DAC Communiqué - November 1999

Information Communiqués should be circulated amongst all DAC Clinical and Administrative staff. They are intended to keep DAC staff informed on current issues and to provide information on the activities of the Minister's Committee on the Designated Assessment Centre System (DAC Committee).

 

This issue provides an update on DAC Committee membership; announces the appointment of Care Source, the new Medical and Rehabilitation DAC in Ottawa; highlights recent roster activity; introduces the new OCF 11A & 11B Designated Assessment Referral and Summary Report; addresses DAC referral issues; speaks to DAC Information Binders; addresses electronic reporting issues; informs about the new Guide for Conducting Disability Assessments; and responds to inquiries about the recent request for DAC Assessor Practice Summaries, questions regarding uncooperative claimants and Catastrophic Impairment assessment reports.

DAC Committee Membership Update

The DAC Committee is pleased to announce the Minister's appointment of Karen Lock, Vice President, Metro Region, Cooperators General Insurance Company.

 

Karen Lock replaces Judy Maddocks, one of the insurance company representatives on the DAC Committee, now that Ms. Maddocks has concluded her two-year appointment to the Committee.

New Medical and Rehabilitation DAC in Ottawa

The DAC Committee is pleased to announce the addition of Care Source Physiotherapy and Rehabilitation Centre to the roster of Medical and Rehabilitation DACs in the Ottawa Area.

 

Care Source (DAC 5010) is an established multi-disciplinary assessment and treatment centre located in the southwest end of Ottawa.

 

Care Source was added to the roster as of September 20, 1999 and is now accepting Medical and Rehabilitation DAC referrals. We welcome Care Source to the DAC community.

Recent Roster Activity

DAC #1027 and DAC#4001

DAC #1027 (Dr John McLachlan, Toronto) and DAC #4001 (Acquired Brain Injury Rehabilitation Services, Peterborough) have both requested that they be removed from the active DAC roster as they have closed their practices. The DAC Committee wishes to thank them for their contribution to the DAC system since 1994. 
 

RECENT ROSTER ACTIVITY (Continued)

 

The revised pages of the DAC roster for the third quarter of 1999 have been distributed with this Communique.

OCF 11A & 11B: Designated Assessment Referral and Summary Report Form

In consultation with the DAC Committee, the OCF 11 Form has been revised and divided into two parts: OCF 11A Designated Assessment Referral Form and OCF 11B Summary Report Form.

 

The OCF 11A is to be used by insurers to refer a claimant for a DAC Assessment. The OCF 11B is to be used by the DAC as a report summary. The primary purposes of these changes are: to promote transparency in the assessment process; to notify the claimant of the referral questions and the list of documents sent by the insurer; and to eliminate the need for a covering letter from the insurer.

 

The OCF 11A will be completed by the insurer, as before. Two new sections have been added: Referral Question(s); and the List of Documents Forming the Referral Package.

 

The insurer will send the OCF 11A to the DAC but they are now required to send a copy to the claimant as well. DACs should review the referral package to confirm that the claimant's copy of the OCF 11A has been sent by the insurer.

 

If the claimant's copy of the OCF 11A is still included in the referral material, it should be sent to the claimant when the DAC sends out its appointment letter.

 

The OCF 11A replaces the need for covering letters from insurers to the DACs, as the form will provide all the information necessary to initiate the assessment. It is, therefore, no longer appropriate for insurers to include a covering letters with their referral packages.

 

The claimant now has the opportunity to provide the DAC with any other documents, such as recent test results, that they feel may be useful to the DAC in completing their assessment. With more complete information, the DAC will be able to more efficiently conduct a comprehensive assessment and better assist the insurer and claimant in resolving their dispute.

 

DACs should be aware that a complete assessment report will now include: the report with signatures from all assessors, a completed OCF 11A, and a completed OCF 11B. This will ensure that all DAC reports are consistent in style.

DAC Referral Issues: What Should DACs Now Do?

The ABAU receives many calls regarding the DAC referral process, specifically with regard to the content of referral packages and covering letters as well as the appropriateness of the referral questions asked.

Covering Letters

DACs should be aware that Bulletin A-5/99, which introduces the new OCF 11A and 11B forms, directs insurers to cease the practice of including cover letters with the referral package.

 

DACs must make insurers, claimants and their representatives aware that covering letters are no longer to be included with referral packages. Any covering letters that are received by a DAC must be shared with the other party, regardless of content.

Referral Questions

Pursuant to the Statutory Accident Benefit Schedules (SABS) and the DAC Assessment Guidelines, DACs must be capable of identifying the appropriateness of referral questions given a particular case.

 

There may be situations when a party asks the DAC to address issues/ questions which are not relevant or appropriate to the DAC type.

 

DACs are mandated to respond only to issues as required by the SABS and the DAC Assessment Guidelines. Any issues which fall outside of these requirements are not to be addressed by the DAC.

DAC Information Binder

The DAC Committee has developed a Table of Contents to facilitate the assembly of a DAC Information Binder at each DAC facility. A copy of the Table of Contents has been included with this Communiqué for distribution.

 

The Table of Contents contains a complete list of all DAC guidelines, Information Communiqués and other information items developed and distributed by the DAC Committee and the Financial Services Commission of Ontario. It is designed to facilitate access to information and ensure that DACs have the most comprehensive and current information.

 

DAC are expected to use this Table of Contents to construct one or more of the DAC Information Binders at each DAC facility.

Electronic Reporting

A review of recent electronic reporting statistics has identified a number of DACs who have not yet reported or have reported zero activity for 1999.

 

All DACs are reminded of the importance of accurately reporting all DAC activity, even in the absence of any DAC referrals. Each DAC must dial up through their Lotus Notes application and connect to our server each month to file an Activity Report, even if it totals zero. This will ensure that each DAC will have the most up-to-date forms and will also indicate to the ABAU that the DAC has reported.

 

For DACs who have made arrangements to submit their Activity Reports through another DAC, we ask that they ensure that their monthly activity reports are electronically filed under the appropriate DAC number.

New Guide for Conducting Disability Dac Assessments

In September, the DAC Committee sent out the new Guide for conducting Disability DAC assessments to Disability DACs for their review prior to an information seminar for DACs which was held on November 5, 1999.

 

Beyond achieving the goal of developing an assessment process that is consistent with the Statutory Accident Benefits Schedule, the Guide allows for and relies on each clinician involved to use his/her own professional clinical judgement in both screening and planning the assessments and also interpreting the assessment outcomes.

 

The main change in the Disability DAC structure is the movement from single assessor centres to centres that are staffed with a multi-disciplinary team. The most frequently heard concern from both insurer and consumer representatives was that all Disability DACs be qualified to perform both physical and psychological assessments for individuals.

 

The Guide outlines standards regarding the necessary physical and human resources required of Disability DACs together with a framework for the key components of intake, assessment and reporting. For single assessor DACs wishing to expand their mandate, the Guide outlines how they may meet the standards.

 

In order for all Disability DACs to have the opportunity to meet the new requirements, the DAC Committee has allowed a transition period to provide each DAC time to acquire and have approved the required physical and human resources.

 

Between now and the end of January 2000, the DAC Committee will be conducting an evaluation of the capability of each Disability DAC to meet the new requirements. Information regarding the submission your DAC is required to make is included with this material.

We've Had Questions:

DAC Assessor Practice Summaries: Does a DAC have to resubmit Practice Summaries for those Assessors who have already been reviewed by Accident Benefit Analysis Unit?

 

The Accident Benefit Analysis Unit wrote to all DACs in July, 1999 indicating the list of DAC Assessors who have been approved and listed on facility rosters. DACs were asked to ensure that they submit completed DAC Assessor Practice Summaries for any individuals who were not noted on these lists.

 

DACs are reminded that they must have a practice summary signed by both the roster member and ABAU staff, on file for each assessor. If a DAC has a practice summary signed but both the practitioner and the ABAU, then they need not resubmit another practice summary unless the status of a health care professional has changed.

 

DACs are reminded that if the practice summaries are not received on all DAC assessors, then those assessors will not be considered approved members of the DAC team.

 

What do we do when a claimant fails to cooperate or complete an assessment?

 

If a DAC encounters a situation where a claimant refuses to cooperate, or misses appointments, that are required for the completion of the DAC report, the DAC should write a letter to the insurer and the claimant clearly explaining why they are unable to complete their mandate.

 

The letter should indicate that the DAC is incomplete and that a DAC report will not be issued until the claimant cooperates and completes the assessment. This applies to all types of DAC assessments.

 

Catastrophic Impairment Assessments:
Are non-catastrophic findings, based solely on a CAT DAC paper review, prohibited?

 

CAT DACs are reminded that they are prohibited from issuing a "non-catastrophic" finding based upon a paper review only.

November 1999

 
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