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Occupational Therapists, Physiotherapists and Case Managers Oh My!

After a serious motor vehicle accident, you will need a lot of help.

You will need help from doctors, nurses, personal support workers. occupational therapists, massage therapists, chiropractors, surgeons, internists, nutritionists, speech language pathologists, social workers, psychologists, psychiatrists, lawyers, accountants, friends, family and more!

Some of these services are FREE because they’re covered by OHIP.

But most services are not free and need to be paid for by an insurance company, or out of your own pocket. The cold hard truth is that most rehab services which don’t fall under the heading “doctor” are NOT covered by OHIP and cost a lot of money. If the insurance company won’t pay, or if you don’t have the means to pay for these services on your own; chances are you won’t get these much needed rehabilitation services.

Even  more difficult is understanding the role which these different health care professionals play in your treatment and road to recovery.

We all understand what a doctor does. But do we really understand the role of an OT, Case Manager, Social Worker, Personal Support Worker etc? The purpose of this Toronto Injury Lawyer Blog post is to explain the role which these various non medical service providers play with respect to the wellness and recovery of a seriously injury accident victim.

Occupational Therapist: Not covered by OHIP (save for an in hospital OT). Cannot prescribe medication. Cannot make a medical referral to a doctor or specialist. Cannot request a diagnostic test like an X-Ray, MRI or CT Scan. The OT will help assess and determine the care needs for the accident victim. They will visit the Plaintiff in hospital and at their home to facilitate the transfer from hospital to home to ensure that it goes smoothly. The OT will conduct an in home or in hospital care assessment to determine what assistive devices are required for the Plaintiff such as wheelchair ramps, grab bars, commode chair, cane, walker etc. The OT will also prepare a Form 1 to determine the attendant care needs for the injured Plaintiff. The OT will work with the Plaintiff to improve their level of functioning and improve their daily living tasks. They will provide them with the tools and exercises to make their lives easier during the hard recovery period. Most importantly, the OT will also recommend for any other service providers to get involved. They will recognize the Plaintiff’s limitations and how other service providers can assist in the recovery process. Should things go wrong from a treatment perspective; the OT is generally the person who the accident victim will contact to see what can be done to make things right. The OT can also play a very hands on role in terms of accompanying the Plaintiff to his/her medical appointments to better articulate to the doctor the functional limitations of the Plaintiff so that the doctor can better appreciate his/her condition.

Case Manager: Not covered by OHIP. Cannot prescribe medication. Cannot make a medical referral to a doctor or specialist. Cannot request a diagnostic test like an X-Ray, MRI or CT Scan. The Case Manager can be an OT, Social Worker or carry a Case Management diploma or accreditation. They don’t have to have any particular background, but they need to understand the complex needs of a catastrophically injured accident victim. Case Managers are only available in accident catastrophic cases, but not other cases save in very special circumstances.  Think of the Case Manager as the project manager or supervisor for the Plaintiff’s care and care team. With so many rehab professionals working with a Plaintiff, it can be difficult to keep track, coordinate services and avoid a duplicity of services. This is where the Case Manager comes in. The team directs all referrals through the Case Manager so that no two service providers have made their own referrals for the same service. The Case Manager arranges and leads team meetings where the accident victim, his/her rehab team, the personal injury lawyer, the family of the accident victim and sometimes even the insurance adjuster all get together (in person or virtually) to discuss the wellness, rehabilitation, progress and future care plans of the Plaintiff.linkedin-2-300x300

Physiotherapist: Not covered by OHIP (save for an in hospital PT treatment following a serious accident). Cannot prescribe medication. Cannot make a medical referral to a doctor or specialist. Cannot request a diagnostic test like an X-Ray, MRI or CT Scan. Physiotherapists are regulated by the College of Physiotherapists. Think of them as the people who work on flexion, strength, mobility, stamina for physical injuries. They can help an accident victim walk again, bend again, flex again or move again. They are experts in movement to help the accident victim regain physical function for their injured body parts. Bad back, broken legs, broken arms? The physiotherapist will work with you to help restore the strength, mobility and flexion of those body parts. It’s like having a work out session to get better. They can either come to your home for treatment, or you can attend at a wellness centre, rehab clinic or physiotherapy clinic for treatment. The physiotherapist is not qualified to assist with depression, anxiety or any other mental health issues which have been brought on from the accident. There are different people for those sort of issues.

Social Worker or Psychologist: Not covered by OHIP (save for an in hospital social work treatment following a serious accident. We rarely see psychologists treatment clients in hospital. We do however see psychiatrists treating patients, but psychiatrists and DIFFERENT than psychologists). Cannot prescribe medication. Cannot make a medical referral to a doctor or specialist. Cannot request a diagnostic test like an X-Ray, MRI or CT Scan. These people deal with the psychological functioning and mental health to the injured accident victim. They do not generally deal with physical issues, though they can certainly address them as they relate to mental health and vice versa. A social worker will meet with you at your home, virtually or at a location of your choosing. A psychologist will meet with you at his/her office or virtually. The psychologist will NOT come to your home to meet with you. A psychologist will be able to diagnose you under the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) criteria for mental health. A social worker cannot make such a diagnosis, save in special circumstances where the social worker has received special training to do so.

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