What the OMPR is for
WCB Manitoba’s opioid policy asks prescribers to reassess, periodically or as circumstances require, the worker’s progress toward pain control and function, any adverse events, and adherence to the treatment plan. The progress report is where that reassessment goes. WCB reads it against the Initial Opioid Management Report to decide whether to continue, adjust or stop paying.
Who completes it
The prescribing physician completes and signs it. WCB expects a single prescriber and a single pharmacy for the worker’s opioids, so the report should come from the same physician who sent the initial one, or the group covering for them.
How to fill in the report
Examination findings and diagnosis
Give the exam date, current symptoms and findings, and the diagnosis that accounts for the pain. Note any change since the initial report.
Pain scale and activities of daily living
Score the average pain over the past week, and function at home, at work, walking, sleeping and overall. WCB’s test is improvement in function, so a lower pain score with no change in function is a weak case for continuing.
Side effects from opioid treatment
Rate nausea, constipation, sweating, dry mouth, depressed mood, cognitive deficits, fatigue or drowsiness, and overall side effects as none, mild, moderate or severe. When side effects are moderate or severe, say in the treatment plan how you’re managing them, since WCB weighs them against the benefit.
Adverse opioid-related factors
Tick any that apply: altering the route of delivery, unsanctioned use, withdrawal symptoms, accessing opioids from other sources, opioid seeking, or social deterioration. If you tick one, the treatment plan should say what you’re doing about it, because misuse is a ground for stopping payment.
Medications, work capabilities and treatment plan
List current medications with strength, frequency and duration. Update the return-to-work answers and any restrictions with a duration. In the treatment plan, include dose changes, a taper if you’re starting one, further investigations or consultations, and the date of the next visit.
Common reasons payment is stopped or questioned
- Function scores flat or worse since the initial report with no explanation.
- A dose increase with no documented re-evaluation of risk and benefit.
- Adverse factors ticked with nothing in the treatment plan.
- A second prescriber or pharmacy appearing on the claim.
- Prescriptions longer than 30 days.
Submitting and who pays
Fax the report 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.