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October is Occupational Therapy Month!

 

If you or a family member has ever required Occupational Therapy Services please help us in the fight to get OT services covered by insurance companies across Canada! Physiotherapy, Massage Therapy and Chiropractic Treatments are all recognized and insured, but Occupational Therapy is not?

 

As occupational therapy becomes well-known and valued by health care consumers, many Canadians are disappointed to find that that their extended health insurance plans provide limited coverage for occupational therapy services. In order to encourage the coverage of these services, consumers need to contact their extended health insurers. Below is a letter that you can "cut and paste" into a word document to send to your insurance company to begin these conversations.

 

This letter is intended as a template and may be changed to specific needs and requirement. Let us know if your insurance company covers OT services and we will add the company name here, so others can see who which companies have jumped on board! We want to hear from you.

  

Address

 

Date

 

RE: Inclusion of occupational therapy services in health benefits plan

 

To Whom It May Concern:

 

I recently required the services of an occupational therapist and, to my dismay, I learned that my extended health benefits plan through your company does not cover these services. I am requesting coverage of occupational therapy services in my plan.

 

Occupational therapy is a recognized, registered health profession that provides a broad spectrum of client centered services that focus on health promotion, disability prevention, and functional restoration. Occupational therapy is offered in many settings including the home, workplace, community, hospitals, educational environments, and personal care homes.  As part of insurable health service, occupational therapists seek to identify and address issues that affect disability, improve daily function and level of independence, and reduce disability claims by offering a perspective that encompasses both the physical and mental health of the individual. Occupational therapists are key members of health care teams; no comprehensive benefits package is complete without occupational therapy.

 

As a policyholder with your company, I would appreciate a response indicating when your company will cover occupational therapy services, which I feel is a valuable allied health provider, and whether or not a flexible plan is being considered as an option for your clients so that I may take advantage of the services that an occupational therapist would offer.

 

Sincerely,

  

Client’s name & insurance number

 
 
 
 
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Even after practicing occupational therapy in Canada for 11 years, I still have a hard time defining what I do in one sentence. The profession of Occupational Therapy (OT) has been around since the first world war, as we provided wives of husbands who were off at war, the skills to make them employable in previously male dominated industries. We also assisted  the injured soldiers with relearning their "activities of daily living" (a term adopted by the profession to describe all tasks related to self-care, productivity and leisure).

 

Since then, the profession, which has grown worldwide, includes rehabilitative therapy for people living with disability throughout the lifespan, from infancy to death. OT's can specialize in a variety of practice areas including the treatment of clients with Mental Health conditions, orthopaedic injuries, spinal cord and brain injuries, the science of Ergonomics and the effects on people, acute hand injury intervention, neonatal care and much more. Through education and skill building we teach injury prevention techniques at work and home, which many companies and groups are benefiting from.

 

Most Canadian OT's are now graduating from a Masters Program in schools of Medical Rehabilitation within the faculty of Medicine, along with other allied health professionals, such as physiotherapists. Our academic credibility is supported by the vast amount of research that comes from the profession of many hats, making strong contributions to the medical research community. For more information about the profession, please visit the Canadian Association of Occupational Therapy at http://www.caot.ca

 

It might seem surprising that most insurance companies do not recognize OT as a basic insurable service, as they do with Massage Therapists, Physiotherapists, Chiropractors and other allied health professionals. Some insurance companies have included OT in their extended health packages, but often these limit coverage to one visit per year or the equivalent in maximum limits. The Canadian Association of Occupational Therapists have been fighting the battle for many years to get the recognition we deserve in the eyes of the insurance companies, with only minimal success.

 

In speaking with insurance companies locally, it is clear that their members are not asking for the services OT's provide, unless they have a family member with a disability or they themselves have been injured. Unfortunately, like any other insurance coverage, you many only see the value in it following a loss, like house insurance if your house burns down. These insurance companies only include services the majority of their members are requesting they cover.

 

We need to do a better job, at least in Canada, to educate people about how occupational therapy can help people following an injury,  medical diagnoses, or in later life when the physical changes with aging affect  mobility and independence. People need to start requesting that their insurance providers cover the services that  they or their family member may urgently need one day. We also need to do a better job of marketing the profession. You have seen comercials for Phyiotherapy  and Chiropractors, but have you ever seen a commercial about Occupational Therapy? Instead of blaming my association for not putting enough resources into marketing and advocating our profession, I am doing my part to spread the word.  OT's are building skills for living, and its time everyone knew what we do and how we can help them.

 

Here is my best stab at a one sentence definition of what an occupational therapist does: "Helping  people to be as healthy and independent as possible in all areas of living, at home, work and play, throughout the lifespan." I would love to hear how you define what OT is or how it has helped you, a friend or family member. I will post a collection of definitions titled "What OT Means to Me" that can be used in our national campaign to have OT recognized by the majority of insurance companies as a basic insurable service.

 

Marnie Courage, OT Reg (OT)

Managing Director

Enabling Access

marnie@enablingaccess.ca

 

 

 

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