Motor Vehicle Accidents (MVA) Insurance
All Albertans involved in a car accident/collision, regardless of who is at fault, are covered under Section B Medical Payments coverage of the Automobile Accident Insurance Benefits Regulation (AAIBR), and the Alberta Diagnostic and Treatment Protocols DTPR.
What should you do first after a vehicle collision in Calgary?
Car accidents are a leading cause of death and injury in Alberta and can cause serious injuries, including whiplash, spinal cord injuries, brain injuries, broken bones, and internal bleeding. If you are experiencing any severe symptoms head to the nearest Emergency Department.
Injuries may also be minor, and you may notice some aches and pains after the initial shock of the collision wears off but symptoms can continue to worsen for several days after the accident. Just because these whiplash injuries are labeled as ‘minor’ does not mean you do not need to obtain treatment to resolve the injury in a timely fashion.
The first step is to contact your insurance company to inform them of the collision asap.
Second, it is important that you schedule an assessment with a physiotherapist or chiropractor within 10 days of the collision for two reasons:
- Outside of 10 days, you will have to go through your extended health benefits first and not qualify under the DTPR.
- The sooner you get treatment the better the clinical outcomes will be from your injury.
We will need you to complete the “Notice of Loss and Proof of Claim Form”, also called an “AB1” and can send it to your insurance company for you.
Following a thorough assessment, your clinician will complete a “Treatment Plan Form”, also called an “AB2” that gets sent to your family physician and your insurance company, so they are aware of the extent of your injuries. You don’t need to see your family doctor first, unless your insurance requires it.
MVA Insurance coverage depends on the severity of the injury
The most common injuries following a minor motor vehicle accident are sprains and strains involving the soft tissue of the ligaments, tendons and/or muscles in your neck and back. Concussion and TMJ injuries are less frequent but may also be present.
Your neck injury will be classified as a whiplash-associated disorder (WAD) by your treating practitioner which rates the severity of the injury and indicates which protocol(s) you qualify for.
WAD I injuries are considered “in protocol” and are covered for a combined total of 10 physiotherapy and chiropractic treatments provided over 90 days.
WAD II injuries are considered “in protocol” and are covered for a combined total of 21 physiotherapy and chiropractic treatments and must be provided within 90 days of your accident.
If your injury has not been resolved within 90 days or by the pre-approved number of visits, additional treatments may be requested over an extended timeframe, but are subject to insurer review and approval.
WAD III injuries are considered “out of protocol” and you must access your own extended health benefits first.
Once they are exhausted, your motor vehicle insurance will cover you under the AAIBR, and you are able to access a “reasonable amount” of care for up to 2 years following the accident if approved by your insurance company.
Your physiotherapist or chiropractor will provide this classification in the diagnosis.
Note that you may have one injury that is WAD I, and another that is WAD II or III.
Each injury may be classified into one of the following protocols, with coverage being determined by the highest-graded protocol:
How is the severity of my injury classified?
1. WAD I criteria:
- Symptoms of spinal pain, stiffness or tenderness
- No demonstrable, definable, and clinically relevant physical signs of injury
- No tenderness and normal range of motion
- Normal reflexes and muscle strength in the limbs
- No objective, demonstrable, definable, and clinically relevant neurological signs of injury
- No fractures to or dislocation of the spine
2. WAD II criteria:
- Symptoms of spinal pain, stiffness or tenderness
- Musculoskeletal signs of decreased range of motion of the spine, and point tenderness of spinal structures affected by the injury
- Paraspinal tenderness and restricted spine range of motion
- Normal reflexes and muscle strength in the limbs
- No objective, demonstrable, definable, and clinically relevant neurological signs of injury
- No fracture to or dislocation of the spine
3. WAD III criteria:
- Objective, demonstrable, definable, and clinically relevant neurological signs of injury
- Abnormal reflexes and/or muscle weakness, often with sensory changes in a dermatomal pattern suggesting nerve root impingement (typically due to disc protrusion)
- No fracture to or dislocation of the spine
4. WAD IV criteria:
- Fracture to or dislocation of the spine
- Neck pain, possibly neurological symptoms in limbs, urinary incontinence due to spinal cord involvement
- Possible hyperreflexia, positive Babinski’s sign, motor weakness and sensory changes suggesting spinal cord injury
Are other services covered in addition to physiotherapy and chiropractic?
These are considered adjunct therapy and include: massage therapy, psychology, occupational therapy, acupuncture and dental services may be covered for injuries sustained in the motor vehicle accident. The DTPR covers a combined total of $1000 for these services.
Why 90 days?
Authorization for treatments under the DTPR expires 90 days after the motor vehicle accident unless the insurer approved additional treatments. Some of the research demonstrates the many WAD I and WAD II injuries will resolve within this time frame.
Can Momentum Health Direct Bill?
Most insurance companies will allow direct billing. Please bring the following to your first appointment:
- Name of the insurance company
- Name and phone number of your adjuster
- Claim number
- Date of accident
- If your accident happened while working, then WCB (Workers’ Compensation Board) paperwork may be required. Please be prepared to answer questions in regards to previous treatments for your injuries due to the motor vehicle accident.
We will help you through this process
Your treating practitioner will communicate with your adjuster as needed and help to complete any required information. They will also work with you to determine the best treatment plan to meet your goals.
Your treating practitioner will give you a thorough assessment and treatment on your first visit and discuss your treatment plan with you.
Throughout your treatment there will be ongoing reassessment check-ins, to ensure effectiveness of treatment and to maximize your functional recovery in a timely fashion. We are here to help make your rehabilitation and funding process proceed as easily as possible!
FAQs for car accidents and vehicular collision-related injuries
Do I have to be seen by a physician before I can start receiving treatment?
No! Under the Diagnostic and Treatment Protocols Regulation of the Alberta Government, physiotherapists and chiropractors are considered primary care practitioners. Any medical assessment required to begin treatment following your motor vehicle accident can be performed by one of our trusted clinicians. Following your assessment the clinician will then coordinate with your insurance company to ensure you are getting the proper treatment for your specific injuries.
Does it matter if I see a physiotherapist or chiropractor first?
No. At Momentum Health, our clinicians will collaborate with each other to ensure you see the right person for your needs, whether it is someone with additional dry needle training or concussion and vestibular experience.
WCB claims need to stay with one practitioner, but MVA claims can be seen by multiple clinicians.
What does my coverage include if I am injured in an accident?
With motor vehicle claims, you will be entitled to a specified number of treatments, depending on the type and severity of your injuries. Such services can include a combination of physiotherapy, chiropractic and adjunct therapies such as massage. The type and duration of needed treatments will be determined at your assessment. We will take a full hour with you on your first visit to ensure we have a complete picture of what we are looking at together.
How do I book in for my motor vehicle accident rehabilitation appointment?
If you have been in a motor vehicle accident, you should first report the injury to your insurance company to begin an injury claim. Once you have the claim started and have been issued a claim number from your adjustor, you can contact the clinic to be booked in for a motor vehicle accident assessment. This must be within 10 days of the accident.
What if I have whiplash? Can you help?
Yes! It sometimes takes up to 48 hours for whiplash symptoms to show up but is one of the most common symptoms we see after any collision, impact or even a fall. From exercises to soft tissue treatment, we will get you on the right track to recovery.
Can I come see Momentum Health if my insurance company will no longer pay for my treatment, if I’m on Assignment or Out of Protocol with my lawyer?
Yes! Momentum Health will accept Out of Protocol, Assignment of Proceeds clients for physiotherapy and chiropractic services. To discuss setting up an Assignment of Proceeds, lawyers or patients can call our Care Center at (403) 455-0025 and we would be happy to assist you.