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TREATMENT BY CHIROPRACTORS
Does the Workplace Safety and Insurance Board
Pay for Chiropractic Treatment?
Yes, the Workplace
Safety and Insurance Board (WSIB) pays for chiropractic
treatment, but there are strict guidelines for the type and length
of such treatment.
When Does WSIB Pay for
Chiropractic Treatment?
WSIB pays for the first health care provider
who treats your work-related injury. If the first health care provider
is a chiropractor, then WSIB will pay for the treatments.
You may select any health care provider you
wish for your next treatment. WSIB calls this your "initial
choice" of health care provider. If your "initial choice"
of health care provider is a chiropractor, then WSIB will pay for
the chiropractic treatments. Once you have made your "initial
choice", you cannot change to another health care provider
without the approval of WSIB.
If your "initial choice" of health
care provider is a medical doctor who refers you to a chiropractor
for treatment, WSIB will pay the cost if they agree the treatment
will help your injury. A medical referral from one doctor to another,
where WSIB agrees with the method of treatment, is not considered
a change of health care providers.
How Do You Get WSIB to Pay for Chiropractic Treatment?
- If your "initial
choice" of health care providers is a medical doctor, he
or she must notify WSIB in writing that chiropractic treatments
will help your injury.
- When WSIB has
approved your chiropractic treatments, they will advise you in
writing.
- You must visit
a chiropractor that treats clients with workplace insurance claims,
as some chiropractors do not.
- Your chiropractor
must send regular reports to WSIB, usually every two weeks.
How Long Does WSIB Pay for a Chiropractor?
- Chiropractic treatments are usually allowed
for the first twelve weeks after an injury. WSIB health
care staff will decide how long the treatments should last beyond
the twelve-week period.
- If your chiropractor believes you need more
than twelve weeks of treatment, after about eight weeks
he or she should write to WSIB to request approval for additional
treatment. In the letter to WSIB, your chiropractor should describe
how the treatment has improved your condition and explain why
additional treatment is necessary.
What If WSIB Decides Not to Pay for Chiropractic
Treatment?
- You can appeal a decision to deny chiropractic
treatment within six months of the date of the WSIB decision.
- Your doctor should write to WSIB explaining
why you need chiropractic treatment.
- Because appeals involving chiropractic treatment
are usually quite straightforward, you may wish to pursue them
on you own. You should collect and submit the information suggested
above to WSIB. Please see the OWA Workers' Information Kit called Appealing
WSIB Decisions for guidance.
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IMPORTANT INFORMATION
There are time limits for appealing WSIB decisions. If you
wish to appeal a decision, contact a qualified representative
as soon as possible. For more information on time limits,
see OWA Fact Sheets 24 and 25 called Appealing
to WSIB and Appealing
to WSIAT.
This Fact Sheet contains general information only. It is
not a legal document. To see what the law says, you should
look at the
Workplace Safety and Insurance Act and WSIB policies.
If you require help and do not have a union to assist you,
contact the Office of the Worker Adviser:
- Our toll free telephone
number is 1-800-435-8980 (English) or 1-800-661-6365 (French)
- or visit our website at http://www.owa.gov.on.ca
Cette feuille-info est
aussi disponible en français
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OWA Fact Sheet 18 - January 2003
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