Many massage therapists in BC will not work with WorkSafeBC injured workers. I was one of the abstainers. The length of appointments, the payments and the reporting and billing processes were all been very limiting and difficult to sort through. In 2011 the Massage Therapists Association of British Columbia signed a new contract with WorkSafeBC which improved the rate of pay and simplify the whole process. Given the huge improvements, I decided to begin treating WorkSafeBC clients. What has changed, and how is the process still unique and challenging? That’s what this blog is all about.
First, the changes and why I like them. The money factor, for better or worse I do this job to support myself and my family and I need to make a certain amount of money to do that, the previous contract just didn’t make fiscal sense for me. The new contract significantly raised the rates and I am now able to offer reasonable appointment lengths balancing treatment effectiveness with fiscal feasibility. The paperwork and hassle factor also decreased. Credit goes to both negotiating parties for many of these improvements, but technology also plays a huge role. The policy change that most helps the quick, effective treatment of WorkSafeBC claimants is the removal of the need for an active claim number. As long as a claimant has a referral from their MD for the treatment and is within 8 weeks of their injury, I can treat them and have a reasonable expectation of payment – even if the claim is later denied. This eliminates a lot of delay and the need to try to get money out of the injured worker later. Policy now allows me up to three treatments a week for 5 weeks with the submission of only one quick form. The technology part of the improvement begins with the form which you can submit by fax – no mailing. Then there is billing submission. Paper billing and the time lags of snail mail made reimbursement ridiculously slow previously and small errors could move the ridiculous into the impossible range. Waiting 30 to 45 days is long enough, but I had heard of 3-6 month waits. The introduction of online billing made the process much simpler. Submission is fast and easy, billing errors are less frequent and caught sooner. All of these factors make being “a part of WorkSafeBC’s Massage Therapy network” a much more appealing.
What are the restrictions that still make the process difficult? Treatment limitations are the big issue for me. The time factor is part of that, though I must say it has been far less bothersome than I had anticipated. The big issue is the, well, let’s call it the geographical restriction. As a Massage Therapist our training emphasizes the idea of the body being a whole. This is not the way WorkSafeBC sees the body. They see the injured part and the non-injured part. When working within the agreement therapists may only deal with the injured area. On the surface this seems reasonable. WorkSafeBC is trying to avoid having undo advantage being taken and limiting their responsibility to the workplace injury. The difficulty, as a therapist, is ignoring the complications of the initial injury that are causing pain and dysfunction for the worker. I need to change my focus from improving the overall well-being of my patient, to restoring function in one part. It seems a subtle difference but it is a difficult shift to make. Reinforcing this shift is another of WorkSafeBC’s policies – get the worker back to work. Again, a reasonable goal for a corporation but sometimes more difficult for a health practitioner.
For all the limitations the thing I like is the challenge. The above mental gymnastics and regional restricts are the less joyful part of the challenge; the injury assessment and restoration of function being the more joyful. WorkSafeBC clients the issues are generally acute, so I get to use types of assessment and treatment rarely called for in my other work. The focused treatment and the newness of the injuries is a more intense and dynamic process, which adds variety to my practice.