Whiplash neck sprains are common. Many people involved in car crashes develop neck pain (with or without other injuries). Women are more prone to a whiplash sprain than men as their neck muscles are less strong.
Some people are surprised at having symptoms after a minor car crash. Even slow car bumps may cause enough jerking of the neck to cause symptoms.
Less commonly, a whiplash neck sprain can occur after a sporting injury, or even with everyday activities such as jolting the neck when you trip or fall.

If your insurance company refuses to pay for your treatments and occurred medical expenses, you still have options and should consider obtaining legal advice:

1. Negotiate: have your legal representative notify your insurance company that you will be disputing the insurer's decision and attempt to resolve the dispute.
2. Mediation: if you cannot resolve your dispute with the Insurance Company, then you can file for Mediation, where a mediator is appointed to your file by FSCO (Financial Services Commission of Ontario) Dispute Resolution Services.
3. Legal: if the mediation failed, then you may file for Arbitration, Lawsuit or Evaluation.
4. Time Limit: you have a maximum of 2 years to file for Mediation and/or Arbitration, Lawsuit or Evaluation form the date that the insurance company refused to pay.

1- If the police have not been notified, they must be informed of the accident. If no police present at the scene then you should go to the nearest accident/collision reporting centre to report the accident with other driver/s involved in the accident/s. Make sure to get the other driver/s information such as name, address, driver’s license number, insurance company name and policy number as well as their vehicle license plate number. Take pictures of the car/s, location, license plate/s and other related objects if you have a cell phone with a camera. Get the name and phone number of witnesses and record all related information. Do not admit fault. Do not compromise yours and other occupant’s safety. Stay calm. 
 
2- If the ambulance has been called you should go to the emergency for examination if you have serious injuries. Takes your valuables with you or give them to someone you know and notify a family member. 
 
3- Contact us as soon as possible to book an appointment if you suffer from any pain or injuries. 
4. It is important that your own insurance company be advised of the accident. If you do not have an insurance company, you will need to contact an insurance company that is involved with the accident such as the company that insured the vehicle in which you were a passenger or the company that insured the vehicle that struck you if you are a pedestrian. Likewise, you should notify any other insurance company that may provide coverage following your accident such as any private disability insurance you may have or any insurance through your employment. Application for benefits under these policies must be made in a timely manner. In respect of automobile accidents, applications for insurance benefits must follow strict provisions and must be accessed immediately in order that you can obtain benefits regardless of fault and before your claim has even been commenced against any responsible party.
 
5. Your school or your employer should be notified that you have been involved and injured in the accident.
 
6- Make sure not to fall into the scam of some of tow truck drivers or body shops who may try to refer you to lawyers and medical clinics. They sell your case and make money off your injuries. Do not accept any money. This is illegal and you should report them to the authorities. You may jeopardize your insurance claim by doing this. 
 
7- It is your legal right and it is your choice to attend any medical clinic, body shop, mechanic shop and seek legal advice from any licensed paralegal or lawyer specialized in personal injury law. Remember that your insurance company, family doctor or lawyer may only suggest and cannot force you despite of your will to attend any service provider including body shops, mechanics and rehabilitation clinics.

8- You must inform your Insurance Company regardless of you being at fault or not if you have been injured in an automobile accident. You must complete and sign the Accident Benefit Form (OCF-1) and other related forms before commencement of any treatment/assessment. We will complete other forms such as Disability Certificate (OCF-03), Treatment and Assessment Plan (OCF-18) and Treatment Confirmation Form (OCF-23) on your behalf. All of the above forms must be signed by you before we submit them to your Insurance Company for their approval.
If you have any additional questions regarding the Injury Claims Process, please do not hesitate to ask your health provider at our facility, or visit:

http://www.fsco.gov.on.ca/en/auto/Pages/default.aspx

The materials provided on this site are for information purposes only. These materials constitute general information relating to areas of rehabilitation. They do NOT constitute medical or legal advice or other professional advice and you may not rely on the contents of this website as such. The contents of the website do not necessarily represent the opinions of ProCare Health Group or its health care providers and directors. For medical emergencies please go to the nearest hospital or contact your family doctor. For legal matters related to your case consult a lawyer specialized in personl injury law.

Home modifications are changes made to adapt living spaces to meet the needs of people with physical limitations so that they can continue to live independently and safely. These modifications may include adding assistive technology, or making structural changes to a home to make it barrier-free and accessible. For more information please click Here.

Health Claims for Auto Insurance Processing is a not-for-profit Ontario corporation established and funded by the insurance industry and operated by a board of directors that includes representatives of the insurance industry and health care communities. The primary role of the CPA (Central Processing Agency) is to act as the agent of insurers to receive specified documents on their behalf; to confirm that the documents are duly completed and contain all of the information required to be included in them; and to then make the documents available for access by the insurers to whom they are addressed. The CPA also acts as an intermediary for the purpose of enabling insurers to communicate information such as claims approval and payment decisions electronically to those health care goods and services providers who wish to receive such communications electronically through the CPA.

The CPA is also expected to be a primary source of the information that automobile insurers will be required (under s. 101.1 of the Insurance Act) to provide to the Superintendent of Financial Services, concerning claims for goods and services for which automobile insurers are liable under contracts of automobile insurance. If you have been involved in an automobile accident the OCF forms must be submitted to your Insurance Company by your health care provider/s via HCAI.

A whiplash neck sprain occurs when your head is suddenly jolted backwards and forwards (or forwards then backwards) in a whip-like movement, or is suddenly forcibly rotated. This can cause some neck muscles and ligaments to stretch more than normal (sprain).

The common cause is when you are in a car that is hit from behind by another car. Being in a car hit from the side or front can also cause a whiplash sprain.

Damage to the spine or spinal cord sometimes occurs from a severe whiplash accident. This is uncommon and is not dealt with in this article. This article deals only with the common whiplash sprain to neck muscles and ligaments. It assumes that you have been assessed by a doctor and serious neck injury has been ruled out.

Note: If you have Extended Health Coverage (EHC), please be aware that the Legislation requires that the funds available in your EHC account be used to pay for treatments prior to your automobile insurance paying for any treatments required as a result of your automobile accident.

• Pain and stiffness in the neck. It may take several hours after the accident for symptoms to appear. The pain and stiffness often become worse on the day after the accident. In about half of cases, the pain first develops the day after the accident.
• Turning or bending the neck may be difficult.
• You may also feel pain or stiffness in the shoulders or down the arms.
• There may be pain and stiffness in the upper and lower part of the back.
• Headache is a common symptom.
• Dizziness, blurred vision, pain in the jaw or pain on swallowing, unusual sensations of the facial skin may occur for a short while, but soon go. Tell a doctor if any of these persist.
• Some people feel tired and irritable for a few days and find it difficult to concentrate.

Initial Examination and Completion of OCF-23 form $ 215

MIG Block 1 (minimum 1 treatment per week for the first 4 weeks) $ 775

MIG Block 2 (minimum 1 treatment per week for the second 4 weeks) $ 500

MIG Block 3 (minimum 1 treatment per week for the third 4 weeks) $ 225

Supplementary Goods and Services (Massage, Acupuncture, supplies, etc) $ 400

MIG Discharge Report (OCF-24) $ 80

Total MIG coverage for the first 12 weeks after the initial Exam $ 2,200

The use of the remaining $ 1,300 out of the total of $ 3,500 must be approved by your insurance company by submitting a treatment and assessment plan form (OCF-18) by your health care provider after the initial 12 week treatment phase has expired. This fund can also be used for additional assessments that may be required if you have not recovered from your injuries to obtain compelling medical evidence that may withdraw you from the MIG and may give you access to the $ 50,000 medical and rehabilitation benefits.

As of September 1, 2010 the Statutory Accidents Benefit Schedule (SABS) has changed in Ontario. The new regulation limits the maximum medical and rehabilitation benefits to auto accident victims to $ 50,000.00 for all related medical expenses (Physiotherapy, Chiropractic, Massage, Assistive devices, Medical Assessments, etc.) However, in order to benefit from such coverage you must:

1. Have suffered from a fracture
2. Have neurological signs/symptoms (numbness, weakness and tingling. etc), which may be attributed to Whiplash Associated Disorder (WAD 3).
3. Have psychological conditions (insomnia, anxiety, stress, depression, phobia and nightmares)
4. Have a pre-existing medical condition(s) that will limit your ability to fully recover from your injury under the Minor Injury Guideline.

In order to be qualified to use the $ 50,000 medical/rehabilitation benefits, your insurance company will require "compelling medical evidence" if you have any of the aforementioned conditions. This evidence consists of, but is not limited to: diagnostic imaging reports (i.e. x-ray, MRI, ultrasound, CT-scans, etc.), list of medications with prescribing practitioner names, letters and referrals by any medical practitioner, and/or a list of pre-existing conditions and date of diagnoses by family physician or other regulated medical practitioner(s).

If you do not have any of the above stated symptoms, your injuries will fall under the Minor Injury Guideline (MIG) and your medical/rehabilitation benefits of $ 50,000 will no longer be available.You will be covered up to a maximum total of
only $ 3,500. This includes all associated goods and services (Medications, Physiotherapy, Chiropractic, Massage, Assistive devices, Medical Assessments, etc.)

For more information please visit FSCO

We provide many different services and depending on the type of injury and the service you require the treatment fee may vary. Please click on the Fee Schedule for more details.

We accept cash, credit card, cheque, extended health plans, auto insurance policy and WSIB claims.

Extended Health Patients are required to pay for any service provided in advance and submit our invoice and their claim form directly to the Insurance for reimbursement if their Extended Health insurance Company does not accept direct billing from providers.

In order to serve you and other patients better, we require a 24 hour prior notice to cancel your scheduled appointment. Please call the clinic you are attending directly for cancellations.

A missed appointment fee of $ 20 will apply to patients who fail to cancel their scheduled appointment without 24 hour prior notice.

You may click on Our Locations tab and directly contact the location near you for their hours of operation, services and details regarding booking an appointment.

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In the majority of cases, the reports of the Insurer Examiners do not support the patient's proposed OCF-18 and is biased in favour of the insurance company. These examiners are regularly used by the Insurance Companies and do not act independently. It is the Insurance company that pays for all the costs associated with these assessments, including the cost of the health practitioner, the written reports and transportation to and from the assessment site.

In many cases Insurance Companies prefer to pay for each Insurer Examination up to $ 2,000 per assessment in order to reject and deny payment of a proposed OCF-18 (Treatment Plan form) of less than $ 1,000 which will actually help patients to recover from their injuries. The insurer examinations do not help patients to recover from their injuries.

In some cases, your health care provider or your legal representative may try to obtain various assessments to provide your insurance company with the compelling medical evidence they require, helping you get the additional benefits (up to $ 50,000) you may require outside of the MIG.

These assessments include, but are not limited to:

• Neurological Assessment
• Psychological Assessment
• Orthopaedic Assessment
• Chronic Pain Assessment
• Dental/Oralmaxofascial Assessment
• In-home Assessment
• Attendant Care Needs Assessment
There are other types of assessments that may be required other than the above.

In Ontario your own insurance company is responsible for the cost of accident benefits including med/rehab services regardless of you being at fault or not. If you have any extended health insurance, you must submit your claim to them first and the unpaid or uncovered portion will be picked up by your own auto insurance company. If you don't have any insurance and are involved in a motor vehicle accident and if you live with your parents, partner or someone who has auto insurance then their insurance may be liable to pay for your cost of medical/rehab expenses and if you live alone then you may be covered by the insurance of the car you were in at the time of the accident or the other car that hit you.

1. Income Replacement: this allows for financial compensation if you cannot work as a result on injuries sustained in your car accident.

2. Non-Earner Benefit: this allows for financial compensation to those who do not work and can no longer carry out normal activities due to injuries sustained in the accident.

3. Attendant Care: this allows for an aide or attendant to help you if you are no longer capable of caring for yourself as a result of injuries sustained in your accident.

4. Caregiver Benefit: this allows for financial reimbursement if you are a primary caregiver and can no longer fulfill the responsibilities required as a result of injuries sustained in your accident.

5. Other Expenses Benefit: this allows for financial reimbursement if you sustained financial losses as a result of the injuries sustained in your accident.

6. Death and Funeral Payments Benefits: a lump sum payment to the survivors of a person that was killed as a result of a motor vehicle accident.

For more details and to find out about your coverage refer to your Insurance policy, contact your Insurance Broker or Insurance company. You may also consult a licensed paralegal or lawyer specialized in Accident benefits and Auto Insurance Law in Ontario.