Learn the basics about massage therapy coverage after a car accident in today’s article. Designed for ICBC claimants and massage therapists we discuss therapy payments for car accident related injuries in British Columbia.
Massage Therapy- ICBC Benefits
ICBC is only required to fund the first $23 of massage treatment performed by a Registered Massage Therapy. Most massage clinics charge a user fee in addition to the funds received from ICBC for each visit. User fee amounts for massage therapy can vary and are not government regulated. I have seen user fees for massage therapy vary from $20 to $60 depending on the experience and location of the therapist.
Massage therapy, as a “physical therapy”, is a benefit ICBC is obliged to pay under s. 88(1) of the IVA Regulation: Raguin v. Insurance Corporation of British Columbia, 2011 BCCA 482. However, reimbursement is only mandatory for 12 physical therapy treatments: Section 88(8) and Jurczak v. Mauro, 2013 BCSC 1320 at para. 35.
ICBC is only liable to pay for more than 12 treatments where, before any additional treatment is given, ICBC’s medical advisor or the insured’s medical practitioner certifies to ICBC in writing that the treatment is necessary for the injury claimant. The claimant needs to get a medical note or brief report certifying the necessity for the massage treatment before treatment commences.
Although user fee payments may be covered under private insurance coverage they are not covered under ICBC accident benefits. Some ICBC claimants cannot afford this medically necessary treatment so some therapist have agreed to provide treatment and wait to be paid following the settlement or court decision in the case.
To get treatment in advance of payment claimants sign a “Letter of Direction” assuring the therapist the treatment bill will be paid. This arrangement has been increasingly used with mixed reviews in the last 10 years. A letter of direction may require the claimant to pay interest on unpaid amounts and is a lien on the personal injury award.
Unlike some other therapists ICBC, the Insurance Corporation of British Columbia, does not currently permit massage therapist to bill the corporation electronically.
Massage Therapy- Cost of Future Care
In the claim against the at fault driver, the tort claim, a claimant can recover the cost of the user fees if the treatment is related to the car accident injuries. Provision can also be made in a court award for future massage therapy treatments if the court is convinced this is reasonable.
If the injury claimant has primarily relied on periodic massage therapy treatment in an effort to cope with neck and back pain this can be claimed as a cost of future care. This is especially true if they have received a substantial degree of relief through the massage therapy, but that the beneficial effects wear off after a few days.
In the case of Westbroek v. Brizuela,2014 BCCA 48, up until trial the claimant had attended for massage therapy on at least a bi-weekly basis at $80.00 per session. The judge’s view was this therapy would be required to age 65. Using a present value discount rate of 3 1/2 percent and the claimant’s age the resulting projected cost was $35,953.63.
The unpaid cost of past massage therapy should be claimed as well as the reasonable cost of future massage treatments. However the court can make deductions from the cost of future care award to account for future ICBC benefits.
ICBC almost always seeks deductions for costs of medications, physiotherapy, kinesiology and massage therapy from the court award under s. 88(1) of the Regulation at the end of the tort trial. However, when ICBC has already reimbursed the claimant for more than 12 physical therapy treatments further benefits for massage therapy are not mandatory and should not be deducted(see Olson v. Farran,2016 BCSC 2149).
Unfortunately, there have been no accident benefit increases for innocent victims since 1990 and in 2017 the ICBC contribution toward the cost of massage therapy remains at $23 per session.
Posted by ICBC Personal Injury Lawyer Mr. Renn A. Holness, B.A. LL.B.– Mr. Holness has over 21 years legal experience representing BC victims of injury in claims to recover accident benefits.