On the advice of our clients, advocates, and stakeholder partners, the Ministry of Community and Social Services is improving the medical review process for people with disabilities who are receiving ODSP. These changes will reduce the burden on clients, health care professionals, stakeholders and staff.
The new medical review initiatives are consistent with a renewed approach to disability adjudication more generally. The ministry is dedicated to a more client-friendly and efficient adjudication process that is both fair and accountable in directing assistance to the people ODSP is intended to help, while reducing the need for appeals.
Medical review dates are currently assigned in about 36 per cent of cases. As ODSP provides income support to people with whose medical conditions may improve, a fair, accountable and responsible way to review eligibility at medically relevant points is required.
By March 2016, the ministry will begin working with stakeholders and advocates to design a new, simpler medical review process and form.
In the first part of the form, if the client's health care professional can indicate that the client's medical condition, impairments and restrictions have not improved, the second part of the form, which requires additional medical information to be provided, would not need to be completed. There will also be an opportunity for the health care professional to advise of relevant new conditions.
To assist the health care practitioner to complete the new form, clients will be provided with the reasons they were originally found to be eligible for support.
The new process will also provide reassurance to the client and their health care professional that a medical review is not a re-adjudication of the original eligibility finding.
The ministry has implemented new quality assurance mechanisms to ensure the process is more fair, responsible and efficient:
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. Over time, improved information analysis, enhanced training and new processes will support more effective and efficient decision making, so that fewer cases proceed to appeal. The ministry will continue to engage clients, advocates, and stakeholder partners as reform progresses.
This work aligns with the government’s efforts to continue to reform social assistance guided by the principles of fairness and simplicity.
The improvements outlined above are important prerequisites to the planned increase in the rate of medical reviews to 1,900 per month. This increase is important to address an unsustainable backlog in medical reviews – but must be accomplished in a manner that is both fair and accountable. The ministry anticipates these improvements will be in place by the fall of 2016. The increase in reviews will not proceed until the improvements are implemented.