FSRA | SABS Forms – Minor Injury Treatment Discharge Report ​(OCF-24)

Minor Injury Treatment Discharge Report ​(OCF-24) – SABS

The Minor Injury Treatment Discharge Report (OCF-24) is a standardized form used in Ontario for reporting the discharge status of patients who have undergone treatment for minor injuries resulting from automobile accidents. The form is utilized for accidents that occurred on or after September 1, 2010, and it is governed by the Minor Injury Guideline.

The OCF-24 form ensures proper documentation and compliance with the guidelines, aiming to facilitate the processing of claims and provide transparency in the treatment and discharge of patients with minor injuries.

General Instructions

• Ensure Consent: Obtain necessary consent for the collection, use, and disclosure of information using the Ontario Claims Form 5 (OCF-5) for permission to disclose health information.
• Accuracy and Honesty: Ensure all information provided is true and correct. It is an offense to provide false or misleading information.

Step-by-Step Guide

Part 1: Insured Person Information

1. • Date of Birth (YYYYMMDD): Enter the insured person’s date of birth in the format YYYYMMDD.
   • Gender: Check the appropriate box for male or female.
   • Telephone Number: Provide the insured person’s contact number, including any extension.
   • Last Name and First Name: Enter the insured person’s last name followed by their first name.

Part 2: Insurance Company Information

1. • Company Name: Write the name of the insurance company handling the claim.
   • Adjuster Telephone: Enter the contact number for the adjuster, including any extension.
   • Adjuster Last Name and First Name: Provide the adjuster’s last name followed by their first name.

Part 3: Health Practitioner Information and Signature

1. • Name of Health Practitioner: Print the full name of the treating health practitioner.
   • College Registration Number: Enter the practitioner’s registration number with their professional college.
   • Facility Name (if applicable): Write the name of the facility where the treatment was provided.
   • AISI Facility Number (if applicable): Enter the AISI facility number, if applicable.
   • Certification and Signature: The health practitioner must certify the accuracy of the information by signing and dating this section.

Part 4: Insured Person’s Discharge Status

1. • Status at Discharge: Check the appropriate box to indicate the insured person’s status at discharge:
     • No additional intervention required.
     • Additional intervention required: Specify if a Treatment and Assessment Plan (OCF-18) is submitted or waived, or if a referral to another health professional is made. Provide the professional’s name, address, and type if known.
     • Non-compliance or voluntary withdrawal: Indicate if the insured person was non-compliant, did not attend sessions, or withdrew from treatment.

Part 5: Insured Person’s Functional Status at Discharge

1. • Employment Status
     • Check if the insured person was employed at the time of the accident.
     • Indicate if they lost time from work and whether they can return to pre-accident work activities, specifying full or partial/modified return.

1. • Care-Giving Status
     • Check if the insured person was a caregiver at the time of the accident.
     • Indicate if they lost time from caregiving and whether they can return to caregiving activities, specifying full or partial/modified return.
   • Regular Activities
     • Check if the insured person had difficulty performing regular activities.