A research study by the descriptive analysis of reports in the National Practitioner Data Bank done during 1991-2002 revealed that annually around 47.73 physical therapy malpractice cases were reported in the U.S.

People go to physical therapists to feel better. Instead, if they are injured or their symptoms worsen, it could be due to the physical therapy specialists’ negligence. Don’t think I’m blaming all PTs; it’s not an uncommon occurrence. Many cases of physical therapist negligence or malpractice have been reported in the United States.

Can you point out the causes of physical therapy or therapist errors? Can physical therapy malpractice insurance protect them from lawsuits? Before delving into these analyses, let’s know some basic facts about physical therapy.

In any minor accident scenario, people may first think of getting treatment from physical therapy specialists to eliminate physical pain. But do you think you can decide on your own? Can physical therapists treat patients without any diagnosis from a specialist doctor?

In the United States, each state regulates physical therapy services through a “state-practice” act. The practice act is a law that governs how physical therapy services can be provided in that state. Each state has a different list of professionals who can refer patients to physical therapy.

The American Physical Therapy Association (APTA) has worked to change the law in many states so that patients can receive physical therapy directly without first obtaining a prescription from their healthcare provider.

Now, around 13 states allow physical therapy specialists to treat people without any physician referrals, which means patients can get treatment from them as a self-referral.

Though it is claimed that there is no evidence that self-referral to physical therapy puts patients at risk, a few negligence and malpractice cases here and there makes the patients raise their eyebrows.

Can you sue physical therapy specialists? Of course, you can. Through this blog, we are going to flip the pages of physical therapy malpractice in the U.S. Before that, let’s know the role of physical therapy specialists in pain management and rehabilitation.

Role of Physical Therapy Specialists


Is physical therapist a doctor?

The American Physical Therapy Association (APTA) guidelines state that physical therapists who hold a doctor of physical therapy degree (DPT) must indicate their status as a physical therapist when using the titles “Doctor” or “Dr,” and must use the titles in accordance with jurisdictional law. In short, they can be addressed as doctors, but they are not physicians.

In the United States, obtaining a Doctorate of Physiotherapy (DPT) is an important step towards eligibility for the physical therapy license exam. This is intended to ensure that all patients receive the best possible physical therapy care. Though physical therapy specialists aren’t like our traditional doctors, they are trained as doctors in their specific field of physical therapy. Before they can practice, physical therapists must complete a minimum of seven years of education in physical therapy.

Their major role is to consult with patients to learn about their physical condition and symptoms. They have to Identify movement dysfunction and develop a safe treatment plan for the ailing patients. They have to teach patients how to use therapeutic exercise techniques properly, either in the therapy center or at home. They administer stimulation or massages to promote healing.

Physical therapists assist injured or ill people in regaining movement and managing pain. They are frequently involved in the prevention, rehabilitation, and treatment of patients suffering from chronic conditions, illnesses, or injuries from slip and falls or motor vehicle accidents. Physical therapists assess and document a patient’s progress during therapy.

However, if they are treating the patients with physician referrals, they are obliged to follow the instructions of the referring physician based on the diagnosis made. Strictly adhering to the diagnosis and offering appropriate massage or adjustments will be safer for both the patients and the physical therapy specialists in the legal context.

Physical Therapy Malpractice

As we have seen earlier, physical therapy specialists can help a patient regain function or strength and help relieve their pain. However, like any other professional, they, too, can make mistakes that endanger their patients. Physical therapists frequently practice independently; they may work without being directly supervised by a doctor. In such instances, they may need to screen and examine the patient thoroughly in order to provide the appropriate therapy.

Physical therapy malpractice is a significant issue in nursing homes and long-term care institutions since many of the patients there are weak, have memory problems, or have communication problems. Patients who are injured may not be able to report it to the therapist if they are irresponsible in the therapeutic exercises they are performing with them.

The major failures in physical therapy management are:

  • Dropping patients
  • Failing to inform patients of risks
  • Failing to supervise
  • Leaving patients unattended on equipment
  • Improper use of therapeutic exercises like over-extending joints or muscles
  • Improper use of biophysical agents like oxygen therapy, electrical stimulation, or ultrasound
  • Sexual assault
  • Using broken equipment
  • Manual therapy errors

Other than these, the following things also will end up physical therapy specialists in malpractice lawsuits.

  • Failure to conduct a thorough evaluation
  • Giving treatment without getting informed consent
  • Continuing therapy, despite the pain
  • Failure to obey the orders of the referring physician
  • Not reporting the change in the patient’s symptoms to the concerned physician

Errors or negligence from the physical therapy specialists can lead to various injuries, such as:

  • Anxiety or stress
  • Broken bones
  • Bruises
  • Concussions
  • Spinal cord or back injuries
  • Strains or sprains
  • Torn ligaments
  • Heart attack or stroke
  • Worsening of prior injuries

The Healthcare Providers Service Organization (HPSO) published Physical Therapy Liability Exposure Claim Report in 2020 based on the study conducted during the period 2011-2016, and it brings out some vital findings:

  • The amount paid in malpractice lawsuits against physical therapists covered by the HPSO Program throughout the five-year study period is $46 million.
  • The average cost of a malpractice claim against a physical therapist, including defense expenses, is $134,761.
  • Improper patient treatment management is the most frequent claim of malpractice against PTs.
  • Fractures are most frequently connected injury to charges of PT malpractice.
  • The average legal fee to defend a PT against a state licensing board complaint is $6,420.

Physical Therapy Malpractice Liability

Proving physical therapy negligence is vital in such malpractice lawsuits.

A physical therapist can be held liable for an error, omission, or negligent act that causes injury or harm to the patients. By holding physical therapists accountable for their actions, civil litigation and professional discipline are two tools that can help reduce medical errors. You must prove the following elements in order to win a negligence case against a physical therapist:

  • The PT owed a duty;
  • The PT breached the standard of care;
  • The breach caused your injuries; and
  • You suffered actual harm or “damages.”

If you are successful in proving that your physical therapy specialist was responsible for your injuries, you can get reparation for your losses. The compensatory damages are not intended to replace pre-existing injuries; rather, they are intended to make up for losses caused by negligence. Typically, they also cover the expense of the care needed to restore any damage caused by the defendant. The type of injuries will determine the extent of the losses.

Will Physical Therapy Malpractice Insurance Shield Therapists from lawsuits?

Are the Physical Therapy Specialists Immune to Liability?

Physical therapy malpractice insurance is purchased by therapists to protect themselves from claims and lawsuits. Most states provide “immunity from liability” to therapists and counselors in limited circumstances.

The general liability claims would cover

  • Accidental harm sustained by the patient during the physical therapy
  • Unintentional damage to someone’s belongings while they are at the physical therapist’s facility
  • Allegations like assault, battery, slander, defamation and sexual misconduct

Immunity from liability essentially means that one is not subject to a lawsuit or monetary liability if the existing circumstances meet the requirements of a specific immunity statute. In a malpractice case, the practitioner will have no liability if it is ultimately determined that the practitioner used reasonable care in treating the patient (the reasonably prudent practitioner under similar circumstances test).

However, liability exists if the practitioner is found to be negligent in the treatment of the patient and the patient suffered harm as a direct result of the negligent acts.

How to Win your Physical Therapy Malpractice Claim?

The first and foremost valuable evidence in your claim is your medical records. Whether you are referred to the physical therapy specialists by other physicians or it is a self-referral, the details of the diagnosis and the recommendations of treatment would have been documented in your medical records.

Establishing the malpractice with evidence is not a simple job as the defendant is a healthcare provider or facility. They will fight tooth and nail to put the blame on you like you have done the exercise in the wrong way or you did not follow the instructions of the physical therapy specialists.

You need to prove that the defendant owed you care and how he breached that duty, like whether he did not assist you or enforced to exercise on the wrong equipment.

Getting your other medical experts’ witness statements to prove that the injury was caused by the negligence of the physical therapy specialists would reinforce your claim for damages. Since the records of the referring physician would have all the recommendations, your attorney can persuade the defense for a settlement or the Jury for a favorable verdict.

An experienced attorney or his medical record review team can plow through the hefty medical documents to find out the evidence for the cause of your ailment and the malpractice. Sifting the valuable evidence that would strengthen your claim is the ultimate aim of the medical record reviewers.

LezDo techmed abets many personal injury attorneys in digging out the evidence in effective medical record review services. Every vital piece of statements in the expert deposition testimonies is pointed out in our effective deposition summaries. They would fortify your claim for damages.

Case Studies on Physical Therapy Malpractice Cases

Let’s plunge through a few negligence cases and physical therapy lawsuit settlements here.

Case study: 1

Cuadrado v. Brookhaven Rehabilitation and Health Care Center

The patient was instructed to walk unassisted using parallel bars. While doing the exercise, she fell down and ensued with left lower leg compartment syndrome. This syndrome could cause tissue death if unattended. She had to undergo a fasciotomy to relieve pressure on the nerves and blood vessels. However, she developed blood clots and septicemia and became permanently disabled.

The Jury accepted the fact that the patient should have been assisted while walking with the help of the parallel bars and the facility, and the therapist’s negligence made her disabled. The Jury gave a plaintiff verdict of $765,000 for her agony and disability.

Case study: 2

The patient was getting physical therapy at an outpatient physical therapy section of a medical center after his right ankle fracture. He was instructed to use a stationary bike as part of the physical therapy session and dismount it once it was done. While dismounting, the stationary bike slid, making the patient fall backward. The bike fell over his body. The patient, who had undergone multiple cervical surgeries, including a fusion in his past life, encountered a dislocation of the prior C4-5 fusion. Due to the fall, he had to undergo multiple posterior and anterior fusions from C3-7.

The facility or the physical therapy specialists were negligent in not being in close proximity of the patient during dismounting as he had instability in his right ankle. The injury had worsened his pre-existing neck injury and pre-existing spastic quadriparesis.

The defendants claimed that the patient was instructed not to dismount without the therapist nearby, and the injuries were related to the worsening of his prior condition and surgeries and not related to the current fall. An efficient attorney’s arguments made the case settle before trial for $1,490,000.

Case study: 3


Karen Censki was referred to Madison Avenue for post-surgery physical therapy after Dr. Sasson repaired a torn ACL in her left knee. Censky testified in her deposition that she heard her knee “pop” and begin to hurt while doing weight-bearing exercises on a leg press. She also testified that a Madison Avenue assistant told her that the popping noise was caused by scar tissue around her knee. While undergoing physical therapy at Madison Avenue, Censki discovered she had a fractured patella of her left knee and it was due to the exercise methods given to her.

She alleged that her physical therapist began the weight-bearing exercises too early after the surgery. The weight used in the machine was too high for her to bear her legs. He failed to supervise her physical therapy sessions. The assistant was also negligent in addressing the issue and neglecting the fracture and pain related to the scar tissue.

The details of the case proceedings or verdict are not available.

To wrap up the article,

Physical therapy specialists are not exempted in any way from escaping from their liability in malpractice cases. Only people who have physical ailments come to physical therapy specialists for treatment. It is their responsibility to ensure safe and suitable therapies or modalities of treatment. The therapy should relieve them of their pain and not exacerbate it.

If you or your loved one has been injured during physical therapy due to the negligence of physical therapy specialists, get the abetment of an experienced physical therapy malpractice lawyer. Convey all the important occurrences in the course of your treatment and the negligence you have encountered. He can shoulder your claim and run through all the oddities to get your recompense.

Share your thoughts and experiences if you have encountered any physical therapy malpractice. Meet you soon in the comment box.

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