Frequently Asked Questions About ICBC Claims

At Triumph Physio, we frequently work with people who receive assessments and care through ICBC claims. These claims cover you to receive the physiotherapy treatments you need to recover from injuries caused by a motor vehicle accident (MVA), ensuring you can get better without breaking the bank. With that said, the process of getting care through an active ICBC claim can often be confusing, with many people unsure of the steps they need to take or the treatments they qualify for.

We get questions about ICBC claims a lot, so we’ve decided to put together a list of some of the most frequently asked questions on the topic. Here’s everything you need to know about receiving physiotherapy and other treatments through an active ICBC claim!

Do I qualify for physio treatment as a result of my motor vehicle accident?

If you were injured as a result of an MVA and sustained whiplash or a neck or back injury, you may be entitled to receive physio treatment as part of your ICBC claim. It all begins when you make your initial claim to ICBC after the accident. When you phone ICBC to make a claim, be sure to declare the injuries you sustained. ICBC will provide you with a claim number, which is essential for getting future care covered by your insurance.

Once you’ve made your claim, declared your injuries, and received your claim number, you will almost certainly be approved to receive physio treatment. ICBC covers 25 sessions of physiotherapy, but this coverage only lasts for 12 weeks from the date of your crash. For this reason, it’s important to book your first physio appointments as soon as possible in order to maximize your coverage. The one caveat is that your claim must be considered ‘active’ in order to get coverage for physical treatment—this means you’ll need to wait for the go-ahead from ICBC before beginning your treatment.

I can’t take care of my home after my accident—does ICBC cover the cost of having someone help me at home? Do I qualify for help at home?

It’s not uncommon for us to work with people with severe injuries that limit their ability to take care of their homes. Tasks like cooking and cleaning can be difficult or near-impossible with certain injuries, leading many to ask about their options for hiring personal care. ICBC does cover these expenses in certain cases, but you’ll first need to complete a Personal Care Assessment with your ICBC recovery specialist.

If your specialist’s report agrees that you need support with caring for your home, you can go ahead and hire someone to help. According to ICBC, this could be a professional assistant, but it could also be a friend or a family member. Assuming you qualify for personal care coverage, you will have to pay for it out of pocket, but these costs will be reimbursed by ICBC. You’ll need to carefully maintain records of the costs of this care, including tracking the amount of hours your assistant works. These records should be regularly submitted online using ICBC’s online claims service.

The amount that ICBC covers for personal care depends on the extent of your injuries. For most injuries, they’ll cover up to $5,703 per month. But if you have injuries deemed ‘catastrophic’ by ICBC (injuries that will take longer than 12 weeks to recover from), you could receive up to $6,820 per month, or up to $11,333 per month if you have catastrophic injuries and require 24-hour care.

Do I need to see a doctor to qualify for physiotherapy care?

Physiotherapy care is pre-approved for the first 12 weeks after your car accident, meaning you don’t need a referral from a doctor or nurse practitioner to get started. However, this only goes for standard physio care, which addresses musculoskeletal (MSK) pain and injuries. If you’ve sustained a concussion from your MVA, you’ll need to get diagnosed by a doctor or other specialist, and then provide that diagnosis to ICBC. Once that’s done, you can get approved for non-standard physio care, such as concussion rehabilitation.

What treatments am I eligible for under an ICBC claim?

ICBC covers quite a few different types of pre-approved treatment after a motor vehicle accident. These include:

• 25 sessions with a physiotherapist

• 25 sessions with a chiropractor

• 12 sessions with a registered massage therapist (RMT)

• 12 sessions with a kinesiologist

• 12 sessions with a psychologist

• 12 sessions with a clinical counsellor

• 12 sessions with an acupuncturist

It’s important to note that you’ll only get coverage for these treatments in the first 90 days after the date of your accident. If your practitioner determines that you need treatment beyond 90 days, they will submit a treatment plan to ICBC prior to the 3-month expiry date. Assuming ICBC approves the practitioner’s request for additional treatments, you can continue to get your sessions covered by ICBC without having to pay out of pocket.

I’ve missed work because of my injury. Will I be compensated for lost wages?

If your injuries have prevented you from working and earning income after 7 days from the date of your crash, you might be eligible for income replacement benefits from ICBC. Under this benefit, you can have up to 90% of your lost wages replaced, based on a maximum gross annual income of $113,000. If you make more than $113,000 per year, you have the choice to buy additional Income Top-Up coverage.

In order to receive income replacement benefits from ICBC, you’ll need to let your recovery specialist know about the situation, including details of your prior employment and income verification. From here, your specialist will calculate the amount of lost wages you’re entitled to be compensated for. You may have to complete an Enhanced Accidents Benefit application as well. Additionally, you’ll need to have your inability to work confirmed by an approved healthcare practitioner, such as a doctor or registered nurse practitioner.

I sustained a concussion from my MVA, can I get care for it under my ICBC claim?

Yes, you can get concussion treatment covered by ICBC. However, the process is a little different than getting coverage for musculoskeletal (MSK) injuries. 

Unlike MSK injuries, ICBC doesn’t accept concussion diagnoses from physiotherapists. You’ll have to receive a concussion diagnosis from a doctor or other approved specialist. This diagnosis is provided to ICBC, who will then approve your non-standard concussion physiotherapy care. You’ll then have to find a physiotherapy clinic that takes on concussion treatment for active ICBC claims. These can be hard to find, but if you’re around Coquitlam, BC, Triumph Physio is a great option.

Our clinic sets itself apart as a centre for all kinds of treatment for those who have been in a motor vehicle accident. Whether you’re dealing with pain in your back, whiplash in your neck, a concussion, or a combination of symptoms, our team is dedicated to supporting your recovery using customized treatment plans and a variety of physiotherapy treatments. 

Contact us today if you’re looking for treatment after a car accident and want to start the conversation!

Disclaimer: This BLOG content is provided for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. The creators of this BLOG are not liable for any actions or decisions taken by individuals based on the information presented herein. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.

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