What the OMIR is for
WCB Manitoba’s opioid policy applies to non-cancer pain after a workplace injury. It pays for the minimum dose that supports a documented improvement in function, and only when the prescriber follows the best practices WCB has adopted. The Initial Opioid Management Report is the first record of that. It sets a baseline for pain and function that later progress reports are measured against. The injury itself is still reported on the Doctor First Report and Doctor Progress Report.
Who completes it
The prescribing physician completes and signs the report. WCB expects one prescriber, generally the worker’s primary treating physician or the group that covers for them. The Opioid Treatment Agreement is a separate form that you and the worker both sign, and a copy goes to WCB with this report.
How to fill in the report
Examination findings and diagnosis
Give the exam date, your symptoms and examination findings, and the diagnosis that accounts for the pain. WCB’s policy says opioids shouldn’t be prescribed for pain that is undetermined or mainly driven by psychological factors, so link the pain to an identified cause.
Pain scale and activities of daily living
Record the worker’s average pain over the past week from 0 to 10. Then score function at home, function at work, walking, sleeping and overall function, each from poor to normal. These are the outcome measures WCB uses, and they become the baseline for every progress report.
Opioid risk assessment and treatment agreement
Say whether you completed the Opioid Risk Tool and give the score. Don’t send the questionnaire. Confirm the treatment agreement is done and attach a copy. The agreement must name the prescriber, the pharmacy and the risks of opioid use.
Current medications and dosages
List every medication with strength, frequency and duration, including new prescriptions. WCB expects a trial of non-opioid treatment before opioids, so include what was tried. Write “prn” doses with a daily maximum, such as one tablet up to twice a day.
Work capabilities and treatment plan
Answer whether the worker will be off past the injury date and when they can return to regular duties. List any modified work restrictions with a duration. In the treatment plan, include further investigations or consultations and the date of the next visit.
Common reasons payment is held
- No diagnosis linking the pain to an identified cause.
- Pain and function scores left blank, which leaves no baseline.
- No copy of the treatment agreement, or one received more than two weeks after the start.
- More than one prescriber or pharmacy involved.
- Open-ended “as needed” dosing with no daily maximum.
- No record of a non-opioid trial.
Submitting and who pays
Fax the report and the treatment agreement to WCB Manitoba at 204-954-4999 in Winnipeg or 1-877-872-3804 toll free. WCB pays a fee for completing its prescribed report forms, set through its agreements with Doctors Manitoba.