Highlights of Noteworthy Decisions

Decision 630 23
P. Ahlfeld
  • Health care (osteopathy)

The issue under appeal was whether the worker was entitled to osteopathy treatment.

The appeal was denied.
OPM Document No. 17-01-02 clearly states that osteopaths are only considered "health care practitioners" for the purposes of entitlement to health care benefits, by virtue of their being "drugless practitioner[s] regulated under the Drugless Practitioners Act." However, the Drugless Practitioners Act was repealed in 2015. The Board did not subsequently amend OPM Document No. 17-01-02 to include osteopaths. The Vice-Chair determined that it would not be appropriate to read in the coverage of osteopaths for the purposes of health care benefits.
Per OPM Document No. 11-01-03, "Merits and Justice", the Vice-Chair determined that there were no exceptional reasons to warrant a departure from the policy. It was acknowledged that an osteopath had been providing maintenance treatment for the worker's low back prior to the November 2021 work accident. This was before the worker had communication with the Board. The Vice-Chair noted that he should have, at the very least, contacted the Board and asked directly if seeing an osteopath would be covered. The worker therefore pursued his treatment with the osteopath on his own initiative without inquiring whether the costs would be covered. There was also no medical evidence to indicate that osteopathy treatments were necessary, appropriate and sufficient as a result of the November 2021 work injury.