TIPS ON COMPLETING THE OCF-18 TREATMENT PLAN (ONTARIO)

If you have been in a motor vehicle accident, after reporting your injuries to your auto insurer, you will receive several forms to complete. These forms are provided form your own insurance company (or the other driver's insurance if, for instance, you are injured as a passenger or pedestrian and do not carry your own insurance) and they are given to you as part of the Statutory Accident Benefits Schedule, also known as the "SABS". The good news is that you do not need to fill these forms on your own. Completing them on time is very important and you should have an experienced personal injury lawyer assist you in filling them out properly.

At the Bernstein Law Group, we know that the aftermath of any motor vehicle accident is stressful on its own. Injured victims of automobile accidents are not only left to cope with their injuries, but they often have to continue supporting their loved ones. Maneuvering the complicated accident benefits system is the last thing any injured victims should be left to do on their own. Our expertise and knowledge of accident benefits help our clients navigate this system from the very outset of the claim until the resolution of it.

The process of completing the various forms can be tiresome and difficult to understand, especially when you are already trying to cope with your injuries. The OCF forms are complicated and we are here to help you every step of the way.

In terms of the OCF-18, it is a form submitted to your insurance company that describes the cause and nature of the injuries sustained in a motor vehicle accident and is critical in attaining your owed medical and rehabilitation benefit.

Your treatment requested in the OCF-18 should be covered in a fair and timely manner provided that the submitted treatment plan is medically supported, necessary and reasonable. Therefore, if you want to get your treatment paid for, then you must get the OCF-18 Treatment Plan completed and submitted to the insurer. Unfortunately, most insurance companies still deny perfectly valid treatment plans.

Download: OCF-18

If the impairment falls within the Minor Injury Guideline (known as the “MIG”), an OCF-23 Treatment Confirmation Form is required instead of an OCF-18. The definition of a minor injury is one or more “sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and any clinically associated sequelae”. 

Download: Minor Injury Guideline here

The OCF-18 treatment and assessment plan identifies the ways in which the injury limits your activities and defines the goals of the treatment plan and barriers that you may face. It also identifies your prior conditions that could affect your response to treatment as well as proposing a treatment plan with the cost estimates.

YOURS RESPONSIBILITIES FOR THE OCF-18

You must complete Part 1, which should be very straightforward for you. This section all you need to do is fill out your date of birth, gender, telephone number, name, and address. Your date of the accident, claim number, and policy number will go at the top of the first page.

In Part 2, you need to fill out the name of the insurance company, the name of the adjuster, and the name of the policyholder on the claim. This information should easily be found on the correspondence from your insurance company addressed to you. After this, you can skip to Part 10 where your printed name, signature, and date are required.

The rest of the OCF-18 Treatment plan is to be completed by your health care provider. Their job is to describe the nature and scope of their practice, the anticipated treatment, your injuries and expectations from treatment, as well as the cost and duration of the proposed treatment.

Unless your insurance company waives the requirement of an OCF-18, a Treatment Plan must be completed before the reimbursement of medical and rehabilitation benefits. Sometimes insurers will choose to agree to pay medical and rehabilitation benefits without requesting a treatment plan. You also do not require the OCF-18 to be completed when requesting compensation for the following: impairments and injuries that full under the Minor Injury Guideline; medical care and emergency services provided within five days of the accident; prescription drug costs; medical items that are $250 or less each; or dental services. You are responsible for providing accurate information when completing the OCF-18. It is also important to note that the legislation changes every few years, and you should consult with a personal injury lawyer to be advised of any changes.

Your OCF-18 should be completed by a regulated health professional. The document will have to be signed by a health practitioner or health care professionals, such as a physician, physiotherapist, chiropractor, optometrist, occupational therapist, dentist, nurse practitioner or speech-language pathologist.

HOW YOUR PERSONAL INJURY LAWYER CAN HELP

Since the system is adversarial in nature, your interests will be protected the best with an experienced personal injury lawyer. Although accident benefits typically involve your own insurance company, they often still put profits over their clients’ health and financial security. Based on the nature of the injuries you have sustained, various types of treatments will be recommended. Some of the more common treatment plans that are submitted include the following:

• Physiotherapy
• Chiropractic Treatment
• Chronic Pain
• Assistive Devices
• Attendant Care Assessment
• Driving and Passenger Therapy
• Psychological Assessment and Counseling
• Neuropsychological Assessment and Counsel
• Behavioral Therapy
• Massage Therapy
• Orthopedic Assessment

The treatment providers our office deals with on a regular basis are very familiar with the OCF forms and with the insurance system in general terms. This form becomes critical to your recovery, and the treatment received and corresponding documents help bolster your case against the at-fault driver.

Our law firm will work with the insurance adjuster to provide you with the best treatment possible. If the insurance adjuster does not cooperate with the process and denies reasonable and necessary treatment, our law office will, without hesitation, file the appeal to the Licensing Appeal Tribunal.

At our office, we understand that following a motor-vehicle accident it can be a very challenging time. By making the most of the accident benefits regime currently in place, we are able to get as much coverage as possible for the treatment our clients need. Our personal injury lawyers are here to maximize your insurance coverage and advance your insurance claim as best as possible. The claim forms can be redundant and frustrating to fill out, sometimes having to fill them out multiple times throughout the process, however, our office is here to assist you. If you have been in a car accident or injured by a motor vehicle as a pedestrian or cyclist, our injury lawyers are happy to provide you with a free case evaluation. If you have any questions about this form or need help filling it out, please contact our office for a free consultation.

Auto insurance is in place to protect injured victims. Our personal injury lawyers advocate for our clients to ensure that insurance does what it is supposed to do. Our law firm proudly services many cities in Ontario, Canada. We provide legal services in Hamilton, Toronto, Oakville, Mississauga, Burlington, Brantford, Stoney Creek, and the rest of Southern Ontario.