What is an Occupational Therapist?

Most people who are injured in an accident instinctively know that they should immediately seek out the closest emergency department or a doctor. If injuries do not require hospitalization, then they are commonly referred to physiotherapists, massage therapists, chiropractors, or another practitioner of physical therapy.

Many people do not know that a registered occupational therapist can be exceedingly helpful to their recovery, rehabilitation, and quality of life after an accident – regardless of the severity of their injuries. In fact, most people don’t know what an occupational therapist is.

What is an Occupational Therapist?

An cccupational therapist is a registered health professional. Often abbreviated to simply ‘OT‘, they are governed by the College of Occupational Therapists of Ontario. The College defines OT practice as:

“the assessment of function and adaptive behaviour and the treatment and prevention of disorders which affect function or adaptive behaviour to develop, maintain, rehabilitate or augment function or adaptive behaviour in the areas of self-care, productivity and leisure.”

Contrary to their title, OTs do not necessarily address an injured person’s occupation. Rather, they help people restore function and participation in all areas of their lives – work, home, leisure and social activities, mobility, and much more. They will often work directly with your physiotherapist and other treating health care practitioners.

What does an Occupational Therapist do?

If you have been injured, it is useful to have an occupational therapist on your rehab team right away. The OT can perform many useful roles:

• If you have been hospitalized, the OT can help with discharge planning and ensuring that the right equipment is ordered and delivered to your home
• Conduct a home safety assessment to determine the need for adaptive and safety devices as well as your mobility needs, such as the need for an entry ramp, bathroom safety devices like grab bars and shower chairs, or a hospital bed.
• Conduct an Attendant Care Assessment under the Statutory Accident Benefits Schedule (“SABS”), to determine the amount of attendant care or quasi-nursing services you may need. If you do need attendant care, then the OT will take steps to put that in place.
• Conduct a mobility assessment to determine if you would benefit from assistive devices to help you walk, sit, stand or transfer between these positions.
• Arrange for transportation to and from medical appointments.
• If you are “catastrophically impaired” – a specific designation under the SABS – many OTs can act as Case Managers and quarterback much of your rehabilitation. If you are not catastrophically impaired, many OTs will nonetheless provide case co-coordination for individuals who have complicated or multi-symptom injuries.
• Because the OT needs to have a thorough understanding of your medical condition and work with your treatment team, they may accompany you to certain appointments and liaise with your family doctor.
• When you are ready to return to work, the OT can liaise with your employer to provide workplace accommodations so that your return to work is a smooth transition.

Many OTs also have sub-specialties, such as in mental health or amputations. These OTs provide further specialized services to individuals with these types of medical conditions.

If a client is not able to function optimally because of brain injury, mental health, or behavioral problems, we also provide direct treatment to help these issues resolve. So, while equipment, education, quasi case management and assessing for benefits are key aspects of our role, when those are stable, we [provide] direct treatment to help people live better.

–Solutions For Living by Entwistle Power Occupational Therapy

Who Pays for Occupational Therapy Services?

OT services, unless delivered in a hospital, are privately-funded. If you are hospitalized following an accident, the OTs services will be covered by OHIP while you are in the hospital. Once discharged, you will need to retain a private OT yourself. If you have a medical-dental benefits plan, it is possible that some OT services may be covered by your plan.

If you have been injured in a car accident, OT services are covered by the medical-rehabilitation sections of the SABS. If you hire an OT, they will obtain the necessary funding from your auto insurer by way of  a Treatment and Assessment Plan – called an OCF-18 – in order to do the initial assessment. Ongoing OT treatment will be set out in a further form. The OT bills the auto insurer directly.

If you require equipment and devices, the OT will complete forms for those items and submit them to the auto insurer on your behalf. If the auto insurer approves the expenses, the OT will assist you with the purchases and provide you with instructions on how to use the equipment and devices.

OTs in the Litigation Process

If you have commenced a lawsuit for your injuries, your lawyer may hire an OT to assist with the case. In the litigation context, OTs provide the following forms of assistance by way of expert evidence:

• They prepare Life Care Plans or Future Cost of Care reports, outlining the type of treatments, devices, equipment, and other care you may need in the future, and how much each of these items will cost over your lifetime.
• They may provide your lawyer with information about your housing needs post-accident.
• They can conduct Functional Capacity Assessments to determine what your workday tolerances are, in assessing your return-to-work capabilities.
• In some scenarios, they can complete Catastrophic Impairment Assessments to determine whether you have sustained a catastrophic injury as categorized under the SABS.

In these scenarios, your OT may be called upon to give evidence in court.

How Do I Find an Occupational Therapist?

You may locate an OT near you by contacting the College of Occupational Therapists of Ontario. Your family doctor and physiotherapist/massage therapist may be familiar with some OTs who work in the community. Finally, if you have retained legal counsel then your lawyer may know of some OTs who are well-versed in the SABS.