With this Bulletin, the Financial Services Commission of Ontario (FSCO) is releasing a revised Pre-approved Framework (PAF) Guideline for Grade I and II Whiplash Associated Disorders and accompanying Pre-approved Framework Extension Request and Discharge Report form (OCF-24/198). This Bulletin also highlights amendments to the Statutory Accident Benefits Schedule (SABS) that enable issuing of this combined Guideline.
Also being highlighted is a regulation under the Insurance Act to define livery vehicles.
Revised PAF Guideline
A revised PAF Guideline for Grade I and II Whiplash Associated Disorders is being issued pursuant to Section 268.3 of the Insurance Act. This Guideline provides an overview of the expected course of treatment for minor whiplash injuries (WAD I and WAD II whiplash associated disorders) currently addressed through two separate Guidelines.
Changes in the revised PAF Guideline include:
- focus on returning the insured person to his/her pre-accident functions,
- inclusion of both "discretionary" and "recommended" interventions,
- permitting treatment to begin at any time post accident,
- addition of a new onsite review and intervention to replace the old Activities of Daily Life Intervention (ANLI) and,
- merging the fees for treatment of WAD I and II injuries.
The revised PAF Guideline is a result of FSCO’s PAF Guideline Project. The PAF Guideline Project examined current scientific literature related to the assessment and treatment of minor whiplash injuries in order to update the current Guidelines, originally issued in 2003. The PAF Guideline Project included extensive consultation with representatives of the insurance industry, health care provider community, legal community and consumer stakeholder groups. More information on the PAF Guideline Project can be found on the FSCO website at www.fsco.gov.on.ca.
Effective Date of PAF Guideline – October 1, 2007
The new PAF Guideline is effective on October 1, 2007. It will apply to all new Pre-approved Framework Treatment Confirmation Forms (OCF-23) that are submitted by a health practitioner on or after October 1, 2007, or when the insurer has waived the requirement for an OCF-23 on or after October 1, 2007. The previous WAD I and WAD II Guidelines remain in effect for OCF-23 forms that are submitted by a health practitioner before October 1, 2007, or when the insurer has waived the requirement for an OCF-23 before October 1, 2007.
Revised OCF-24/198 Form
The Pre-approved Framework Discharge and Status Report Form (OCF-24/198) has been revised to reflect changes in the new PAF Guideline. The form has been re-named the Pre-approved Framework Extension Request and Discharge Report to better reflect its purpose.
This form is submitted by the health practitioner to the insurer when the insured person is discharged or withdraws from PAF Guideline treatment.
This form is effective October 1, 2007, and must be completed in connection with goods and/or services provided under the revised PAF Guideline.
Amendments to the SABS
Ontario Regulation 295/07, filed and effective on July 3, 2007, amended the SABS to reflect the replacement of the two current PAF Guidelines with the revised PAF Guideline.
New Regulation to Define Livery Vehicles
Effective March 1, 2006, the Budget Measures Act, 2005 (No.2) introduced a third party liability cap that applies to owners of rental or leased vehicles under the Insurance Act. The cap does not apply to public passenger vehicles such as taxis, limousines for hire or livery vehicles. Ontario Regulation 296/07, filed and effective on July 3, 2007, clarifies the meaning of livery vehicle by defining the term for the purposes of the Insurance Act.
Copies
Copies of the PAF Guideline for Grade I and II Whiplash Associated Disorders and the Pre-approved Framework Extension Request and Discharge Report (OCF – 24/198) are attached for your information and can also be downloaded from the FSCO website at www.fsco.gov.on.ca.
The PAF Guideline for Grade I and II Whiplash Associated Disorders will also be published in a forthcoming edition of The Ontario Gazette.
Ontario Regulation 295/07 and Ontario Regulation 296/07 can be downloaded from the Ontario e-laws website at www.e-laws.gov.on.ca. These regulations will also be published in a future edition of The Ontario Gazette.
Bob Christie
Chief Executive Officer and
Superintendent of Financial Services
July 11, 2007
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