Accident Benefits
Accident Benefits

Independent Medical Examinations (IMEs)

NYRC conducts in-person assessments with appropriate neuro-musculoskeletal or mental and behavioural health practitioners to produce unbiased and objective reports. The assessment assists in determining disability status, attendant care needs, catastrophic entitlement and medical/rehabilitative requirements to return claimants to their pre-accident state.

Medical Rehabilitation

Medical Rehabilitative Assessments evaluate an individual’s current functional status to determine what medical or rehabilitative interventions are reasonable and necessary to return the individual to their pre-accident status. These types of assessments are completed by NYRC’s roster of healthcare professionals including specialists, physicians and other allied health practitioners.

Disability Assessments

A Disability Assessment includes a comprehensive file review in addition to an in-person evaluation consisting of a detailed history and physical, psychological, psychiatric or functional examination. This assessment is conducted to determine the individual’s ability to complete activities of daily living such as employment requirements to return claimants to their pre-accident state. These assessments are conducted by the appropriate neuro-musculoskeletal health practitioner or mental and behavioural practitioner.

Post-104 and Residual Earning Capacity (R.E.C.) Assessments

Post-104 and Residual Earning Capacity Assessments provide a physical demands analysis and a review of the claimant’s transferable skills; this includes a labour market survey. The Post-104 assessment will generate an occupational cluster that determines the employment type that is reasonably suited to the individual and will determine if the individual is able to return to any employment for which he/she is reasonably suited by education, training or experience.

In-Home Assessments

In-Home Assessments examine the home environment and provide recommendations that can assist the claimant with re-integration into their activities of daily living following discharge from a hospital or long-term care facility. The in-home assessment can also identify the claimant’s pre-accident activities of daily living and determine their current functional abilities within the home to comment on their housekeeping and/or home maintenance needs. A Form 1 Assessment of Attendant Care Needs is completed, if applicable. These are typically done by an occupational therapist.

Functional Capacity Evaluations (FCE)

Functional Capacity Evaluations assess a claimant’s Functional Capabilities with respect to the physical demand of the claimant’s pre-accident occupation and/or activities of daily living. The assessment employs standardized and/or occupation-specific tests to provide objective measurements to evaluate and determine an individual’s physical abilities and limitations.

Work Site Assessments

Work Site Assessments outline the essential tasks and physical demands of an individual’s pre-accident occupation including on-site consultation with employers. This is the most valid way to determine the essential tasks of one’s job. A report is completed with digital photos of their workstation or work environment. These assessments are typically done by an Occupational Therapist, Kinesiologist, Physiotherapist or appropriately trained healthcare professional.

Catastrophic Determination Assessments

A Catastrophic Determination Assessment Plan is compiled based on the submitted OCF-19 and a comprehensive file review. This includes identifying the accident-related diagnoses and assigning an appropriate team of medical professionals to perform either a file review or a multidisciplinary direct assessment, based on the criteria outlined in the OCF-19 form. Once the assessment plan is approved by the insurer, the assessments are then scheduled.

The Catastrophic Determination Assessments are performed in accordance with the Statutory Accident Benefits Schedule (SABS) and the American Medical Association Guides (AMA) to the Evaluation of Permanent Impairment, 4th Edition. This is to ensure an appropriate impairment rating determination. The assessments are compiled for the lead medical assessor, who then performs a Catastrophic Impairment Rating and Catastrophic Determination Analysis.

All catastrophic medical professionals have a minimum of five (5) years experience with independent medical examinations. The lead evaluator remains current with provincial guidelines and is current with medico-legal requirements with regard to impairment determination and entitlements with their respective province.

Comprehensive Psychological Vocational Assessments

A Comprehensive Psychological Vocational Assessment analyzes the claimant’s transferable skills, prepares a labour market survey, assists with career planning, vocational counseling, job searches and placement to determine future vocational options. An occupational cluster of suitable employment is identified based on the claimant’s education, training and experience. The review is conducted by physical, mental and behavioural specialists to determine return-to-work suitability.

Future Care Assessments

Future Care Assessments are an evidence-based review to identify future care needs and life plan requirements. They are provided by Certified Life Care Planners that have a wide range of experience. Our professionals will provide an organized, concise plan for current and future medical needs with associated costs to assist in returning the injured claimant to their pre-accident life activities.

Home/Vehicle Modification Assessments

Home Modification Assessments identify accessibility barriers, and risks based on the claimant’s accident-related impairments and specify modification to or adaptations of the home environment. This is a multidisciplinary assessment that typically uses an occupational therapist, an engineer and an architect to determine reasonable and necessary home modifications.

A vehicle modification assessment will determine reasonable and necessary changes to a vehicle to improve accessibility for a claimant.