Child support is more than just providing a roof over a child's head or food on the table. When a child has specific medical vulnerabilities or requires specialized physical rehabilitation, the legal obligation of support expands significantly. Under Philippine law, a parent's duty to provide for their child's healthcare is absolute, non-waivable, and strictly enforceable.

1. The Legal Foundation of Child Support

The primary governing legislation for child support in the Philippines is The Family Code of the Philippines (Executive Order No. 209).

Under Article 194 of the Family Code, support is broadly defined:

"Support comprises everything indispensable for sustenance, dwelling, clothing, medical attendance, education and transportation, in keeping with the financial capacity of the family."

This mandate establishes that child support is not limited to a flat cash handout; it must directly account for the holistic well-being of the child, with "medical attendance" explicitly hardcoded into the law as an uncompromisable component.

2. Are Medical and Physical Therapy Expenses Covered?

Yes. The term "medical attendance" encompasses a broad spectrum of healthcare necessities. In contemporary legal application, this includes:

Routine Healthcare: Regular check-ups, pediatric visits, dental care, and vaccinations.
Emergency and Hospital Care: Hospitalization, surgeries, laboratory tests, and emergency room bills.
Prescription Medications and Supplies: Maintenance drugs, vitamins prescribed by medical practitioners, and specialized medical equipment (e.g., braces, wheelchairs, or orthotics).
Therapeutic and Rehabilitative Care: Physical therapy (PT), occupational therapy (OT), and speech-language therapy.

If a child suffers from a medical condition, developmental delay, congenital disorder, or an injury that requires regular physical therapy sessions, these costs are considered indispensable expenses. A non-custodial parent cannot arbitrarily choose to pay only for food and school tuition while ignoring specialized therapy bills.

3. Support for Children Beyond the Age of Majority

A common misconception is that the obligation to provide child support automatically terminates when the child turns 18 (the age of majority).

Under the Supreme Court’s Rules on Action for Support (A.M. No. 21-03-02), the right to claim support applies to:

Children below 18 years of age.
Children 18 years of age and above who, because of physical or mental disability, are unable to fully support themselves.

If a child requires lifelong physical therapy or specialized medical maintenance due to a physical or psycho-social disability, both parents remain legally obligated to provide support well into the child's adulthood.

4. How the Amount of Support is Determined

There is no fixed formula, standard chart, or automatic percentage in the Philippines to determine the exact amount of child support. Instead, courts rely on the principle of equity and proportionality.

According to Article 201 of the Family Code, support is determined by balancing two factors:

The Necessities of the Recipient: The itemized, actual cost of the child's needs (including specific tallies for medical treatments, therapy sessions, professional fees, and special dietary needs).
The Resources or Means of the Giver: The income, properties, business earnings, and overall financial capacity of the paying parent.

The Rule on Fluctuations (Article 202): Child support is never permanent or final. It can be increased or decreased at any time depending on the fluctuating needs of the child or the changing financial status of the parent. For instance, if a child suddenly requires an intensive, expensive physical therapy regimen, the custodial parent can petition the court for an upward modification of the support amount.

5. Demandability and the Necessity of Documentation

Under Article 203, the obligation to pay support becomes demandable from the moment the child needs it, but it is only legally payable from the date of judicial or extrajudicial demand.

This means if a custodial parent has been paying for a child's physical therapy entirely on their own without formally asking the other parent for their share, they generally cannot claim those past expenses retrospectively until a formal demand has been made.

To protect the child's rights, the custodial parent or guardian should implement the following steps:

Send a Formal Demand Letter: A written, dated demand letter served via registered mail or courier to the non-custodial parent, detailing the child's medical/therapy needs and requesting financial contribution.
Maintain Strict Records: Retain every single medical abstract, physical therapist's prescription, developmental evaluation report, official receipt, and invoice.

6. Legal Remedies for Refusal to Pay

If a parent unjustly refuses or fails to provide their share of medical and physical therapy expenses, the law provides robust civil and criminal remedies:

Civil Action for Support: A formal complaint filed in the Family Court. Under the Rules on Action for Support, timelines are shortened to ensure swift relief. The court can also grant support pendente lite (provisional support) while the case is ongoing to ensure therapy sessions are not interrupted.
Criminal Liability via R.A. 9262 (VAWC Act): Under the Anti-Violence Against Women and Their Children Act of 2004, the willful denial of financial support to a child or the child's mother constitutes Economic Abuse. This is a criminal offense punishable by imprisonment and fines.
Contempt of Court and Execution: If a parent defies a court order to pay for medical/therapy expenses, they can be cited for indirect contempt (resulting in detention) or the court can order the garnishment of their salary or the attachment of their properties.

Summary

In the Philippine legal framework, the welfare of the child is paramount. Medical attendance—specifically inclusive of rehabilitative treatments like physical therapy—is an uncompromisable aspect of parental obligation. Whether a child is legitimate or illegitimate, and regardless of whether the parents are married or separated, the duty to ensure a child's health and physical development remains absolute.