Many clients and prospective clients want to know where they should go for treatment after a serious car accident in Ontario.
It’s a common question because there are so many options and there is no “right way” of doing it. But there is certainly a wrong way of getting treatment.
For starters, there is no substitute for seeing your family doctor, or any other doctor for that matter who is covered by OHIP. These doctors are free and have no vested interest in your personal injury case. All they want to do is see that you get better and get the treatment you need. There’s nothing wrong with that.
Where people go wrong is that they leave their family doctor (or nurse practitioner) out of the picture when it comes to their post accident wellness and rehabilitation. Your family doctor is probably THE MOST IMPORTANT person when it comes to getting the treatment you need.
Lawyers and Judges rely heavily on the clinical notes and records of your family doctor.
Your family doctor can prescribe you with medication to get better. Your family doctor can make referrals to other specialists to help you recover. Your family doctor can request an x-ray, CT Scan, MRI or refer you to a pain clinic or brain injury program (all covered by OHIP). These are indicators to lawyers and to insurers that a Plaintiff is in pain and that something has gone wrong. If those diagnostic tests come back with objective evidence of a serious injury then it’s very hard for an insurer to refute that nothing is wrong with that Plaintiff. The doctor will know what’s wrong with his/her patient so that the patient can get the treatment which s/he needs. Don’t leave your family doctor or nurse practitioner out of the loop. A physiotherapist, occupational therapist, naturopath, chiropractor or social worker is NO SUBSTITUTE for your family doctor or nurse practitioner.
If you don’t have a family doctor or nurse practitioner, don’t fret. Get on a waitlist. These waitlists clear up faster than you would think. While you’re waiting, go to a Walk In Clinic or to your local Urgent Care or Emergency Department for check ups or for pain management. If you go to the same Walk In Clinic with frequency, they will get a sense of what you’re going through. It will be reflected in the records. Walk In Clinic doctors can make the same referrals and prescribe the same medication as a treating family doctor. If you have a health card, then you have access to a walk in clinic or urgent care clinic.
After a car accident, your car insurer will likely provide with you a list of their preferred clinics for treatment. This treatment likely includes physiotherapy, massage, chiropractic care or occupational therapy. These are known as multidisciplinary rehab clinics.
There is a reason why insurance companies want you to go to one of their preferred clinics. It’s no coincidence that these clinics are on their list. In all likelihood, these clinics will view a Plaintiff’s injuries through the lens of an insurance company. They won’t bite from the hand that feeds them per se. This will result in reports and treatment recommendations which favour an insurer’s view of the case; as oppose to a Plaintiff’s view. If an insurer has recommended that you seek treatment from a particular clinic; run in the opposite direction. There is usually a reason that they want you to go there.
There are two keys to finding a rehab clinic that will work best for you.
- Is the clinic close to home? The closer the clinic is to your home, the greater the chance you will attend treatment. Imagine having to drive a long distance just for a 30 minute physio session. The insurer won’t pay for your gas if the drive is less than 50km. It’s a waste of your time and money needing to travel far for physio. It should be close to home and convenient so that you will attend sessions.
- Make sure that the clinic knows how to bill car insurers. Ask the receptionist if the clinic is familiar with the HCAI System for billing auto insurers in Ontario. The truth is that anyone can perform the treatment. That’s not the issue. The issue becomes who will pay for that treatment. If the Plaintiff has collateral benefits through work, or if the Plaintiff is very wealthy and has the means to pay thousands of dollars for treatment out of pocket then this isn’t an issue. But this is not the case for the majority of Plaintiffs. An insurer should pay. But if the local clinic isn’t familiar with doing car accident work, filling out the forms for car accident cases and isn’t familiar with billing a car insurer then you’re at the wrong clinic. The secret sauce so to say is the ability to complete these forms the right way and to get the auto insurer to pay. A Plaintiff should not have to pay for treatment out of pocket for his/her treatment provided that the treatment is reasonable and necessary. The clinic needs to know how to bill insurance companies for their services. Clinics who are seeking for Plaintiffs to pay out of pocket because they don’t know how to bill auto insurers or don’t want to fill out the auto forms for getting treatment approved should not be seeing car accident victims. They are doing these people a disservice.
A Plaintiff can select any clinic which s/he wants to attend. It doesn’t make any difference if a car insurer or a personal injury lawyer wants you to go to a specific clinic. An accident victim has the right to go to the clinic of his/her choosing. If that accident victim wants the advice of their personal injury lawyer on a clinic, or a recommendation on where to go; we are here to help. But at the end of the day, it’s the Plaintiff’s choice in terms of where they want to go for treatment.