CHIROPRACTIC AND OSTEOPATHIC SERVICES

As of 1 September 1995, LMOs will be able to refer eligible veterans to chiropractors and osteopaths for treatment at departmental expense.

The new policy legitimatizes treatment by these service providers in the department's eyes and raises the question of how Compensation should treat opinions from these service providers. It is now possible for a veteran to be receiving treatment from a chiropractor or osteopath at departmental expense for an accepted disability and to lodge a claim for a new disability to be supported by a report or x-rays from the service provider.

This DI sets out guidance on how evidence from chiropractors and osteopaths should be evaluated in the determination of claims.

How chiropractors and osteopaths should be used to obtain evidence in support of a claim or an application for increase.

In the same way that claims assessors would seek information from a LMO, claims assessors are able to approach chiropractors and osteopaths for treatment history and evidence of the severity of the disease. As with any other report, if any doubts arise as to its acceptability or accuracy, a further opinion from a medical practitioner may be requested.

What weight should be given to opinions and x-rays submitted by the veteran from these service providers about:

Causation

RMA Statements of Principles (SOPs) are the authority for causation. Chiropractors and osteopaths opinions on causation are not required so should not be sought or considered. An opinion that a particular disease or injury was caused by a factor not in the SOP is not acceptable. However such an opinion supported by medical-scientific evidence may be forwarded to the RMA.

Diagnosis

The opinions and x-ray reports of service providers, including chiropractors and osteopaths, commenting in their field of expertise should be given due weight if soundly supported by the evidence. Only diagnosis that sit within the SOP or, where no SOP exists, within ICD-9 should be considered. However for involved diagnosis additional comments from a DMO or a specialist may be sought including, if appropriate, interpretation of x-rays by a radiologist.

Degree of impairment.

The opinions and x-ray reports of service providers commenting in their field of expertise should be given due weight. Chiropractors and osteopaths may use GARP IV to discuss their opinions as to the severity and effects of the disease or injury. However, as with any other opinion from a service provider, it may be put aside if it is contradicted by a specialist in the field.

W R MAXWELL

BRANCH HEAD

COMPENSATION AND REVIEW