurance companies may scrutinize and challenge physical therapy claims to minimize payout. Every dollar paid out in claims directly impacts insurance companies’ bottom line. Physical therapy often involves multiple sessions over extended periods, creating a recurring cost.

Other tactics the insurance companies may use to challenge your claim may include:

• Questioning medical necessity
• Duration of treatment disputes
• Correlation between injuries and accident
• Treatment effectiveness challenges
• Challenging documentation discrepancies

Contact Schmidt Kramer for Legal Help After a Car Accident

Pennsylvania’s complex insurance system often prevents victims from collecting physical therapy claims after a car accident. However, an attorney can help with your claim by collecting proper evidence and negotiating with the insurance company.

At Schmidt Kramer, we have helped countless Harrisburg accident victims navigate challenges to obtain the compensation they need to recover. Our attorneys know the nuances of Pennsylvania’s insurance laws and how to counter common denial tactics effectively. Learn about your legal rights in a FREE, no-risk case review.

No Upfront Fees. Call today: 717-727-2500.