OCF-18 Form (Treatment and Assessment Plan)
The OCF-18 (Ontario Claim Form 18) is the standardized Treatment and Assessment Plan form used in Ontario's motor vehicle accident insurance system. Regulated health professionals, including audiologists, submit OCF-18 forms to an injured person's auto insurer to request pre-approval for treatment programs and assessments related to injuries sustained in a motor vehicle accident.
When an audiologist identifies that a person's hearing loss, tinnitus, or vestibular disorder arose from or was worsened by an MVA, an OCF-18 outlines the proposed assessment or treatment, the expected number of sessions, the goals of treatment, the cost, and the clinical rationale. The insurer then reviews the plan and either approves it, requests more information, or disputes it. Pre-approval is generally required before treatment begins for costs to be covered under the Statutory Accident Benefits Schedule (SABS).
Completing an OCF-18 accurately is important for ensuring that the clinical rationale is clearly communicated to non-clinical insurance staff and adjudicators. Audiologists submitting OCF-18s should document the connection between the MVA and the audiological findings, reference relevant diagnostic test results, and ensure that proposed treatment aligns with best practice guidelines. Forms are submitted through the HCAI platform.
