Ontario Simplifies Medical Reviews for People on Disability Support

Onerous reviews for people on ODSP many of whom suffer from mental illness will become less stressful under a new process.

About 30 per cent of Dr. Gary Bloch’s family-practice patients survive on ODSP payments of about $1,110 a month for a single person. By: Laurie Monsebraaten Social Justice Reporter, Published on Thu Feb 18 2016

Queen’s Park is scrapping its “difficult and intimidating” medical review process for people receiving income support from the Ontario Disability Support Program, in favour of a simpler approach.

Provincial officials will work with anti-poverty advocates to design a new, streamlined medical review process and form, Community and Social Services Minister Helena Jaczek told the Star on Wednesday. It will be implemented this fall.

“People, especially with mental health issues, find (the current process) particularly difficult and intimidating,” Jaczek said. “What we’re trying to do is lessen the burden on families and individuals and the health care providers and the legal clinics . . . who often end up appealing decisions made.”

Almost one-third of about 336,000 cases receiving Ontario Disability Support Program (ODSP) assistance have disabilities that are expected to improve, requiring medical reviews every two to five years.

Legal and medical advocates who have been working for years to persuade the province to improve the system heralded the announcement.

“This feels like a sea change,” said Mary Marrone, legal director of the Income Security Advocacy Centre, a legal aid clinic that specializes in social assistance cases.

“It will mean that people whose medical conditions have not improved will be spared the burden of an inappropriate reapplication process, and will have a much simpler form for their doctor to complete,” she said.

The new process, along with Jaczek’s longer-term plan to improve the initial ODSP application, will free up community legal clinic time spent on needless appeals, she added.

Advocates predicted the reforms will eliminate unnecessary appointments and medical tests and limit the anxiety faced by some of the province’s most vulnerable people with disabilities.

“This will reduce the overall burden on me and other parts of the health care system,” said Dr. Gary Bloch, a Toronto family physician at St. Michael’s Hospital, who also works with the homeless at Good Shepherd Ministries.

“But it will have a significant impact on the small number of people who are difficult to reach because they may not have a phone or an address or whose physical or medical condition make it difficult for them to attend multiple appointments,” he said. “They face the greatest risk of just being cut off, at huge detriment to their health.”

About 30 per cent of Bloch’s family-practice patients survive on ODSP payments of about $1,110 a month for a single person.

Due to rising ODSP caseloads, a backlog of more than 60,000 medical reviews prompted the province last spring to more than triple the number of forms issued each month, from 600 to 1,900. An outcry by legal aid and medical professionals, highlighted by the Star, prompted Jaczek to re-examine the process.

“We couldn’t be more happy about the outcome,” said Camille Quenneville, of the Canadian Mental Health Association, Ontario, who has been working with legal and health care providers on the issue. “When you consider that 46 per cent of people on ODSP struggle with mental illness, this will have a very important impact on those we represent.”

Under the proposed simpler medical review form, Jaczek said the ministry would eliminate the current requirement to duplicate information on the original ODSP application.

If an individual’s medical condition, impairments and restrictions have not improved, the health care provider could say so and the process would be complete. Similarly, if the individual’s condition had changed, there would be an area in the new form where a doctor or other medical professional could mention the relevant new information without having to list the original issues, Jaczek said.

To make it easier for a new health care provider to quickly determine if there have been any changes, the proposed review package would include the original reasons an individual was deemed eligible for support, she added.

Although the ministry is continuing to issue ODSP medical review packages under the current system, Jaczek said officials are checking every file in advance to ensure there is a clear need for review. As a result, the ministry has cut 30 per cent of backlogged reviews examined so far, she added. The current backlog sits at about 53,000 cases.

Reproduced from http://www.thestar.com/news/gta/2016/02/18/ontario-simplifies-medical-reviews-for-people-on-disability-support.html