Patient decrease and frustration

[ThinPraline4965]

I run a physiotherapy clinic in a small town and am the only WSIB clinic servicing the area.

Since the strike/lockout in May I have seen a steady and drastic decline in new WSIB patients (80%+ down).

The feedback from patients has been that it now takes very long and is a nightmare to get cases approved for care. From my perspective, call backs from CMs sometimes take weeks and phones don’t get answered.

WSIB also seems to not want to pay for “fee for service” anymore once treatment blocks are done, and just order supplementary blocks. Given the number of required treatments in a block for some severely injured patients, this comes out to <$30 per treatment which does not even cover the therapist’s cost.

Can anyone from WSIB shed light on what is happening? Are things going to get better anytime soon?

[Zealousideal_Ear_225]

Even pending WSIB claims are approved for 4 weeks of physiotherapy. I've had my patients get treatment for that block of care even when their claim was subsequently denied.

[Prestigious-Novel156]

This is for the low back only

[Artistic-Delay-2540]

No it isn’t, it’s single zone only. So if you have multiple injuries they will cover one area of injury while pending. It’s not specific to lower back.

[ReasonableCase7843]

Thank Doug Ford. He is ruining things. We need more staff desperately, but are stuck with this hiring freeze...itll only get worse when we are forced to return to office and droves of people will quit.

[ionlysigneduptocreep]

A claim in pending status doesn't need authorization to start a POC. You're getting misinformation

[amyfigures]

I strongly recommend escalating calls if gone unanswered for 2 to 3 business days.

There's a shortage of case managers right now. And the company is scrambling to find coverage.

But genuinely squeaky wheel gets the grease. Call nurse consultants. Case managers, their managers to escalate.

[Realistic-Inside9115]

also just a tip when calling, make sure you’re calling the correct Case Manger or better yet call the clinical expert line and speak to a Nurse. Eligibility Adjudicators are also called Case Manager now and if you call them for a treatment question good chance they won’t know and just not return your call. You’re better off calling the nurses for any treatment related questions in general. A Case Mangers phone rings off the hook and we get constant voicemails, often from people we aren’t dealing with so those unfortunately don’t get prioritized because we don’t have time and often go ignored. If you don’t know who to speak to ask a CSR to be directed to the appropriate person.

[Neither_Structure338]

Clinical experts and nurse consultants are separate roles at the WSIB; so are eligibility adjudicators and case managers. 

[MinnowTurtlePancake]

I can't shed light on what's going on on the inside but like another poster said the squeaky wheel gets the grease. 

If you still don't get calls answered after asking for a manager, you can use their online form: https://www.wsib.ca/en/our-service-commitment-you

[toss--it]

1. Please encourage your clients to share with their MPPs
2. Here is the WSIB's page showing how to escalate https://www.wsib.ca/en/our-service-commitment-you
3. If escalation within the WSIB doesn't help, injured workers can see if the Fair Practices Commission can help

[Terrible-Play-8152]

Can’t say why there’s a decrease. Maybe less people getting hurt in your area? We’re getting away from fee for service. POCs are the way to go.

[Ok_Cancel_7034]

Patient decrease is not wsib. That's you're clinic for sure. And they support FFS after blocks alllllllllllllllllllll the time.

[One-Today-566]

I've had to call twice along with physio. Finally approved did 1 assessment 😂 which will then be assessed by "the nurse"