Rehab benefits. We are here to help you get better.

What are “No Fault Benefits?”

 

It does not matter who caused the accident, all parties are entitled to receive benefits for income loss and rehabilitation.

 

What will ICBC pay for as “No Fault Benefits?”

 

•    Income loss benefits called “total temporary disability benefits” or “TTD Benefits”.

•    Medical and rehabilitation expenses which include physiotherapy. massage therapy, chiropractic treatments, home care assistance, special medical equipment, ambulance transportation, and others. Funeral expenses, Death benefits.

 

Do I qualify for TTD Benefits?

 

You will only get TTD benefits if you have exhausted all other income replacement benefit programs you may pay into i.e. Employment Insurance Sick Benefits and/or Short-term Disability Benefits.

 

If you are off work because of an accident and you are eligible for EI Sick Benefits, you must apply for these Benefits. You are to attend at your local EI office and obtain the Sick Benefit package, or you can apply on-line. ICBC must be given proof of your application for EI Sick Benefits before they will consider assisting you during the 6-weeks it will take for your first cheque to arrive from EI. In addition, if you receive less than $300.00 a week from EI, you may be eligible for a “top-up” from ICBC.

 

If you have Short-term Disability Benefits through your employer or privately, you must apply for these benefits immediately.It is only if you do not have EI Sick Benefits or Short-term Disability Benefits and have given proof that you do not qualify, will ICBC then pay TTD Benefits.

 

How do I apply for TTD Benefits?

 

ICBC pays up to 75% of your average gross weekly earnings to a maximum of $300.00 per week. To apply for TTD Benefits, you must provide proof of your income either by letter from your employer, or through pay stubs going back the last 12 months. In addition, you will require a note from your family doctor stating that you cannot work because of your injuries in the accident.

 

How do I get medical and rehabilitation benefits?You need a note from your family doctor stating that you require therapy. The note must state the kind of therapy you need i.e. physiotherapy, and that this is needed because of the MVA or “motor vehicle accident”. ICBC will not pay for any treatment without a doctor prescribed referral note. In addition, ICBC will only pay for treatment on a monthly basis. Therefore, every month, when you see your doctor, you must get an updated note that states that your therapy should continue for another four weeks.ICBC will only pay for what it considers “reasonable” expenses. You should therefore discuss you needs with your doctor, and you should ask that any recommendations be recorded. You should also obtain a note from your doctor confirming his or her recommendations.

 

What happens if ICBC disagrees with my doctor’s prescribed treatments?

 

Unfortunately, this does happen, sometimes on the basis of an adjuster’s, not a doctor’s opinion. The first step in fixing this problem is to tell your doctor. ICBC will often change its mind on treatment expenses if your doctor provides more information. At the very least, your doctor should note in your medical file “Patient denied treatment”. If you can afford it, continue to pay the medical expenses and make the costs part of your claim (see “special damages” below).

 

How do I get my prescriptions and other accident related expenses reimbursed?

 

In the event that you have extended health insurance coverage i.e. Blue Cross or Manulife, you must first submit your receipts for these expenses to that insurer. ICBC is, however, obligated to reimburse you for any shortfall which you may incur. That is, if your extended health insurance plan covers only a portion of your expenses (for example, 80%) and/or you surpass the limit set out by that insurer (for example, $500.00 per year), ICBC is obligated to reimburse you for the difference.Please keep copies of all receipts and claims forms which you may submit to your extended health insurance provider and forward them to us, together with a copy of the documentation confirming the total reimbursed to you. We will forward the appropriate documentation to ICBC and request reimbursement of any shortfall.If you do not have extended health insurance, please forward your original prescription receipts to us when they total $100.00 (or depending upon your financial need). We will forward these receipts to ICBC and ask them for reimbursement.

 

Who pays the physiotherapist, massage therapist, etc.?

 

Your therapist will usually bill ICBC directly for your treatments. However, you will be required to pay an additional “user fee” of $10.00 to $20.00 per treatment.Unfortunately, ICBC is not required to reimburse you for these “user fees” up front. However, if you have extended health care, you must submit the receipts to that provider for reimbursement. If you do not have extended health care, please provide us with your receipts for the user fees on a regular basis, and we will add them to your claims as a “special damage” (see below).If ICBC refuses to pay for your treatment as billed directly by your therapist, the therapist will bill you directly. If your therapist bills you directly, please keep all therapy receipts and, again, provide them to us when they total $100.00.

 

What about other out-of-pocket expenses or “special damages"?

 

You may have a number of other out-of-pocket expenses resulting from this accident which do not fit neatly under the heading of rehabilitation expenses. These expenses are generally called out-of-pocket expenses or “special damages” and they are only recoverable at the conclusion of your claim for personal injuries. ICBC has no obligation to reimburse you immediately. You must keep receipts proving that you have incurred this expense.Examples of special damages are:

1. the cost of replacing clothes or damaged personal items destroyed in the accident;

2. reasonable taxi fares (not tips) incurred during the period of time immediately after the accident when you may have been unable to drive or use public transit;

3. reasonable car rental which ICBC may have failed or refused to pay during the time that your car was being repaired;

4. payment to a housekeeper, a gardener, or any other individual who provided you with assistance; 5. over-the-counter medications i.e. Advil, Robaxacet, etc. 6. mileage for the use of your care to attend doctor and therapy appointments. Please note that ICBC does not pay gas receipts. ICBC pays $0.30 per km.These are only some examples, there are many more.

 

Please discuss with us any expenses that you may have incurred that you feel should be reimbursed at the conclusion of your claim so that we may provide you with a preliminary opinion on whether or not it is a recoverable expense.