Section B Treatment Protocols
12/8/2014 9:00 AM
Section B Treatment Protocols (Automobile Accident Diagnostic and Treatment Protocols Regulations, NS Reg 20/2013) – they have been around since April 2013, but they are still a bit of a mystery for many.
The idea behind the Protocols is to enable people who have suffered minor injuries to be able to access treatments faster, without having to use their own private insurance, in the hopes of a quicker recovery. The Protocols apply to sprains, strains, and whiplash injuries for a person who is insured under an automobile insurance policy and eligible to receive section B benefits. When a family physician, chiropractor or physiotherapist diagnoses the insured person as having suffered a sprain, strain or whiplash injury as a result of a motor vehicle accident, then that insured person, along with their health care practitioner, can decide whether they want to follow the Protocols.
If an insured person decides to follow to follow the Protocols, they must inform their insurance company within 10 days or as soon as practicable. The insurance company must deny the request in writing, or else the treatment plan proposed by the health care practitioner will be assumed to be accepted and the insurance company will be required to cover the costs of the treatments.
The types of treatments can include chiropractic treatment, physiotherapy, massage therapy, acupuncture or occupational therapy. The number of treatments covered will depend on the diagnosis made by the health care practitioner. In the case of sprains and strains, a 1st or 2nd degree diagnosis allows for up to 10 treatments, while a 3rd degree diagnosis allows for a maximum of 21 treatments. The same allotment applies for Whiplash I (10 treatments) and Whiplash II (21 treatments). All treatments must be completed within 90 days of the date of the accident. The treatments are paid for directly by the insurance company and the insured person does not have to pay out of pocket or process it through their private insurance policy.
If, after all treatments are complete, the insured has not recovered, they may be seen by an injury management consultant (approved doctors, chiropractors and physical therapists) who can offer a second opinion to the originating health care practitioner.
In the event that the insured person continues to suffer from their injuries after exhausting all the benefits under the Treatment Protocols, they are able to access the usual Section B benefits available to them.
If you have questions or would like to discuss this topic further, please contact Melissa P. MacAdam at Patterson Law at 1-888-897-2001.
Please note that this article is meant to provide information only and is not intended to confer legal advice or opinion. Please note as well that many of the statements are general principles which may vary on a case by case basis. If you have any further questions, please consult a lawyer.