Treatment Philosophy
Primary Treatment
Return to Work
Assessment
Secondary Treatment
Tertiary Treatment
Treatment Philosophy
The WCB supports a functional restoration approach that promotes a return to normal activity - including work - in a safe manner. Passive care is
discouraged. The goals are to maximize the injured worker's functional abilities to the pre-injury condition, if possible, and enable an early
return to work, preferably with the pre-injury employer.
The Functional Rehabilitation Model of care is encouraged because it:
- uses the restoration of function as the first measure of treatment success.
- encourages care providers and clients to recognize that successful long-term recovery is associated with return to function, even in the presence of increasing symptoms where there are no objective signs of harm.
- Is supported by significant evidence-based literature.
The Symptomatic Model of care is discouraged because it:
- uses reduction or abolition of subjective symptoms as the measure of success.
- uses passive care to ease symptoms.
- may contribute to chronic disability patterns.
Primary Treatment
Primary treatment is provided as soon as possible following an injury. Single service health care providers throughout the province provide primary
level treatment. The primary practitioner is usually the first health care provider to see an injured worker after an accident, and is generally
a family doctor or general practitioner, a chiropractor, dentist, optometrist or physiotherapist.
A primary practitioner assesses an injured worker and develops a management plan that may include: diagnostic investigation; referrals to
specialists, other health care professionals or treatment facilities; and a referral, if appropriate, to an assessment team via the WCB.
Sometimes, workers seek treatment without knowing their condition is work related. (A work injury is an injury that happens on the job and that
needs medical treatment and/or time away from work.) In these cases, the WCB asks primary practitioners to:
- inform the worker that the condition might be covered by the WCB.
- submit an Initial Report to the WCB to initiate a claim.
- advise the injured worker to report the injury to the employer and the WCB.
Because most workers can perform sedentary or light duties very soon after their injuries, the primary practitioner should, with the knowledge and
agreement of the injured worker, provide information to the employer regarding the worker's fitness for transitional return to work.
Return to Work
Return to work is a vital part of the recovery process. Because most workers can perform sedentary or light duties very soon after their injuries,
the primary practitioner should give the worker a list of any restrictions they may have because of the injury. The worker should be advised to
give the list to the employer so the employer can adjust the workers duties to allow a return to work during recovery. See our
Recovery and
Return to Work for Injured Workers brochure.
The primary practitioner should maintain ongoing communication with the worker, the employer, other health care professionals and the WCB to
support and encourage full return to work when appropriate.
For more information, see our
Recovery and Return to Work brochure.
Assessment
If a worker's recovery doesn't proceed as expected, the primary practitioner is expected to:
- Recognize patients who would benefit from an assessment team review, and to ask the WCB to arrange the review.
- Provide information to an assessment team when needed.
- Review the assessment team's recommendations with the injured worker and implement a treatment plan.
- Cooperate with return-to-work programs.
If the injured worker's recovery does not proceed as expected, they are referred to an assessment team that confirms the diagnosis and
recommends a plan of treatment to assist the primary practitioner in management of the patient.
Besides recommending any specialist and diagnostics services, assessment teams also identify the appropriate level of treatment for the worker
(primary, secondary or tertiary), a timeline for RTW planning, and an indication of whether the worker has pathology to preclude his/her return to
the pre-injury job on a permanent basis.
The WCB has a network of approved assessment teams and treatment centres around the province, so that injured workers can receive treatment close
to their homes.
Secondary Treatment
Secondary treatment programs provide multiple services by an interdisciplinary team of health care providers. At the secondary level:
- Functional impairment may be greater than expected.
- Psychosocial issues may be delaying recovery, but generally are not affecting participation in a treatment program and the worker is reasonably expected to return to full pre-injury job duties
- Treatment programs are available regionally, are typically six to eight weeks long and have a functional focus.
- Discharge from the program is related to the ability to perform pre-injury job duties.
- Development and support of the worker's transitional and full RTW plans are also part of the treatment program.
Tertiary Treatment
Tertiary (third level) treatment programs provide multiple services by an interdisciplinary team of health care providers experienced in the
management of injury with permanent impairments and/or significant psychosocial and pain management issues. At this third level of treatment:
- Functional impairment may be far greater than expected.
- Psychosocial and pain management issues often interfere with the injured worker's participation in a treatment program and prevent recovery,
and/or the worker may have permanent restrictions from the pre-injury job.
- Programs are available regionally, generally last eight to 12 weeks and have a functional focus.
- Development and support of the worker's transitional and full RTW plans are part of the treatment process.
Treatment & Assessment