Acquired Brain Injury (ABI) Teams
PRO 55/2016

Effective date: June 1, 2016

Application: All injured workers requiring ABI treatment services.

Policy subject: Health care services – providers

Purpose:

To provide administrative guidelines for approving and evaluating Acquired Brain Injury (ABI) services.

BACKGROUND

  1. The Workers’ Compensation Act, 2013 confirms that the responsibility for the provision and funding of health care for injured workers lies with the Workers’ Compensation Board (WCB) in consideration of the exemption of injured workers by the Canada Health Act.
  2. The WCB negotiates identical agreements (including practice standards and a fee schedule) with the Saskatchewan Health Region (SHA). The WCB will negotiate changes to these agreements as needed.

PROCEDURE

  1. All ABI teams providing services to WCB customers can access the following at www.wcbsask.com:
    1. The Acquired Brain Injury (ABI) Practice Standards for WCB Service Provides (the “practice standards”).
    2. The ABI Service Fees and Fee Codes for WCB Service Providers.
    3. Reporting forms.
  2. Where the ABI resulted from an accepted work injury, the ABI team will assess the worker, and will provide the WCB with an initial report and an estimate of costs within one month.
  3. All services provided by the ABI team requires:
    1. The agreement of the primary care provider (PCP) prior to implementation of any treatment, and
    2. The agreement of the WCB Customer Care Facilitator (CCF) prior to billing the WCB.
  4. An updated treatment plan must be provided every six months or sooner if the treatment plan or the cost estimates change.
  5. Changes to the initial cost estimate or an extension to the initial treatment plan requires authorization from the WCB Customer Care Facilitator (CCF). Any changes to the treatment plan will require the ABI team to obtain the PCP’s agreement.
  6. A neuropsychological examination will be completed six months post injury to confirm the diagnosis and the appropriateness of the treatment plan. Where the ABI team’s neuropsychologist cannot accommodate the worker within a two-week timeline, the ABI team will ask the WCB to arrange a timely assessment.
  7. To prevent the secondary effects of the work injury and to ease the transition back into the workplace, early transitional return to work (RTW), followed by an appropriate permanent RTW plan, will be implemented by the ABI team in consultation with the WCB customer care facilitator Team. A concurrent goal will be the worker’s reintegration into their home community to ensure quality of life.
  8. Progress reports must be forwarded to the WCB by the ABI team after every three appointments with a worker or at three month intervals, whichever comes first.
  9. The ABI Team will forward a discharge report within one month of termination of services.
  10. The quality of care is assured by required compliance with the ABI Practice Standards. Compliance will be reviewed by the Health Care Services department, which will include an evaluation of outcomes.

Policy references

Legislative Authority

The Workers’ Compensation Act, 2013

Sections 58, 103(1), 103(2), 104(1), 104(2), and 111

Document History

(1)    November 1, 2019. Procedure reviewed and updated to change health districts to the Saskatchewan Health Authority (SHA).
(2)    PRO 52/2012, Medical Fees – Acquired Brain Injury (effective October 1, 2012 to May 31, 2016). 
(3)    PRO 53/2008, Acquired Brain Injury Teams (effective June 1, 2008 to September 30, 2012).
 

Complements

POL 18/2016 Health Care Services

Two people signing documents
Two people signing documents

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