A worker brought a complaint that his requests for ongoing chiropractic treatment expenses were treated inconsistently by the WSIB. Recently, he had been informed in writing by the WSIB staff that “Board policy does not allow ongoing or maintenance chiropractic treatment”. In support of his concerns, the worker submitted a number of WSIAT decisions in which the Tribunal granted payment of ongoing chiropractic treatment, applying the test in Operational Policy Document #17-01-02. That policy requires a determination of whether the treatment is necessary, appropriate and sufficient as a result of the injury. The worker was appealing the decision to deny ongoing treatment but asked the Commission to look into the broader policy issue.
The Commission’s review of the file supported the worker’s concern. Some staff appeared to misunderstand the need to review the merits of the individual case following the period of treatment allowed under Operational Policy Document #17-01-03. The Commission also found that there are no current guidelines available to assist staff when making individual decisions on the issue of on-going chiropractic treatments.
The Commission met with the Director of Quality Improvement and the Chief Operating Officer about the policy. The WSIB has now prepared an adjudicative advice document for decision-makers to clarify that the policy allows chiropractic maintenance treatments.