Hello Again! We receive many questions regarding how Occupational Therapy fits in with ICBC/motor vehicle accident claims.
We hope you find this overview of information helpful!
Why Would I Need an Occupational Therapist (OT) After an Accident?
There are many reasons why you may need the help of an OT! Many people think of the term occupation as just meaning going to work, but in reality, it’s much broader than that. Occupations are the activities that we want or need to do every day. Think about all the activities that you do (or at least aim to do) during your week. For example, at home (cooking, dressing, cleaning, sleeping), in the community (walking, shopping, driving, socializing), and at work (standing, sitting, organizing, multi-tasking, lifting). Within all those activities are smaller physical, cognitive, and mental tasks that work together to allow you to successfully complete an activity. When individuals experience an injury, their ability and confidence to complete occupations can be altered, leading to dysfunction. When the dysfunction prevents successful completion of activities, it’s time to call an OT!
At Windward Healthcare, our professional OT’s can assist you in your recovery. We can assist you if you are:
- Having difficulty completing daily tasks and activities.
- Dealing with post-concussion symptoms or ongoing cognitive deficits.
- Experiencing pain that is impacting your ability to perform day-to-day activities.
- Having trouble with ongoing physical, emotional or mental symptoms that are not well managed.
- In need of adaptive equipment to move around safely in yourhome or other personal space.
- Returning to work and would benefit from assistance in negotiating a plan, developing a plan, and monitoring the plan to ensure a successful transition.
- Unsure of where to start in establishing a plan for treatment
- Unsure of the roles and responsibilities of the many people involved in your recovery.
- Being discharged from the hospital and would benefit from assistance and coordination of care.
What Does a Windward Healthcare Occupational Therapist Actually Do?
Our goal is to help you get back to doing the activities you were doing before the accident. At Windward Healthcare, we provide an umbrella of services to help you manage and improve your symptoms, and get you back to your day-to-day level of function.
- Direct treatment.
- Techniques and strategies to deal with day-to-day activities.
- Rehabilitation assistance(physical, cognitive, emotional).
- Adaptive equipment to make your home a safe place and to accommodate you in your recovery.
- Gradual return-to-work planning and monitoring. We support you the whole way through.
- Case coordination. Case coordination helps with planning your recovery and allows you and your healthcare providers to focus on what they do best – helping you to recover and heal.
So, It Sounds Great But Who Pays?
In the event of a motor vehicle accident, our services are billed directly to ICBC (no user fees!). You are entitled to a variety of benefits and treatment through your basic insurance coverage regardless of fault. These benefits are known as Part 7 benefits. Occupational therapy is fully covered under Part 7 benefits. A Windward Healthcare professional will work with you, your physician, ICBC adjuster, and your lawyer (if you have one) to determine your needs and your qualification for coverage/benefit approval.
Part 7 Benefits, What Exactly Are Those?
Part 7 is just the 7th part of the 15-part Insurance (Vehicle) Act. Part 7 legislates injury rehabilitation and outlines the cost allowances and terms of services. These benefits are available to assist you in your recovery after you have been injured in a motor vehicle accident by a B.C. insured vehicle. Part 7 benefits are “No Fault”, meaning it doesn’t matter who caused the accident, everyone injured can still receive these benefits. Whether you are a driver, passenger, pedestrian or cyclist, you may be covered. Your claim will have claim-specific parameters. Our experienced and knowledgeable team, can help you determine what your entitlements are by communicating with your doctor, adjuster, and representative.
If you would like to learn more about this legislation, please follow this link to the Insurance (Vehicle) Act.
Part 7 Benefits, Do I Qualify?
You, your claim, and your recovery needs are unique. It’s important that there is clear communication with your ICBC adjuster or legal counsel (if you’ve retained a lawyer) to know the status of your approval for coverage. At Windward Healthcare, we will work directly with you, your adjuster and your other healthcare professionals to assist in determining coverage entitlement related to your needs.
Once we’ve helped you determine your coverage, one of our dedicated OT’s will start working with you by completing an assessment and making recommendations to ICBC for treatment services, personal needs, and adaptive medical equipment. We establish a plan, coordinate treatment, provide treatment, and make arrangements for direct payment. Examples of commonly coordinated services are physiotherapy, vestibular therapy, massage therapy, psychology, kinesiology, and neuro-optometry, home care, community assistance, personal care assistance, and rental equipment.
Who Does Windward Healthcare Work For?
WINDWARD HEALTHCARE WORKS FOR YOU! Our Focus is on our client’s care. We are a private company that is also an independent provider registered with ICBC. We function similarly to your physiotherapist, physician, massage therapist, or chiropractor in providing a service to assist you with your rehabilitation.
What Are The Steps to Having a Windward OT on My File?
The process can vary from person to person, but generally speaking the steps are as follows:
- We receive your OT referral or you contact us to get the process started.
- We instigate the processes to confirm your coverage for occupational therapy.
- Once coverage is confirmed, we contact you to schedule an appointment.
- The OT meets you in the community (home, work, or other convenient location) for assessment.
- The OT develops a customized rehabilitation program and writes a report containing recommendations.
- Once the recommendations have been approved for funding, we contact you to initiate services.
- We then invoice ICBC directly for the ongoing rehabilitation program, so that you are not out of pocket.
How Do I start?
If you think our OT services would be helpful for you or someone you know, please call us. The process to verify funding benefits can sometimes take a few weeks to coordinate, so the sooner you call, the sooner we can start working on a recovery plan.
We invite you to find out more today by calling 604-364-8631 to discuss how we can help you in your recovery.