Mandatory no-fault insurance regulation in Ontario that outlines the benefits provided to those injured in a motor vehicle accident. These benefits are included in all standard auto insurance policies and cover medical, rehabilitation, income replacement, and attendant care costs.
A pre-approved pathway within the SABS for sprains, strains, Whiplash Associated Disorder (WAD), and other common injuries, with funding capped at $3,500
Funding within the SABS beyond the MIG for more severe or complex injuries with set maximum rates
Treatment Plan Pathways
Is the Injury Classified as Minor within the Statutory Accident Benefits Schedule?
If YES, Use the MIG Pathway:
Submit OCF-23 of up to $2600 ($2200 for treatment, $400 for supplementary goods and services)
Deliver care in 3 treatment blocks (Week 1–4, Week 5–8, Week 9–12)
Invoice using OCF-21C with flat fees per block
If more care is required, re-assess and submit an OCF-18 for up to $1300.00
Total maximum: $3,500
If NO, use the Non-MIG (PSG) Pathway:
Assess and submit OCF-18 treatment plan with full clinical justification
Wait for insurer response (typically within 10 business days)
Invoice using OCF-21B with itemized CCI/GAP codes
PSG hourly rates and limits apply
Tips and Notes
Not all Ontario Claims Forms (OCFs) are mandatory for each claimant, depending on their injury and medical needs after an accident. There are, however, two specific forms that are mandatory for each claimant, and without these forms, you will not be paid your invoices. The mandatory forms include the OCF-1 (Application for Accident Benefits) and the OCF-3 (Disability Certificate).
Use the most up-to-date codes for billing. ICD-11 codes are the most recent and should be used to avoid billing delays.
Submit your forms as promptly as possible to avoid approval and payment delays
Want more resources to help you navigate the auto insurance sector? Let us know by emailing physiomail@opa.on.ca
OPA recently partnered with PaRx, an initiative of the BC Parks Foundation, driven by health-care professionals who want to improve their patients’ health by connecting them to nature. Featuring practical resources like quick tips and patient handouts, PaRx’s goal is to make prescribing time in nature simple, fun and effective.
OPA welcomes our members across Ontario to become partners with PaRx, access their resources, and encourage clients to spend more time in nature.
Register for PaRx to learn more about the health benefits of nature, access exclusive resources, and join the national nature-health movement.
1. It’s easy and effective. Health-care providers are always looking for simple, practical interventions they can make to improve their patients’ lives. The beauty of PaRx is that almost anyone can increase the time they spend in nature, no matter what their physical abilities are or where they live.
A growing body of research suggests that spending time in nature has a wide range of positive effects on human health. From reduced chronic disease to improved birth outcomes—over and above the benefits of exercise. Learn more about the health benefits of nature here.
2. Writing it down works better. Studies suggest that written prescriptions are better received than oral advice in motivating patients to make a change.
3. Patients trust their health-care providers. Surveys reveal that health-care providers consistently rank among the most trusted professionals in the country.
4. Prescribing nature is good for the earth. Research shows that people who are more connected to nature do more to protect it. So not only are you improving your patients’ health, but you’re also doing your part for the planet.
5. We’re reducing barriers for your patients. To ensure that everyone in Canada has ready access to the health benefits of nature, PaRx is collaborating with outdoor organizations like Parks Canada to provide free or discounted access to green and blue spaces for patients in most need.
Speakers: Nitin Madhvani, CPO President, Craig Roxborough, Registrar and CEO, and Mary-Catherine Fraser Saxena, PT and Practice Advisor
Thank you to all who joined the College of Physiotherapists of Ontario for an OPA pre-conference webinar.
Speakers:
Nitin Madhvani, CPO President
Craig Roxborough, Registrar and CEO
Mary-Catherine Fraser Saxena, PT and Practice Advisor
“The interests of the public and the interests of the profession are almost always aligned. We are all working toward a common goal – to provide safe and effective care to Ontarians.”– Nitin Madhvani, President of the College of Physiotherapists of Ontario (CPO) shared those words during March 5’s Chat with the College.
He was joined by Craig Roxborough, CEO & Registrar, Mary Catherine Fraser-Saxena, Practice Advisor, OPA staff, and many physiotherapists. The CPO shared their approach to “right-touch” regulation, their strategic plan, and engagement with equity and inclusion.
We heard about the role of the Practice Advisors, the purpose of Practice Standards and the work CPO is doing to incorporate the national standards into practice in Ontario.
The Ministry of Health’s Health Force Ontario recommended that providing clarity on roles and responsibilities, including scopes of practice and competencies, is important to building a strong foundation for interprofessional care.
OPA has developed a resource to help with that clarity for physiotherapists and kinesiologists. The resource aims to increase understanding of these two regulated professions in the physical rehabilitation sector in Ontario, with key differences in scope of practice, core educational requirements and complexity of conditions they assess, treat and manage.
We extend thanks to those who reviewed the document and provided input including physiotherapy academic leaders, the College of Physiotherapists of Ontario, the Canadian Physiotherapy Association and the Ontario Kinesiology Association.
College of Physiotherapists of Ontario Evidence-Informed Practice Standard
Physiotherapists are expected to integrate the best available research evidence with their clinical expertise and patients’ values to guide assessment and treatment decisions. This approach ensures that physiotherapy care is grounded in scientifically credible information, supports optimal patient outcomes, and includes clear communication about the evidence behind any conventional, emerging, or complementary therapies offered.
Physiotherapy Canada publishes the results of qualitative and quantitative research including systematic reviews, meta-analyses, meta syntheses, public/health policy research, clinical practice guidelines, and case reports. PTC is available in print and online. Login to CPA gain full access.
OPA and WSIB hosted a webinar about the WSIB MSK POC on March 21 and March 27, 2023. All OPA members have exclusive access to this webinar recording.
WSIB’s presenter provided an overview of the harmonized musculoskeletal (MSK) program of care (POC), including what’s changing and what this means for you.
Learning Objectives:
WSIB’s health care continuum and what the MSK program of care is.
Key updates in the MSK program of care including admission, structure, and delivery of the program.
The registration process and implementation timelines.
Presenter: Jessie Farran (she/her), OT Reg. (Ont.), is the Director in Health Services at the Workplace Safety & Insurance Board (WSIB). In this role, she leads a team of clinicians in the quality oversight and development of WSIB’s health care programs and services.
Evidence based resources and tools on the experiences of people with long term symptoms, assessment and treatment considerations for rehab professionals
To provide clinical guidance for physiotherapists with respect to the management of people recovering from COVID-19; and
To ensure system planners and organizations understand the evolving role of physiotherapy to address the rehabilitation needs of patients who are experiencing residual health issues due to COVID-19
CMAH and the University of Toronto developed a weekly program called ECHO Coping with COVID. Designed for health care professionals, it is a space for them to connect virtually and gain new skills, knowledge, and confidence in caring for themselves and their clients during COVID-19. Access over 100 resources and presentations.
Bounce Back Ontario has designed 10 tips focused on how to reduce anxiety, stress, and worry related to COVID-19.
Breaking Free online offers free access to addiction and substance use programs to help alleviate pressure on services and provide support to clients who can no longer access interventions. Access the program.
Crisis Services Canada is a 24/7 national network of distress, crisis and suicide prevention line services. This service is available across Canada via toll-free phone, or text in English.
