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The Medical Review Process for ODSP Clients is Being Improved

February 12, 2016 Fast Facts

 

The Ministry of Community and Social Services has finally announced how they plan to fix the medical review process.

Advocates led by the Income Security Advocacy Centre (ISAC) and the Steering Committee on Social Assistance have been working since 2010 to ensure that medical reviews should not be treated like a re-application.  The focus, they have argued, should be on whether or not the person’s disability has improved since the date they were granted benefits.

Unfortunately, the government seemed to be going in a different direction.  They decided to ramp up medical reviews last April.

In response to this development, ISAC and the Steering Committee on Social Assistance asked that the government:• Commit to a simpler new process. • Work with advocates and health professionals to develop a process that it works for everyone. • Review all files before requesting more information from the client.  This would avoid unnecessary reviews.  Suspend medical reviews until the new process is in place. • Take more active steps to contact clients who do not respond to medical review notifications.  The client’s caseworker is in a better position to know how to reach them than the Disability Adjudication Unit.

The Ministry listened.

They have accepted the recommendations that medical reviews should not be treated like a re-application, and that the focus should be on whether or not the person’s disability has improved since the date they were granted benefits.

In fact, they accepted every recommendation listed above except the one to suspend all medical reviews. Instead, they suspended the ramp-up while they work on the process.  Only after the new process is in place will they resume their plan to initiate 1900 reviews/month.

Other improvements will be made.

The Ministry says that improving the medical review process is part of a wider effort to improve ODSP disability adjudication and ensure that ODSP will be available for all those who are eligible.

Mary Marrone, Director of Advocacy & Legal Services at ISAC (pictured to the right) is pleased.

“It appears that the Ministry has finally heard the concerns voiced by clinic caseworkers for many years. We hope to hear more soon about quality measures that will be put in place to review all denials and assignment of medical review dates to ensure sound decision-making.”

Hugh Tye, Executive Director of the Hamilton Community Legal Clinic called it an important systemic victory.

“Great advocacy work by the Steering Committee, ISAC and many community partners. And it is terrific that this is part of a larger review of ODSP process generally,” says Tye.

You can find out more on Medical Reviews by going to http://incomesecurity.org/policy-advocacy/improving-odsp-medical-reviews-amelioration-des-examens-medicaux-du-posph/

 

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