What the OCF-3 is for
The Disability Certificate supports a claim under Ontario’s Statutory Accident Benefits Schedule for accidents on or after November 1, 1996. You certify the injuries caused by the accident and answer a set of disability tests: whether the applicant can do the essential tasks of their job, carry on a normal life, provide care as a primary caregiver, continue in school, or do their housekeeping and home maintenance.
Requests to fund treatment go on the OCF-18 Treatment and Assessment Plan, or the OCF-23 for injuries within the Minor Injury Guideline.
Who completes it
The applicant completes Parts 1 to 3, covering their details, work and caregiving at the time of the accident, the insurer, and what happened. They sign the authorization in Part 4 after you have explained their accident-related injury to them. You complete Parts 5 to 10 from your most recent assessment and return the form to the insurer in Part 2.
When the insurer asks the applicant to complete the form, they usually print it, fill in the first pages by hand, and bring it to the appointment, or fill them in at the front desk while they wait. You then handwrite Parts 5 to 10 on the same printout, or type them into a fresh copy and staple the two together. In Medulla, you send Parts 1 to 3 to the patient over a secure link before the visit. They answer on the form itself from any device, their answers are on the PDF when Medulla fills Parts 5 to 10 from your assessment, and the patient signs Part 4 once you’ve explained their injury. The insurer gets one complete, legible certificate.
How to fill in Parts 5 to 10
Part 5, Injury and Sequelae Information
List each injury and sequela caused by the accident, most significant first, with its ICD-10-CA code. The HCAI user manual has the coding guidance. Leave out conditions that predate the accident here; they belong in Part 8.
Part 6, Disability Tests and Information
Give the dates symptoms began, of the first post-accident examination, and of your most recent one. Then answer each test. The employment test asks whether the applicant is substantially unable to perform the essential tasks of the job they had at the time of the accident, as a result of the accident and within 104 weeks of it. The normal-life test is stricter and asks about an impairment that continuously prevents substantially all of their pre-accident activities.
Duration
If you answered yes to any test, choose the anticipated duration. For more than 12 weeks, the form asks why the limitations are likely to persist, so describe the findings and course that support it.
Parts 7 to 9
Report examinations, investigations or consultations not previously reported, and any planned. In Part 8, describe conditions before the accident that affected the same activities, any disability benefits for them, and any new unrelated conditions since. In Part 9, list current medications for the accident injuries and for prior conditions, and whether you prescribed them.
Part 10, Health Practitioner Signature
Enter your college registration number, tick your profession and sign. Add the facility name and its AISI facility number if you work through one.
Common reasons the insurer questions it
- A yes on a disability test with no explanation of what the applicant can’t do.
- Duration over 12 weeks with no reason given.
- Prior conditions in Part 8 left as unknown when your own records show them.
- Injuries listed without ICD-10-CA codes, or pre-existing conditions listed as accident injuries.
- Part 4 not signed by the applicant or their substitute decision-maker.
Submitting and who pays
Return the completed certificate to the insurer named in Part 2. Clinics registered with HCAI, the electronic system Ontario auto insurers use to exchange claim forms with health care facilities, may send forms through it. The form states that the fee for completing it must be billed to the insurer directly.