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Motor Vehicle Accident

GLA Rehab Motor Vehicle Accident

Assessments
Treatments

Assessments

Hospital Discharge

A care plan is developed before discharge. Our OT/Case Manager will communicate with the client’s team and will complete a home assessment to assess accessibility, should this be an issue.

The OT/CM then communicates with the insurer to ensure collaborations with regards to approvals for assistive devices, paid personal care and any issues related to a smooth discharge plan.

The discharge therapist will send a report to the client, insurer, and lawyer with recommendations.

The following is an example of what can be done following the discharge:

  • The client will receive a name and phone number of the provider to contact should any questions arise.
  • Recommendations for home support will be discussed with the client and family. These recommendations may include OT, PT, Rehab Therapy, Social Worker etc. Assistive Devices will be ordered form vendors.
  • They will also learn when and how often support will be provided and how the support will be monitored and reviewed.

The next step:

  • An assessment of attendant care needs will be scheduled as soon as possible. Further recommendations for care needs and rehabilitation will be documented and treatment plans will be sent to the insurer for approval.

OT Functional Assessment and Attendant Care Assessment

The Statutory Accident Benefits Schedule (SABS) of Ontario’s Insurance Act sets out a provision for an Attendant Care Benefit for eligible claimants who have been injured in motor vehicle accidents.

Our occupational therapists assess the attendant care needs of their clients. The OT’s assessment of physical, psychosocial, behavioural, cognitive or perceptual functions, lends a comprehensive insight to the client’s ability to manage daily living skills independently.

According to the OSOT ‘Assessment of Attendant Care Needs Form 1: Resource for Reflective Practice,’ (April 2011) “consideration must be given to the impact of all injuries and sequelae arising from the automobile accident, which impact function, whether that be from a physical, psychosocial, behavioural and/or cognitive perspective.”

The assessment report will identify the client’s needs with regards to medical and rehabilitation services, the level of assistance with self-care tasks needed, as outlined in the required Assessment of Attendant Care Needs (Form 1) and the assistance with housekeeping and childcare/caregiving and transportation.

The next step:

  • The Form #1 will be sent to the insurer through HCAI ( an online platform developed for communication with insurers)
  • Treatment plans for further recommendations will be sent to the insurer
  • Referrals for further assessment and treatment outside of GLA Rehab will be made
  • Rehabilitation therapy will commence upon approvals from the insurers.

OT Cognitive Assessment

When medical records indicate that the clients are experiencing cognitive problems affecting their ability to complete daily function, schooling or work related tasks, our OT’s can offer a cognitive-perceptual assessment.

The occupational therapist uses standardized assessment tools, to assess attention skills, memory, visual perception, executive skills, and organization. The OT is also observing the client’s cognitive, physical, behavioural, and psychosocial impairments and strengths, while performing functional tasks.

The result of this assessment can assist to determine areas of cognitive deficits and to plan interventions to remediate or compensate for these deficits, when the main long term goal is to help client return to ADLs, work, school and leisure.

Next step:

Following the assessment and analyzing the results, the OT will complete the following:

  • Write a comprehensive cognitive assessment report that will be circulated to the client and their rehab team so that everyone is aware of the difficulties.
  • Develop cognitive remediation activities to provide feedback to the client regarding their abilities and progress.
  • Develop cognitive compensation strategies to assist the client to develop further independence by using some tools to eliminate cognitive mistakes. For example, for individuals with impaired memory, the OT will set up alarms on the client’s cell phone to remind them of their appointments or when to ingest medications.
  • Coordinate cognitive-behavioural goals, tools and strategies with the rehab team to ensure a team approach.

Job Site Evaluation (JSE)

A job site analysis is an on-site evaluation that analyzes the client’s job demands and identifies the physical, cognitive and emotional/behavioural factors required to perform each job task.

Components of a Job Site Analysis:

  • The physical job demands include sitting, standing, horizontal and vertical reaching, motor dexterity, resistive tool handling, lifting/carrying, pushing/pulling, stooping/kneeling/crouching/crawling, walking, climbing, balancing, foot/hand controls, visual acuity/talking/hearing/handling. The frequency of these demands and the force needed are determined.
  • The ergonomics component incudes assessing the work station design and set up, and tool design.
  • Environmental factors include noise, temperature, light, and vibration, which may influence performance.
  • Administrative controls include: scheduled breaks, sequencing of tasks, pace of work or quotas, deadline, stressors etc.
  • Cognitive data include attention, memory, organization, awareness, judgment, executive skills, new learning requirement, etc.
  • The social components include: team work, work in isolation, relationship with superior, collaboration, sharing workload, etc.
  • Further information is obtained through co-workers, the supervisor, and the Physical Activity Factors identified in the National Occupational Classifications.
  • JSEs can be used to assist in determining if the client is ready to return to work, if job modifications are needed, and to identify the duties and the demands that need to be focused on, in a work-conditioning program.
  • It establishes the expectation of the employer and a plan for a return to work program. It may be helpful in identifying psychological factors that may impact returning to work.
  • The assessment establishes job demands to allow off-site simulation in a work conditioning program.

Next step:

  • The OT or the PT will produce a Job Analysis Report that provides a description of the client’s job demands and will identify barriers to return to work.
  • This report will be shared with the rehab team and with the insurer. The rehab team will then develop collaborative goals to help the client with a return to work process.
  • For example, the PT will identify the physical demands of the job that the client should be able to perform and will help the client to restore these abilities. The OT will identify the cognitive and behavioural demands and will develop therapeutic activities that will help the client progress in this area.
  • The social worker can address the emotional components of the job and how it may relate to the client’s fear, low self-esteem, symptoms of depression, etc.
  • The team will also communicate with the insurer and the family physician with regards to the client’s ability/inability or capacity to work.
  • The outcomes of this assessment can affect Income Replacement Benefits.

Social Worker Assessment

Social work assessments involve gathering information about an individual’s or family’s circumstances, emotional and functional strengths, challenges, and needs. This process typically includes interviews, observations, and reviewing relevant documents and records.

The assessment addresses the problems that affect a person or family’s emotional status, and mental health issues. It highlights the existing support networks, coping mechanisms, and personal assets of people and communities, and it recognizes their innate resilience and capabilities.

Following the assessment, social workers can create interventions that encourage positive change and improve well-being, by being aware of these factors. Social workers can help people and families overcome obstacles and capitalize on their resources by leveraging their strengths.

Next step:

  • The social worker will complete the report, which will outline the client’s and family’s emotional difficulties following the MVA. The report will include a care plan or intervention strategy, which will be tailored to the individual’s or family’s specific needs and circumstances.
  • The report can also provide a better understanding of the wellbeing of the whole family following the accident.
  • At times, the social worker will recommend individual sessions for different family members and family therapy to address the family unit’s emotional health.
  • The social worker will collaborate with the rest of the rehab team to ensure a team approach.

Psychological Assessment

Psychological assessment is the process of evaluating a client’s mental health and behavioural functioning through the use of standardized tests, observations, and other methods.

Psychological assessments can assist in diagnostic clarification and treatment planning. Our clinicians have specialized training and experience in the assessment of trauma and sequelea post MVA.

All of our assessments include a thorough psychosocial interview with our clinician. As well, they involve the use of several psychometric tests to provide objective data. The use of these testing instruments facilitates a more accurate and valid diagnosis.

Next step:

  • The psychologist makes recommendations for therapeutic intervention and further referrals such as a referral to a psychiatrist if needed. Our rehab team will follow the recommendations and treatment plans will be sent to the insurer.
  • Psychological diagnosis can assist with Catastrophic application, with income replacement benefits and with access to other services.

Physiotherapy Assessment

Our neuro-physiotherapist tests movement, strength, joints, balance, gait, posture and neurological problems . Physiotherapists are skilled health professionals whose training allows them to accurately diagnose musculoskeletal injuries, as well as other conditions such as vestibular disorders.

The use of outcome measures helps to determine effective treatment options and monitor progression.

Following a physical assessment, the findings might lead to a more detailed assessment in other specific areas such as spasticity, postural assessments, cognitive assessments, or splinting assessments to name a few.

Recommendations following physiotherapy assessment can include PT treatment, assistive devices, other rehab services such as OT or kinesiologist and home modifications related to accessibility.

Next step:

  • Following the assessment the PT will complete a detailed report with recommendations for PT treatment to improve overall mobility, device recommendation and other services. The report will be circulated within the team and will be copied to the client and the stakeholders. Treatment plans will be sent to the insurer.
  • The PT will maintain communication with the rehab team to ensure a team approach as the client progresses.
  • Our physiotherapy services take place at home and in the community. If possible, and when the client is ready, our PT will refer the client to a clinic.
  • The physiotherapy report can explain the client’s functional difficulties with regards to completing self-care tasks, housekeeping tasks, driving and with working.

Functional Capacity Evaluation (FCE)

A functional capacity evaluation (FCE) is a set of tests that are used to identify a person’s physical skills, functional capabilities, activity endurance, and work tolerances. It is an evaluation of a person’s functional capacity in relation to a job’s demands.

The FCE is a 6-to-8-hour evaluation that is administered over one or two days by an occupational therapist or physical therapist.

The unilateral and bilateral functional testing are based on job demands, such as reach forward, reach waist to shoulder, work above shoulders, forceful grasping, handle/grasp (power), fine manipulation, lift floor to waist, waist to shoulder, shoulder to overhead, carry, and push and pull.

The tasks are broken down into measurable physical demands. The evaluation measures functional abilities and limitations to perform physical demands.

The client’s functional abilities and limitations are a combination of the client’s test scores, ability to work at a competitive rate, effort, medical contra-indications, tolerance and endurance.

The results of the FCE can be used to direct rehabilitation and/or as part of a disability determination.

Next step:

  • A Functional Capacity Evaluation (FCE) or Functional Abilities Evaluation (FAE) can be invaluable in dealing with an occupational or non-occupational injury or illness, including such injuries as those sustained in motor vehicle accident claims, slip and fall cases, workplace accidents, as well as impairments and restrictions pertaining to medical conditions.
  • It can assist in determining the reason the person can or cannot work which can affect income replacement benefits and short and long term disability benefits.

OT Cognitive Functional Capacity Evaluation (COG-FCE)

The Cog-FCE assessment includes an in-depth interview, a series of standardized assessments related to job demands and individual challenges, a complete cognitive job demands analysis (overview), structured work simulation and gathering collateral information from the family or employer.

The assessment accounts for the physical, functional, cognitive, psycho-emotional and behavioural issues, faced by those with cognitive challenges that can result following brain injury, secondary to mental health concerns, or with neurological conditions.

It is used to determine if the physical and cognitive abilities of the client at the time of the assessment match the demands of your job.

A Cognitive Functional Capacity Evaluation is a one to two day assessment that objectively assesses cognitive abilities, including attention and memory, planning and problem-solving, and behavioural changes and fatigue.

Recommendations are related to the feasibility for employment, overall work capacity, and return-to-work goals for people with cognitive-behavioural problems.

Next step:

  • The report will include a detailed description of current cognitive and behavioural abilities, related to typical demands clients may face at work and in their day to day life, and if their current abilities match these demands.
  • If these areas do not match, the Cog-FCE is a helpful tool that can be used to develop an individualized rehabilitation program. This includes strategies and accommodations addressing specific areas of concern that may help clients either return to work safely, improve their work performance, or increase their daily activities.

Orthotic Assessment

Post accident clients may have mobility problems and compromised gait. A foot orthosis can be inserted in a shoe to help support or improve the function of the foot and/or ankle.

The main goals of an orthotic device are to improve biomechanics, re-distribute pressure or to accommodate acquired deformities.

The ultimate goals are to improve and maintain joint alignment during the gait cycle or the individual’s highest functional level.

Foot orthotics can support the feet and ankle, correct gait, accommodate position if the client is not walking, provide shock absorption and re-distribute pressure on the feet.

Next step:

  • Once assessed prescribed and received, the orthotic assessor will prescribe the devices and will visit the client one more time to make adjustments once prepared.

Vocational Assessment

A vocational assessment is a comprehensive evidence based evaluation of an individual’s transferable skills, qualifications and aptitude and interests. This evaluation aims to identify potential return to work and future employment and/or training options.

The evaluation includes the client’s skills, education, age, disabilities, and work history.

It is completed by a vocational expert that will likely conduct a personal interview, complete medical and other records review and complete the testing and analysis of ability to return to employment for which the client was trained and experienced for or return to any employment for which the client is physically and cognitively able to perform.

Next step:

  • Once completed, a report will be generated to include a detailed description of current physical, cognitive and behavioural difficulties, related to typical demands that clients may face at work and the ability to return to the work force on any level.
  • This report is a helpful tool to indicate probability of return to work and any recommendations with regards to a return to work plan, retraining or developing an a-vocational plan.
  • The assessor may recommend accommodations addressing specific areas of concern that may help clients either return to work safely, improve their work performance, or increase their daily activities. The assessor may recommend a retraining program or development of different interests and productive activities if the client is unable to return to the workforce.

Future Care Cost

A Cost of Future Care Report, also called a Life Care Plan or Future Care Cost Analysis, is an assessment, completed by a Certified Life Care Planner CCLCP, and is used to outline the medical and rehabilitation needs and associated costs for an individual who has experienced long term and chronic healthcare needs.

It is a dynamic document that is based on published standards of practice, comprehensive assessment, thorough research, interview with client and family, discussion with health care providers and rehab team and data analysis.

Anticipating future requirements involves considering needs with regards to future assessment and rehabilitation services, including physiotherapy, occupational therapy, psychology, nutrition, etc, medications, assistive devices, housing needs, caregiving needs, attendant care, housekeeping and home maintenance, transportation and other health care and non healthcare expenses.

A Cost of Future Care Report is written by a regulated healthcare professional who is also a Canadian Certified Life Care Planner (CCLCP).

Next step:

  • A Cost of Future Care Report provides the client, family, treatment team, and legal representatives with a comprehensive outline and quantifies the client’s needs over a lifetime and the costs associated with accessing the treatment, services, and equipment they will require.
  • This can help with allocating funds throughout a claim and with settling a claim.

Catastrophic Assessment

When one is injured in a motor vehicle accident in Ontario, the insurer places the client in a certain medical and rehabilitation funds category, based on the severity of the injuries.

Persons who have severe and complex injuries will often require access to funding for their rehabilitation and care needs over their lifetime. Clients with injuries meeting the Catastrophic Impairment (CAT) definition requirements, may have access to a higher level of benefits for medical and rehabilitation goods and services.

There are several criteria that can move a client from a non-Catastrophic category to Catastrophic. These are time sensitive and are based on the type of injury and functional impairments.

Throughout the rehabilitation process, clients may apply to move to a higher category of funds (Catastrophic) which is based on the severity of the outcome/complications of their injury.

A CAT assessment will determine whether the client is entitled to a catastrophic level of funding. Assessments evaluate the client’s physical, mental, and behavioural state to determine if the injuries and impairments affect their daily living and ability to work.

Our professionals are fully trained and certified in the use of the AMA Guides to the Evaluation of Permanent Impairment and in catastrophic impairment assessments.

We established a team of OTs, orthopedic surgeons, psychologists, psychiatrists and other physicians to complete a team approach assessment for catastrophic determination.

Next step:

  • Once the reports are produced, our physician will sign the OCF19 (application for Catastrophic Determination) and the insurer will most likely arrange a second opinion assessment.

Treatments

Occupational Therapy

Following a motor vehicle accident, many people face a wide range of physical, cognitive and emotional challenges.

Our Occupational therapists will start the intervention by assessing the unique needs of each individual.

Our OTs address the clients mobility, home safety, independence with activities of daily living, cognitive functions and ability to participate in self care tasks, homemaking, childcare, school, work, leisure and social activities.

Throughout therapy intervention, the OTs will educate the client on symptoms management and will facilitate return to productive and meaningful life by developing remediation and compensation strategies for functional impairments.

The long term goal is to return the clients to their optimal functional level.

Occupational therapists use cognitive rehabilitation strategies to improve mental functioning and support the return to daily routines.

Our OTs work closely with individuals and their families to develop personalized rehabilitation plans that focus on restoring functionality and achieving the highest level of independence possible.

Case Management

A case manager is a health professional appointed to support you with your rehabilitation. The case manager will carry out a need assessment. This report is essential for identifying your medical and rehabilitation needs and link you with right resources.

Case management involves planning, implementing, coordinating, monitoring and evaluating the options and services available that will help meet your needs.

Holding a wealth of knowledge about rehabilitation and care, case managers provide invaluable insight for your rehabilitation and litigation team. The overall aim is to maximise your daily functions.

In Ontario, case managers are usually employed following a CAT designation.

Some of the areas a case manager may get involved with include:

  • Setting up and monitoring your treatment team.
  • Finding appropriate accommodation if your current residence is unsuitable.
  • Coordinating with various health and social services to ensure your needs can be met.
  • Arranging or organizing assessments by healthcare professionals, including therapists, psychologists and other professional services, such as orthotics, pain specialist, psychiatrist, etc.
  • Ensuring you have the correct equipment that will help promote confidence, increase independence and aid comfort and safety.
  • Working closely with you and your family, offering help, support and guidance.

Personal injury claims can be long and complex. The case manager role is vital in helping you secure the compensation you need for the best quality of life possible.

Physiotherapy

After a motor vehicle accident, individuals may experience a range of physical and neurological challenges that can affect their daily lives. Neuro-physiotherapists play a pivotal role in helping clients recover and regain function following an accident.

Our physiotherapists start their intervention by assessing range of motion, strength, balance, mobility, safety within the home and in the community and ability to perform physical skills such as walking, sitting, standing, lifting, carrying, stairs management and more.

Throughout the intervention, our PTs will use various orthopedic and neurological techniques to improve physical impairments. When needed, the PT will prescribe assistive devices or will refer to the proper professional to address it.

Our in-home PTs provide care to individuals who cannot access clinic treatment for different reasons such as severity of injuries, inability to stay in multi stimulus environment such as a clinic and inability to get to a clinic.

The main long-term goal is to return the clients to their optimal mobility and functional level.

Rehab Therapist

Rehabilitation therapists have various training and skills. They work closely with our occupational and physical therapists, and other healthcare professionals, to deliver comprehensive care for individuals who have experienced physical, cognitive and emotional problems.

They carry out prescribed exercises and therapeutic goals as established by the healthcare professionals to improve independence and function. In addition, they follow homework and strategies developed in OT or Speech Language Pathology sessions to augment on these professionals goals.

Our Rehab Therapists engage the clients back in the community through functional and fun activities to improve productivity, improve mood and eliminate social isolation.

Massage Therapy

Motor vehicle accidents can leave individuals with a range of physical and emotional challenges, from muscle tension and pain to stress and anxiety. In these situations, massage therapists play a crucial role in promoting the healing and recovery process.

Massage therapy after a motor vehicle accident is a holistic and effective approach to healing. It addresses both the physical and emotional aspects of recovery, helping individuals regain their comfort, mobility, and peace of mind as they navigate the path to recovery.

Social Work

Social workers provide counseling and therapy sessions to help individuals cope with the emotional trauma resulting from a motor vehicle accident. They provide a safe space for individuals to express their feelings, including anxiety, fear, grief, and anger. They help in developing coping strategies, manage stress and work through trauma to promote mental well-being.

Our social workers use Cognitive Behavioral Therapy (CBT) techniques, Eye Movement Desensitization and Reprocessing (EMDR), Safe Talk therapy, Mindfulness, Art therapy and other trauma approach strategies to improve emotional functions.

Social workers also offer support and guidance to families dealing with the aftermath of an accident, including helping them understand how to best support their loved one’s recovery.

Kinesiologist

Kinesiologists are regulated professionals who focus on physical rehabilitation, pain management, and functional improvement, with the goal of helping clients regain their independence and productivity.

Kinesiologists design exercise programs that focus on improving strength, mobility, and flexibility. These exercises help clients regain physical function, reduce pain, and enhance their overall fitness, resulting in returning to daily activities, school, work and leisure and hobbies.

Aqua Physiotherapy

Aqua physiotherapy can help individuals regain mobility, manage pain, and work towards a full recovery with the guidance of trained physiotherapists.

The buoyancy of water reduces the impact on joints and muscles, making it a gentle, yet effective form of therapy for individuals with post-accident injuries. This reduces pain and minimizes the risk of further injury.

Physiotherapy in water allows for easier movement, making it possible for individuals with mobility limitations to perform exercises they might find challenging on land. This can help regain flexibility and range of motion.

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