Table 1 Key features of WCB policies for PT care
British Columbia | Ontario | Quebec | |
|---|---|---|---|
Payment model | Block care model1 [Care is provided as a predetermined block of services in weeks and payment is provided for the whole block] | Program of care (POC) model2 • Low back • Shoulder • Musculoskeletal [Care is provided as a predetermined block of services in weeks] OR Fee-for-service (if patient is not eligible for a POC) | Fee-for-service model [Physiotherapists are reimbursed separately for each treatment session provided to the injured worker] |
Length of treatment | Standard block: • 7 days for evaluation • 6 weeks of treatment Post-surgical block: • 7 days for evaluation • 8 weeks of treatment For both blocks, there is a possibility for a four-week extension if requested at least seven days before the end of the standard or post-surgical treatment block | Programs of care: • Low back POC: 8 weeks • Shoulder POC: 8 weeks • Musculoskeletal POC: 8 weeks For the fee-for-service model, the length of treatment is not specified | No pre-defined or maximum length of treatment but patient needs to see his or her treating physician after either: • 8 weeks of PT • 30 PT visits |
Minimum treatment sessions per week | 2 sessions per week [Fewer than two visits per week may be appropriate if the injured worker has either returned to work or is actively participating in a return to work plan, but this must be approved by the WCB] | Depending on the POC: • Low back: A minimum of 3 visits must be provided within the first 4 weeks of the program • Shoulder: A minimum of 7 visits must be provided during the 8 week program • Musculoskeletal: A minimum of 6 visits must be provided during the 8 week program | No requirements |
Contact with the employer | Required by the WCB (by phone) during the evaluation period | Strongly recommended by the WCB (by phone or by a written form) | Physiotherapists usually do not communicate with patient’s employer |
Clinical evaluation requirements | Physiotherapists must complete a functional evaluation that aligns with their patients’ work tasks and critical job demands | Physiotherapists are required to use a functional outcome measure to track the functional improvements of their patients, which is set by the WCB and differs for each POC | No requirements |
Guidelines with regards to clinical modalities to use | None provided, treatment is left to the physiotherapist’s judgment | Yes, described in each POC manual and based on evidence | None provided, treatment is left to the physiotherapist’s judgment |