Rehabilitation: Courtesy of your insurance company
By R. Brian Webster, LLB
It’s no secret that prompt rehabilitation practices have reduced the ultimate cost of ICBC claims, and ICBC rehabilitation coordinators are an integral part of this process. But it’s important to remember that these coordinators are part of the insurance defence team and not your client’s advocate.
It’s when your patient is discharged from the rehabilitation facility that an ICBC rehabilitation coordinator becomes involved. It’s the coordinator’s job to assist your patient in achieving the highest level of gainful employment and self-sufficiency within the shortest possible time. At this point, ICBC and the health care system become enmeshed and it’s vital to know which rules apply.
ICBC allots the claimant a maximum of $150,000, which can be used to pay for medical (and quasi-medical) treatment not otherwise covered, specially equipped transportation and housing, attendant care up to the cost of a group home or twelve hours per day, aids, vocational rehabilitation, discretionary rehabilitation funds, and weekly temporary total disability benefits, among other things. Of course many restrictions apply to these benefits. It’s important as a health care professional to keep these facts in mind:
- Your duty is to the patient.
- The ICBC coordinator is not a sworn professional treating your patient.
- The ICBC coordinator is part of a system designed to reduce the amount of money paid to your patient.
- The ICBC coordinator is not entitled to confidential information without your patient’s consent.
- Any information you give to the ICBC coordinator can be used against your patient’s claim.
- Your patient’s rehabilitation process and future health care is between you and your patient, and cannot be decided by the ICBC coordinator.
The real value of keeping these guidelines in mind is that they can enhance the coordinator’s participation in your patient’s rehabilitation process. An experienced coordinator may know ways of improving your patient’s rehabilitation process, whether it be by informing you of other professional service providers who can assist you or suggesting routes not otherwise considered.
Of course, part of the coordinator’s job is to reduce rehabilitation expenses. The Insurance (Vehicle) Act regulations do allow arbitration if you feel a reasonable request has been unfairly denied by the coordinator. It can be a speedy, but expensive remedy. ICBC does have the right to refuse otherwise reasonable rehabilitation expenses when they are submitted late, they are not pre-approved, and the medical treatment requested has already been refused on several other grounds. If you’re unsure of your position, consult an experienced lawyer.
ICBC’s rehabilitation regulations are designed to reduce claims by providing legitimate and adequate rehabilitation for their claimants. It’s a system that does work well, but as a health care professional it’s important to know how you fit into the rehabilitation process.
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