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Décisions des tribunaux
A-3.001, r. 1
- Regulation respecting medical aid
Table des matières
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À jour au 12 mai 2022
Ce document a valeur officielle.
chapter
A-3.001, r. 1
Regulation respecting medical aid
INDUSTRIAL ACCIDENTS — MEDICAL AID
Act respecting industrial accidents and occupational diseases
(chapter A-3.001, ss. 189 and 454)
.
A-3.001
09
September
01
1
2012
DIVISION
I
INTERPRETATION
1
.
In this Regulation,
“
account
”
: means an invoice, a bill of fees or a payment transaction by electronic link or other technological support authorized by the Commission des normes, de l’équité, de la santé et de la sécurité du travail under section 356 of the Act respecting industrial accidents and occupational diseases (
chapter A-3.001
); (
compte
)
“
border region
”
means a part of the territory of Québec comprised within 80 km of any point along the border with Ontario, New Brunswick or Newfoundland; (
région frontalière
)
“
health worker
”
: means a natural person, other than a health professional within the meaning of the Act respecting industrial accidents and occupational diseases, entered on the roll of a professional order governed by the Professional Code (
chapter C-26
) and referred to in this Regulation, including a holder of a psychotherapist’s permit issued by the Ordre professionnel des psychologues du Québec, but excluding a member of the Ordre des audioprothésistes du Québec and an audiologist who is a member of the Ordre des orthophonistes et audiologistes du Québec; (
intervenant de la santé
)
“
professional service
”
: means an act performed by a health worker, other than care and treatment; (
service professionnel
)
“
session
”
: means a visit, with or without an appointment, to a health worker by a worker suffering from an employment injury to receive care or treatment or to obtain an initial evaluation, including home care and professional services according to the rate per session provided for in Schedule I. (
séance
)
O.C. 288-93, s. 1
;
O.C. 888-2007, s. 1
;
185-2017
O.C. 185-2017
,
s.
1
1
;
565-2018
O.C. 565-2018
,
s.
1
1
1
;
703-2022
O.C. 703-2022
,
s.
1
1
1
.
DIVISION
II
GENERAL
2
.
In addition to the medical aid to which a worker is entitled under the Regulation respecting hearing devices and audiology services (
chapter A-3.001, r. 14.001
), the care, treatment, professional services, technical aids and other costs provided for in this Regulation constitute the medical aid to which a worker may be entitled where his condition requires such aid as a result of an employment injury.
O.C. 288-93, s. 2
;
565-2018
O.C. 565-2018
,
s.
2
1
;
703-2022
O.C. 703-2022
,
s.
2
1
.
3
.
The Commission assumes the cost of care, treatment, professional services and technical aids received in Québec, in accordance with the conditions and amounts prescribed by this Regulation if they were prescribed by the health professional in charge of the worker before they were received or before the expenditures for them were made. Unless otherwise provided, the amounts include the supplies and costs related to the care, treatment, professional services or technical aids.
Every claim submitted to the Commission concerning the care, treatment, professional services or technical aids must be accompanied by the health worker’s recommendation, where applicable, and by vouchers detailing their cost. The health worker must keep the prescription in the worker’s record and provide it to the Commission on request.
O.C. 288-93, s. 3
;
O.C. 888-2007, s. 2
;
565-2018
O.C. 565-2018
,
s.
3
1
.
3.1
.
The account related to costs provided for in this Regulation must be sent to the Commission within 180 days from the date of provision of the service, care, treatment or technical aid, or from the performance of the act related to another cost. In the case of a report, the 180-day period begins to run from the date on which the report becomes exigible.
565-2018
O.C. 565-2018
,
s.
4
1
.
4
.
Where the employment injury occurs in a border region of Québec, the Commission shall assume the cost of the following care, provided that the Commission had first given authorization to the worker:
(
1
)
the cost of care, treatment and technical aids received outside Québec and described in this Regulation, including, where applicable, supplies and expenses related thereto, up to the amounts provided for in this Regulation;
(
2
)
the cost of care and treatment received in a hospital centre and the services of health professionals, dentists, optometrists or pharmacists received outside Québec, including, where applicable, the cost of supplies and expenses related thereto, on the basis of what similar care, treatment and services would cost under a public hospital insurance or health insurance plan in force in Québec.
O.C. 288-93, s. 4
.
5
.
Notwithstanding section 3, where the worker sustains an employment injury outside Québec, the Commission shall assume the actual other cost of the care and treatment listed in Schedule I, received outside Québec, including the supplies and expenses related thereto, upon presentation of vouchers and of a health professional’s attestation as to necessity.
The Commission shall also assume the charges for technical aids and other costs up to the amounts and under the conditions provided for in Division IV.
O.C. 288-93, s. 5
;
565-2018
O.C. 565-2018
,
s.
5
1
.
DIVISION
III
CARE, TREATMENT AND PROFESSIONAL SERVICES
O.C. 288-93, Div. III
;
565-2018
O.C. 565-2018
,
s.
6
1
.
§
1
. —
General rules
6
.
The Commission assumes the cost of the care, treatment and professional services determined in Schedule I up to the amounts provided for therein, if such care, treatment and services are provided personally by a health worker who is a member of the professional order corresponding to the prescribed care, treatment or services. Such health worker must also be duly authorized to practice, to perform the act billed and, where applicable, must hold a valid permit for that purpose.
O.C. 288-93, s. 6
;
O.C. 888-2007, s. 3
;
565-2018
O.C. 565-2018
,
s.
7
1
.
7
.
The Commission shall assume the cost of the sessions for nursing care and chiropractic and physiotherapy treatment provided in the home by a health worker at the rates listed in Schedule I, where the health professional in charge of the worker observes that it is impossible for him to leave his home because of his employment injury and where the health professional previously prescribed such home care.
O.C. 288-93, s. 7
;
565-2018
O.C. 565-2018
,
s.
8
1
.
8
.
An amount indicated for a type of care or for a treatment includes the cost of the health worker’s travel expenses, x-rays, the supplies used by the health worker, and ancillary costs.
O.C. 288-93, s. 8
;
O.C. 888-2007, s. 4
.
9
.
The first session with a health worker, even for an initial evaluation, is paid for up to the amounts provided for in Schedule I, or the amounts for a care or treatment session if no specific rate is provided for therein, except in the case of professional services in speech therapy.
No other amount is payable by the Commission for an initial evaluation where the evaluation goes beyond the first session with a health worker.
O.C. 288-93, s. 9
;
565-2018
O.C. 565-2018
,
s.
9
1
;
703-2022
O.C. 703-2022
,
s.
3
1
.
10
.
Where health workers practise their profession as a group on the same premises, they shall indicate on their accounts the group number assigned to them by the Commission.
Those health workers shall send to the Commission, in writing, the name of each person in the group, the address to which payment must be sent, the name of the person designated to receive payment from the Commission, as well as any change in such information.
O.C. 288-93, s. 10
;
565-2018
O.C. 565-2018
,
s.
10
1
.
11
.
A health worker who practises his profession alone shall indicate on his accounts the services supplier number assigned to him by the Commission.
O.C. 288-93, s. 11
;
O.C. 757-2011, s. 1
;
565-2018
O.C. 565-2018
,
s.
11
1
.
12
.
(Revoked).
O.C. 288-93, s. 12
;
O.C. 888-2007, s. 5
.
§
2
. —
Special rules for physiotherapy and occupational therapy
13
.
For physiotherapy or occupational therapy care and treatment, the Commission assumes the cost thereof up to a maximum of one care or treatment session per day and up to 3 care or treatment sessions per week, subject to a prescription to the contrary from the health professional in charge of the worker.
O.C. 288-93, s. 13
;
O.C. 888-2007, s. 6
;
565-2018
O.C. 565-2018
,
s.
12
1
.
14
.
Where an initial evaluation goes beyond the first session, and care or treatment is also provided at the same time, the initial evaluation must neither hinder the care or treatment, nor reduce the quality or duration thereof.
O.C. 288-93, s. 14
;
O.C. 888-2007, s. 7
;
565-2018
O.C. 565-2018
,
s.
12
1
.
15
.
A physiotherapist, a physiotherapy technologist and an occupational therapist must keep a register indicating, for each session, the date, the professional act performed, either the initial evaluation or care or treatment, and the name of the health worker who met the worker.
The worker must sign the register at each session.
The register must be kept in the record kept by the health worker for as long as the health worker is required to keep the record. The register must be put at the disposal of the Commission, on request.
A register kept on a medium based on information technology must comply with the provisions of the Act to establish a legal framework for information technology (
chapter C-1.1
).
O.C. 288-93, s. 15
;
O.C. 888-2007, s. 8
;
565-2018
O.C. 565-2018
,
s.
12
1
.
16
.
A physiotherapist or a physiotherapy technologist, and an occupational therapist must send to the Commission a first account whose form and content must comply with the form in Schedule III or, if sent using another technological medium, complying with that authorized by the Commission, within 7 days of the first session. They must also use that account form or an authorized technological medium to claim an amount for care or treatment.
The account form is available on the Commission’s website.
O.C. 288-93, s. 16
;
O.C. 888-2007, s. 9
;
565-2018
O.C. 565-2018
,
s.
12
1
;
888-2020
O.C. 888-2020
,
s.
1
1
.
16.1
.
At the request of the Commission, a physiotherapist, a physiotherapy technologist or an occupational therapist must provide a report whose form and content must comply with the form in Schedule III.1 or, if sent using another technological medium, complying with that authorized by the Commission.
The report form is available on the Commission’s website.
The report must be sent to the Commission and to the health professional in charge of the worker within 15 days following the date of the Commission’s request.
565-2018
O.C. 565-2018
,
s.
12
1
.
16.2
.
A report is payable by the Commission only if it is made on the form in Schedule III.1 or, if sent using another technological medium, complying with that authorized by the Commission, and is complete.
565-2018
O.C. 565-2018
,
s.
12
1
.
16.3
.
Except in case of superior force, where a report is not filed within the time provided for in the second paragraph of section 16.1, the Commission withholds payment of the accounts for the care and treatment sessions provided after the deadline for filing the report, until it is sent to the Commission.
When the report is filed, the Commission pays the accounts for the care and treatment sessions whose payment was withheld.
565-2018
O.C. 565-2018
,
s.
12
1
.
17
.
The Commission assumes the cost of a session for care or treatment provided for in the worker’s personal care or treatment program established on the basis of the worker’s specific needs, even if a worker receives the care and treatment simultaneously with other persons.
O.C. 288-93, s. 17
;
565-2018
O.C. 565-2018
,
s.
12
1
.
17.0.1
.
The following occupational therapy services are not medical aid:
(
1
)
a work integration program or a program for a therapeutic return to work;
(
2
)
an assessment of a workstation or its adaptation and equipment testing;
(
3
)
an assessment of driving ability and vehicle adaptation;
(
4
)
residence adaptation;
(
5
)
a social integration program or any other evaluation or intervention as part of the rehabilitation provided for in Chapter IV of the Act;
(
6
)
an intervention as part of an interdisciplinary or multidisciplinary program;
(
7
)
a development program or any other service to evaluate functional or occupational capacities, or any other intervention pursuing the same objectives;
(
8
)
a mental health intervention.
565-2018
O.C. 565-2018
,
s.
12
1
.
17.0.2
.
Subject to a prescription to the contrary from the health professional in charge of the worker concerning the date on which treatment begins, the Commission assumes only the cost of the occupational therapy sessions held from the sixth week following the date of the employment injury and if the employment injury is not consolidated on that date. The foregoing also applies to the reimbursement of the cost of an initial evaluation.
Despite the first paragraph, the Commission assumes the cost of sessions held before that date, if the prescription of the health professional in charge of the worker pertains to one or more of the following injuries:
(
1
)
a hand or wrist injury;
(
2
)
a complex regional pain syndrome, regardless of the site of the injury;
(
3
)
nerve damage to the upper limbs;
(
4
)
a burn, regardless of the site of the injury.
565-2018
O.C. 565-2018
,
s.
12
1
.
§
3
. —
Special rules for psychology, psychotherapy and neuropsychology
O.C. 757-2011, s. 2
;
185-2017
O.C. 185-2017
,
s.
2
1
.
17.1
.
The Commission assumes the cost of psychological, psychotherapeutic and neuropsychological care administered by a psychologist entered on the roll of the Ordre professionnel des psychologues du Québec and the cost of psychotherapeutic care administered by the holder of a psychotherapist’s permit.
It also assumes the cost of the reports required in this subdivision.
O.C. 757-2011, s. 2
;
185-2017
O.C. 185-2017
,
s.
3
1
1
;
888-2020
O.C. 888-2020
,
s.
2
1
.
17.2
.
The Commission pays the amount in Schedule I for psychological, psychotherapeutic and neuropsychological care if the Commission and the health professional in charge of the worker have received, for each worker, an evaluation report and, if treatment is provided, a progress report, where required, and a final treatment report.
A progress report must be prepared for each 10-hour period of treatment. If treatment is completed within or at the end of a 10-hour period, only a final report must be prepared.
The reports must be sent within 15 days of the date of the last meeting giving rise to the report.
O.C. 757-2011, s. 2
;
185-2017
O.C. 185-2017
,
s.
4
1
.
17.3
.
A report referred to in section 17.2 must contain the information prescribed in Schedule IV and be signed by the psychologist or by the holder of a psychotherapist’s permit who administered the care.
O.C. 757-2011, s. 2
;
185-2017
O.C. 185-2017
,
s.
5
1
.
17.3.1
.
The hourly rate provided for in Schedule I for the care referred to in this subdivision applies for the payment of the reports required under section 17.2, up to the following limits:
(
a
)
evaluation report:
i
.
psychology and psychotherapy: 2 hours;
ii
.
neuropsychology: 8 hours;
(
b
)
status report: 1 hour;
(
c
)
final report: 2 hours.
The reports are payable when they are sent to the Commission.
888-2020
O.C. 888-2020
,
s.
3
1
.
DIVISION
IV
TECHNICAL AIDS AND OTHER OSTS
O.C. 288-93, Div. IV
;
565-2018
O.C. 565-2018
,
s.
13
1
.
§
1
. —
General rules
18
.
The Commission shall assume the cost of leasing, purchasing and renewing a technical aid provided for in Schedule II, under the conditions and in accordance with the amounts set out in this Division and in that Schedule, where the technical aid is used in treating an employment injury or is necessary to compensate for temporary functional disabilities resulting from such injury.
The Commission shall also assume the costs set out in Schedule II, under the conditions and in accordance with the amounts indicated therein, upon presentation of vouchers detailing such costs.
O.C. 288-93, s. 18
.
19
.
(Revoked).
O.C. 288-93, s. 19
;
506-2019
O.C. 506-2019
,
s.
1
1
.
20
.
Notwithstanding section 18, where the Health Insurance Act (
chapter A-29
), the Act respecting the Régie de l’assurance maladie du Québec (
chapter R-5
) or a regulation made under those Acts provides for a cost for purchasing or renewing a technical aid having the same characteristics as a technical aid provided for in this Regulation, the Commission shall assume only the cost provided for in those Acts or regulations.
O.C. 288-93, s. 20
.
21
.
Where a technical aid estimated to cost $300 or more is purchased or renewed, the worker shall also furnish the Commission with 2 estimates, except in the cases referred to in sections 20 and 27.
O.C. 288-93, s. 21
.
22
.
Every adjustment, purchase or renewal of a technical aid estimated to cost $150 or more must be previously authorized by the Commission, except in the case of the adjustment, purchase or renewal of an aid referred to in sections 20 and 27.
O.C. 288-93, s. 22
.
23
.
The Commission shall assume only the cost of leasing a technical aid where Schedule II provides only for the leasing thereof.
O.C. 288-93, s. 23
.
24
.
In the case of canes, crutches, walkers and accessories therefor listed in Schedule II, the Commission shall assume the estimated leasing cost for the foreseeable consolidation period or the purchase cost if such cost is lower.
O.C. 288-93, s. 24
.
25
.
The Commission shall assume the cost of adjusting, repairing or renewing a technical aid except during the guarantee period, insofar as the aid is used in accordance with the manufacturer’s instructions.
O.C. 288-93, s. 25
.
26
.
Where the estimated cost of repairing a technical aid exceeds 80% of the renewal cost, the Commission shall assume only the renewal cost.
O.C. 288-93, s. 26
.
§
1.1
. —
Special rules for daily life aids
506-2019
O.C. 506-2019
,
s.
2
1
.
26.1
.
The Commission shall assume the cost of purchasing or leasing, according to the case provided for in Schedule II, of a daily life aid where
(
a
)
it has been prescribed by a health professional in charge of the worker in accordance with section 3; or
(
b
)
its use is recommended by an occupational therapist or a physiotherapist to whom the health professional in charge of the worker referred the worker.
506-2019
O.C. 506-2019
,
s.
2
1
.
§
2
. —
Special rules for certain therapeutic aids
27
.
The Commission shall assume the cost of a transcutaneous nerve stimulator having the following characteristics:
(
1
)
2 channels;
(
2
)
direct current;
(
3
)
biphasic square waves;
(
4
)
variable frequencies adjustable from 2 to 80 cycles per second;
(
5
)
impulses adjustable between 50 and 250 micro-seconds;
(
6
)
frequency modulator.
O.C. 288-93, s. 27
.
28
.
The Commission shall assume the cost of leasing a transcutaneous nerve stimulator only for the first 3 months of its use.
At the end of that period, the Commission shall assume the cost of purchasing such device, less the initial leasing cost where the medical prescription for the use of the device is renewed.
The cost of leasing, purchasing or renewing a transcutaneous nerve stimulator includes the accessories required for its use.
The accessories are wires, batteries, battery charger and either electrodes, gel and hypoallergenic adhesive tape, or self-adhesive rigid or flexible electrodes, where the health professional in charge of the worker prescribes the use for such electrodes.
The cost of purchasing and renewing a transcutaneous nerve stimulator may not exceed $590 plus, where applicable, the cost of self-adhesive rigid or flexible electrodes, up to $400 for the first year.
O.C. 288-93, s. 28
;
506-2019
O.C. 506-2019
,
s.
3
1
1
.
29
.
The cost of renewing accessories of a transcutaneous nerve stimulator is assumed by the Commission up to the amounts provided for in paragraphs 1 and 2 or, where the health professional in charge of the worker prescribes the use of self-adhesive rigid or flexible electrodes, paragraphs 2 and 3:
(
1
)
$180 per year for all of the following accessories:
(
a
)
4 electrodes;
(
b
)
gel;
(
c
)
hypoallergenic adhesive tape;
(
2
)
$120 per year for all of the following accessories:
(
a
)
2 pairs of wires;
(
b
)
batteries and battery charger;
(
3
)
$400 per year for self-adhesive rigid or flexible electrodes.
O.C. 288-93, s. 29
;
506-2019
O.C. 506-2019
,
s.
4
1
.
30
.
(Revoked).
O.C. 288-93, s. 30
;
703-2022
O.C. 703-2022
,
s.
4
1
.
§
3
. —
Special rules for communication aids
506-2019
O.C. 506-2019
,
s.
5
1
.
30.1
.
The Commission shall assume the cost of purchasing a communication aid listed in Schedule II if the following conditions are met:
(
1
)
the worker has a prescription from the health professional in charge of the worker recommending a consultation in speech therapy; and
(
2
)
the use of such an aid is recommended by a speech therapist.
506-2019
O.C. 506-2019
,
s.
5
1
;
703-2022
O.C. 703-2022
,
s.
5
1
.
31
.
(Omitted).
O.C. 288-93, s. 31
.
SCHEDULE I
CARE, TREATMENT AND PROFESSIONAL SERVICES PROVIDED BY HEALTH WORKERS
1. Care and treatment:
Rate
Acupuncture
Acupuncture care administered by an acupunctor, per session
$54.00
Chiropratic
Chiropractic treatment, per session, including cost of x-rays
$40.50
Occupational therapy
Treatment, per session
$46.00
Physiotherapy
Treatment, per session
$47.00
Podiatry
Per session
$54.00
Psychology
Psychological, psychotherapeutic and neuropsychological care, hourly rate
$94.50
Home care
Chiropractic treatment, per session
$63.00
Physiotherapy treatment, per session
$50.00
Nursing care, per session
$64.62
2. Professional services:
Occupational therapy
Initial evaluation
$85.00
Reports
$25.00
Speech therapy
Speech therapy (interview, record consultation), per session
$32.00
Tests for speech reading due to deafness
$32.00
Voice parameter tests
$48.00
Expressive language tests
$32.00
Receptive language tests
$32.00
Phonetic inventory tests
$16.00
Written language tests
$64.00
Prosody tests
$47.50
Complementary tests (such as praxia, math), per test
$16.00
Issue of a speech therapy evaluation report
$30.50
Physiotherapy
Reports
$25.00
Laboratory examinations
The cost of those examinations is reimbursed according to the amounts provided for in the agreement made under section 195 of the Act.
O.C. 288-93, Sch. I
;
O.C. 561-94, s. 1
;
O.C. 888-2007, s. 10
;
O.C. 368-2009, s. 1
;
O.C. 757-2011, s. 3
;
185-2017
O.C. 185-2017
,
s.
6
1
;
565-2018
O.C. 565-2018
,
s.
14
1
;
O.C. 506-2019, s. 6
;
888-2020
O.C. 888-2020
,
s.
4
1
1
;
703-2022
O.C. 703-2022
,
s.
6
1
.
SCHEDULE II
(
ss. 18, 19, 23 and 24
)
TECHNICAL AIDS AND OTHER COSTS
TECHNICAL AIDS
1. Locomotive apparatus:
(
1
)
the cost of acquiring, renewing or leasing canes, crutches, walkers and their accessories;
(
2
)
the cost of leasing a manually propelled wheelchair;
(
3
)
the cost of leasing a motorized wheelchair where the worker is unable to use his upper limbs to move the wheelchair or where the health professional in charge of him attests that it is contraindicated for him to use a manually propelled wheelchair.
2. Daily life aids:
(
1
)
Adapted objects:
The cost of purchasing aids for eating, dressing, personal hygiene care or household activities, made or modified for use by a worker having sustained an employment injury; such aids include jar openers, stocking-pullers, long-handled combs or brushes, buttoners or other similar objects;
(
2
)
Transfer aids:
The cost of leasing the following transfer aids:
(
a
)
hydraulic, electrical or mechanical patient lifters;
(
b
)
seat lifters for the bathtub;
(
c
)
armchairs for the bath and shower;
(
3
)
Bathroom apparatus:
(
a
)
The cost of purchasing the following bathroom apparatus:
i
.
bedpans;
ii
.
urinals;
iii
.
elevated toilet seats;
iv
.
safety handles and grabs;
(
b
)
The cost of leasing the following apparatus:
i
.
commodes and their accessories;
ii
.
shower chairs;
(
4
)
Hospital beds and accessories:
The cost of leasing a hospital bed and its accessories, namely, bedboards, a bed table, a bed cradle, a trapeze and a footstool.
The cost of leasing an electrical hospital bed is assumed only where the worker has no-one to position his bed for him and he is capable of positioning an electric bed by himself.
3. Therapeutic aids:
(
1
)
Transcutaneous nerve stimulators (T.E.N.S.);
(
2
)
The cost of purchasing epidural and intra-thalamic nerve stimulators;
The cost of purchasing those apparatus;
(
3
)
Other therapeutic aids:
The cost of purchasing the following therapeutic aids:
(
a
)
accessories for the prevention and treatment of bed sores such as a sheepskin, a mattress and a cushion, an elbow pad, a foot-drop splint, a heel pad and a donut;
(
b
)
corsets, collars and splints;
(
c
)
exercise equipment such as the following, used in the home as part of an active occupational therapy or physiotherapy program: exercise balls, a balloon, an elastic band, plasticine, a system of pulleys for shoulder ankylosis, weights for the wrist or ankle, a sandbag with a velcro fastener, a fixed resistance exercise apparatus, and a set of light weights under 5 kg;
(
d
)
compressive clothing;
(
e
)
lumbar belts and hernia bandages;
(
f
)
cervical traction devices with dead weights;
(
g
)
intrathecal pumps;
The cost of leasing the following aids:
(
a
)
muscular nerve stimulators;
(
b
)
osteosynthesis apparatus;
(
c
)
continuous passive motion machines (C.P.M.).
4. Communication aids:
(
1
)
the cost of purchasing:
(
a
)
imagers;
(
b
)
communication boards;
(
2
)
(paragraph revoked);
(
3
)
Any other technical communication aid on prior authorization by the Commission.
OTHER COSTS
5. Extricating equipment:
The cost of using extricating equipment where the worker’s condition so requires because of an employment injury sustained outside his employer’s establishment or away from a construction site.
The costs incurred for the use of extricating equipment are refundable, up a maximum of $360. Where the distance to be travelled is more than 50 km, the refund is increased by a maximum of $1,75 per kilometre travelled to transport the extricating equipment to the site of the accident.
6. Long distance calls:
The long distance calls made by a worker admitted to and sheltered in an institution within the meaning of the Act respecting health services and social services (
chapter S-4.2
) or the Act respecting health services and social services for Cree Native persons (
chapter S-5
), because of an employment injury, up to a maximum of $10 per week insofar as the worker is sheltered.
O.C. 288-93, Sch. II
;
O.C. 565-2018, ss. 15 and 16
;
O.C. 506-2019, s. 7
;
703-2022
O.C. 703-2022
,
s.
7
1
.
SCHEDULE III
(
s. 16
)
PHYSIOTHERAPY OR OCCUPATIONAL THERAPY CARE AND TREATMENT ACCOUNT
O.C. 288-93, Sch. III
;
O.C. 888-2007, s. 11
;
O.C. 757-2011, s. 4
;
565-2018
O.C. 565-2018
,
s.
17
1
.
SCHEDULE III.1
(
s. 16.1
)
PHYSIOTHERAPY AND OCCUPATIONAL THERAPY REPORTS
565-2018
O.C. 565-2018
,
s.
17
1
.
SCHEDULE IV
(
s. 17.3
)
CONTENT OF PSYCHOLOGY, PSYCHOTHERAPY AND NEUROPSYCHOLOGY REPORTS
(
1
)
An evaluation report, a progress report and a final treatment report must contain
(
1
)
the worker’s name, health insurance number, telephone number and address, and the Commission’s record number;
(
2
)
the psychologist’s name and permit number, the telephone number and services supplier number or, where applicable, the group number;
(
3
)
the signature of the psychologist who administered the care and the date of the signature;
(
4
)
the name of the health professional in charge of the worker and the number of the health professional's permit to practise;
(
5
)
the date of the employment injury and, where applicable, the date of any relapse, reoccurrence or aggravation; and
(
6
)
the diagnosis by the health professional in charge of the worker giving rise to the referral or, where applicable, the reason for the referral.
(
2
)
An evaluation report must also contain
(
1
)
the dates of the evaluation meetings;
(
2
)
the history of the case and the relevant antecedents that may have an impact on the treatment plan;
(
3
)
the factors intrinsic and extrinsic to the employment injury that could have an impact on the worker’s psychological and social functioning and his or her return to work;
(
4
)
the worker’s perception of his or her situation in relation to the employment injury and his or her capacity to return to work;
(
5
)
the problems associated with the employment injury and their impact on the return to work;
(
6
)
the nature, dates and frequency of the activities carried out, including, where applicable, the tests carried out;
(
7
)
an analysis of all the data and observations and, where applicable, of the tests carried out;
(
8
)
the findings of the evaluation and the recommendations;
(
9
)
in the case of a neuropsychological evaluation,
(
i
)
the observations on the worker’s behaviour during the meetings and when taking the tests, and the evaluation of the worker’s behaviour in the following areas: cognitive, motor, somesthetic, affective, personality and perception;
ii
.
the identification and results of the validity scales used to corroborate the results of the tests taken;
iii
.
the correlation between the results of the tests referred to in subparagraph i and those of the validity scales;
(
10
)
in the case of treatment, an individualized treatment plan containing, among others things,
(
i
)
the clinical approach and the therapeutic methods being considered;
ii
.
the objectives sought by the treatment;
iii
.
the therapeutic activities to be implemented in relation to the objectives sought;
iv
.
the participation expected from the worker with respect to the means and activities for attaining the objectives;
v
.
the means and progress indicators used to measure progress made under the individualized treatment plan for each of the objectives sought;
vi
.
the prognosis regarding the attainment of results;
vii
.
the date set for the beginning of treatment;
viii
.
the number and frequency of the meetings scheduled.
(
3
)
A progress report must contain, in addition to the information required by section 1,
(
1
)
the dates of the meetings for each 10-hour period of treatment;
(
2
)
a reminder of the objectives sought by the treatment;
(
3
)
the therapeutic activities implemented in relation to the objectives sought;
(
4
)
the evaluation of the worker’s progress in relation to each of the objectives sought taking into account progress indicators;
(
5
)
the worker’s perception of his or her progress in relation to each of the objectives sought;
(
6
)
where applicable, the changes to be made to the individualized treatment plan and the recommendations; and
(
7
)
the number and frequency of the meetings scheduled.
(
4
)
A final treatment report must contain, in addition to the information required by section 1,
(
1
)
the dates of the meetings since the previous report;
(
2
)
the problems associated with the employment injury identified in the initial evaluation;
(
3
)
the therapeutic activities implemented in relation to the objectives sought;
(
4
)
the worker’s perception in relation to the attainment of each of the objectives;
(
5
)
an analysis and an evaluation of the results in relation to each of the objectives sought taking into account progress indicators and including the intrinsic and extrinsic factors having contributed to or hindered the attainment of the objectives; and
(
6
)
the grounds for terminating treatment.
(
5
)
Subject to the acts a psychotherapist is authorized to perform under his or her permit, sections 1 to 4 apply, with the necessary modifications, to the holder of a psychotherapist’s permit.
O.C. 757-2011, s. 5
;
185-2017
O.C. 185-2017
,
s.
7
1
1
;
O.C. 506-2019, s. 8
.
TRANSITIONAL
2020
(O.C. 888-2020)
SECTION 5
.
The care and treatment provided before the date of coming into force of this Regulation (2020-09-17) are paid by the Commission according to the rate applicable at the time at which they were provided.
2019
(O.C. 506-2019)
SECTION 9
.
The goods and services provided before the date of coming force of this Regulation (2019-06-13) are paid by the Commission according to the rate applicable at the time at which they were provided.
2018
(O.C. 565-2018)
SECTION 18
.
Despite the second paragraph of section 3, as replaced by section 3 of this Regulation, a member of the Ordre professionnel de la physiothérapie du Québec and a member of the Ordre professionnel des ergothérapeutes du Québec must send to the Commission a prescription for care or treatment that does not comply with the standards set out in section 13 or 17.0.2, as made by section 12 of this Regulation, until 31 March 2020.
SECTION 19.
The 180-day period provided for in section 3.1, made by section 4 of this Regulation, begins to run as of 24 May 2018 in respect of professional services, care or treatment provided before that date.
SECTION 20.
Despite section 7, as amended by section 8 of this Regulation, a worker may continue to receive occupational therapy home care if it has been prescribed before 24 May 2018.
The rate for such care, provided for in Schedule I as it read before being replaced by section 14 of this Regulation, continues to apply to the home care referred to in the first paragraph.
SECTION 21.
The costs payable for the first visit to a health worker, referred to in section 9, before its replacement by section 9 of this Regulation, which are exigible at a date prior to 24 May 2018 are not payable if the account is sent to the Commission more than 30 days after that date.
SECTION 22.
Section 13, made by section 12 of this Regulation, applies only to a change in a worker’s treatment plan or to a prescription issued as of 24 May 2018.
SECTION 23.
The costs payable for treatment after the filing of an initial report, a progress report, a treatment termination report and a reasoned opinion, required under sections 14 to 16, before their replacement by section 12 of this Regulation, which are exigible at a date prior to 24 May 2018 are not payable if those reports and opinions are sent to the Commission more than 30 days after that date.
SECTION 24.
Sections 17.0.1 and 17.0.2, made by section 12 of this Regulation, apply only to an employment injury occurring as of 24 May 2018.
SECTION 25.
The goods and services provided before 24 May 2018 are paid by the Commission according to the rate applicable at the time they were provided.
REFERENCES
O.C. 288-93, 1993 G.O. 2, 963
O.C. 561-94, 1994 G.O. 2, 1502
S.Q. 1994, c. 40, s. 457
O.C. 888-2007, 2007 G.O. 2, 2925
O.C. 368-2009, 2009 G.O. 2, 1276
O.C. 757-2011, 2011 G. O. 2, 1633
S.Q. 2015, c. 15, s. 237
O.C. 185-2017, 2017 G.O. 2, 631
O.C. 565-2018, 2018 G.O. 2, 1933
506-2019, 2019 G.O. 2, 811
O.C. 506-2019, 2019 G.O. 2, 811
888-2020, 2020 G.O. 2, 2327
O.C. 888-2020, 2020 G.O. 2, 2327
S.Q. 2020, c. 15, s. 74
S.Q. 2020, c. 6, s. 94
703-2022, 2022 G.O. 2, 1187
O.C. 703-2022, 2022 G.O. 2, 1187
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