Document name
Psychologists
Document number
PRO 02/2021

Effective date: March 1, 2021

Application: All claims where workers require primary psychological care.

Policy subject: Health care services – providers

Purpose:

To provide administrative guidelines for approving and evaluating services provided by psychologists.

BACKGROUND

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  1. Upon Workers’ Compensation Board (WCB) approval, a worker entitled to benefits under The Workers’ Compensation Act, 2013 is also entitled to (Section 103):
    1. Any medical aid that may be necessary because of the work-related injury.
    2. Any other treatment by a health care provider.
    3. Any orthotic appliance or apparatus that may be necessary as a result of the injury, and
    4. Any travel and sustenance costs associated with receiving medical treatment as a result of the injury.
  2. The WCB is authorized to determine health care services fees (Section 104).
  3. The Act directs the WCB to cover the costs of treatment or medical aid that may be required as a result of a work injury (Section 115(c)).

PROCEDURE

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General

  1. Psychologists who are fully licenced members in good standing of the Saskatchewan College of Psychologists (SCP), hold the Authorized Practice Endorsement (APE) and are accredited by the WCB to provide services to injured workers can access the following at www.wcbsask.com:
    1. Practice Guidelines for Psychologists Providing Primary Level Services and Assessment Services to WCB Customers.
    2. Accreditation requirements.
    3. Fees.
    4. Reporting forms.
    5. Primary Authorization to Treat forms.

The WCB will update these documents, as needed, under the advice of the WCB Psychological Consultant.

  1. If the injured worker is receiving counselling from a service provider who does not meet the WCB accreditation requirements, the WCB may approve up to eight weeks of treatment. However, if return to work (RTW) or recovery does not immediately occur, the WCB will arrange treatment with an accredited provider and the services with the unaccredited provider will cease.
  2. Claims Entitlement Specialists (CES) will review Primary Level Authorization to Treat – Psychology/Counsellors forms completed by accredited psychologists, initial reports (PSYI) and progress/discharge reports (PSYP) that the WCB receives within the first four weeks post-injury. Case Managers (CM) will review reports received after four weeks unless Claims Entitlement retains the file.
  3. CES and CM can request the assistance of the WCB Psychological Consultant at any time during the review of claims.
  4. If the CES, CM or WCB Psychological Consultant determines that the WCB should deny coverage, the file manager (CES or CM) will inform the psychologist. The WCB will pay for services up to and including the date of notification.
  5. Quality assurance and compliance:
    1. Psychologists treating injured workers must participate in any quality assurance programs that the WCB develops to ensure compliance with the WCB’s Practice Guidelines for Psychologists.
    2. Psychologists who do not comply with the practice guidelines will be notified of corrective actions by the WCB’s Medical and Health Care Services (MHCS). Further non-compliance may result in the loss of WCB accreditation.
    3. Psychologists who do not comply with WCB’s reporting requirements will be notified of corrective actions by MHCS. Further non-compliance may lead to the WCB denying payment for treatment.
    4. Workers can report complaints of any nature to the WCB. If the complaint alleges professional incompetence or misconduct by a care provider, the Manager of Health Care Services will direct the complainant to the SCP.
    5. MHCS will note all complaints and resolutions on the service provider’s accreditation file.
  6. Workers who want to receive treatment from a different psychologist must discuss their concerns with their primary care provider who made the initial referral. If the primary care provider disagrees with the worker’s request for a new referral, WCB staff may follow-up with them on a case-by-case basis. If an alternative method of treatment is recommended, WCB will evaluate this option and implement, as needed.

Policy references

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Section heading

Legislative Authority

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The Workers’ Compensation Act, 2013
Sections 55, 103, 104, 115(c)

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Document History

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(1)    PRO 50/2017, Psychologists (effective April 1, 2017 to February 28, 2021).
(2)    PRO 51/2014, Medical Fees – Psychologists (effective April 1, 2014 to March 31, 2017).
(3)    PRO 54/2010, Medical Fees – Psychologists (effective September 1, 2010 to March 31, 2014).
(4)    PRO 103/2001, Fees for Services Provided by Psychologists and Counsellors (effective July 1, 2001 to August 31, 2010).
(5)    PRO 54/1999, Medical Fees - Psychologists and Counsellors (effective April 1, 1999 to June 30, 2001).
(6)    PRO 09/98, Fees for Services Provided by Psychologists and Counsellors (effective April 1, 1998 to March 31, 1999).
(7)    PRO 04/97, Implementation of Fees for Services Provided by Psychologists and Counsellors (effective April 1, 1997 to March 31, 1998).
 

Section heading

Complements

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