The current payment scheme under the Minor Injury Regulations puts some unfair pressure on physiotherapists to diagnose a ‘minor’ soft tissue injury. The reason for this is that if they diagnose your injuries as a WAD I or WAD II (‘WAD’ stands for ‘Whiplash Associated Disorder’) which is defined as a ‘minor’ injury, then they are paid directly by the insurance company for the first 21 treatments – no questions asked. If, however, they diagnose you as a WAD III or WAD IV (non-minor injury involving either neurological signs such as tingling or numbness in hands/fingers/toes etc. or a fracture of the spine) you will have to pay the physiotherapist yourself and then seek reimbursement from your own insurer. Obviously this is a much more difficult situation to manage and you may not be able to pay the upfront costs of multiple physiotherapy sessions before your insurer starts reimbursing you. For many, this will be a large disincentive to receiving significant numbers of physiotherapy treatments.
Recently, several insurance companies complained about a physiotherapist who was diagnosing people as having non-minor injuries. The insurance companies want physiotherapists to diagnose your injuries as ‘minor’ and have set up the direct-payment scheme to make it easy for the physiotherapists to do so.
The ‘moral’ of the story is to clearly voice your concerns with both your physiotherapist and your family physician. Here are some additional tips:
- Don’t allow your physiotherapist (if you feel they are) to minimize or downplay your injuries;
- If you’re in pain say so;
- Provide specific examples of numbness/tingling if you are experiencing any;
- Be sure to provide specific examples of everyday tasks that you are having problems with;
- Ensure your complaints go into their chart.
Working with an injury lawyer will also ensure you have an advocate looking after your best interests. Don’t hesitate to get in touch with our office for a free consult.