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My Insurance Company said I get 21 treatments...?

26/9/2016

 
Often, people who have been in a motor vehicle accident and have been able to walk away don’t immediately realise the full extent of their injuries.  Adrenaline kicks in.  A few hours after the accident, or the next morning, many people will begin to feel stiff and sore, and find moving difficult. 

If you have a sore neck or back, your doctor (or other health care practitioner) is likely to diagnose you with “WAD”, which is short for Whiplash Associated Disorder.  There are three “degrees” of WAD.  1st degree WADs are minor and usually temporary.  2nd degree WADs are more substantial and will likely include pain and a loss of range of motion, but might be temporary, especially if treated.  A 3rd degree WAD is a severe injury.  So severe, in fact, that you might not ever be clear of the symptoms.

Sprains, strains, and WAD is so common from a motor vehicle accident that, under the Diagnostic and Treatment Protocols Regulation, if you have suffered a sprain, strain, or whiplash in a motor vehicle accident, you are entitled to up to 21 treatments in the first 90 days.  These are the “Protocol Treatments”, and are a small benefit that is easy to receive.  They are direct billed to the insurance provider by your treatment provider.  Your insurance provider could approve further direct bill payments, but if further direct bill payments are not approved, it does not mean that you can’t get your Section B coverage.

It is hoped that if you treat your strains, sprains, or WAD early, they will resolve quickly. The down side is that if you have been injured and you’re in pain, you probably don’t care about if the treatment you are receiving is a “Protocol Treatment” or a “Section B” benefit.  In fact, it may seem to you that your insurance company is being difficult.

The important thing to remember is:
  1. Protocol Treatments are short term and direct-billed to your insurance company
  2. When they are done you still get your Section B benefits, which are reimbursed by your insurance company.

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Calgary Personal Injury Lawyer - Mark I. Lawson
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