Overview

For many injury victims, loss of income is one of the most stressful consequences of a car accident. In Nova Scotia, Section B of the Standard Automobile Insurance Policy provides wage replacement benefits for individuals who are substantially disabled from performing the essential tasks of their own occupation.

As a treatment provider, your clinical assessments, treatment records, and administrative documentation can directly impact whether your patient is approved for income replacement benefits. This guide from our auto accident lawyers explains your role and responsibilities in supporting a wage loss claim, including:

  • Recognizing occupational disability, 
  • Documenting functional limitations, 
  • Completing required insurance forms, 
  • Ensuring records support both subjective complaints and objective findings. 

First: Understand the Wage Loss Test

The standard for Section B weekly indemnity benefits is inability to perform “the essential duties of one’s own occupation” due to accident-related injuries.

This is often referred to as the “own occupation” test and should not be confused with a broader “any occupation” or total disability test.

Key point: If a person is unable to perform key tasks of their regular job—due to pain, restricted mobility, fatigue, or other symptoms—they may qualify, even if they are not completely bedridden or unable to work in any capacity.

Step-by-Step Guide for Providers

1. Recognize Red Flags for Occupational Disability

Ask yourself during assessment and follow-up visits:

  • Can the patient sit/stand for extended periods without exacerbating symptoms? 
  • Do they need to take frequent breaks, lie down, or avoid certain movements? 
  • Is there impaired concentration, sleep disturbance, or medication side effects that would impact work? 
  • Are there safety concerns if they returned to work prematurely (e.g., operating machinery with limited ROM)? 

These observations form the basis for supporting a wage loss claim.

2. Document Functional Impairments Clearly

To support a disability claim, your clinical notes should:

  • Specify what the patient cannot do, not just that they have pain. 
    • ❌ “Patient has neck pain.” 
    • ✅ “Patient reports neck pain rated 6/10, which increases with sustained computer use beyond 10 minutes, preventing return to desk work.” 
  • Quantify limitations wherever possible. 
    • “Forward flexion limited to 45 degrees; patient unable to lift items above shoulder height.” 
  • Connect limitations to occupational tasks: 
    • “Patient unable to perform repetitive reaching required in their warehouse role.” 
  • Note fatigue, concentration, and secondary effects (e.g., dizziness, medication drowsiness). 

Use the SOAP format (Subjective, Objective, Assessment, Plan) consistently, and keep in mind that records may be reviewed months or years later in court or by an insurer.

3. Complete Insurance Forms Properly

Key forms in a Section B wage loss claim:

✅ Form 1: Notice of Claim for Accident Benefits

  • Completed by the patient. 
  • Ensure they list accurate employment information. 
  • Assist them in identifying your clinic as their treatment provider. 

✅ Form 1A: Disability Benefits

  • Completed by a physician, chiropractor, or physiotherapist. 
  • Must certify that the patient is “substantially disabled from performing the essential tasks of their employment.” 
  • State how the injury impairs work: e.g., “Cannot maintain sitting posture at workstation due to lumbar strain. Unable to meet occupational demands as administrative assistant.” 
  • Estimate recovery time and whether modified work might be possible. 
  • Indicate if further medical or specialist referral is needed. 

4. Support the Claim with Strong Clinical Notes

Insurers will compare what you write in the forms with your clinical chart notes. Make sure:

  • Visit notes show consistent reporting of symptoms and limitations. 
  • Objective findings support subjective reports. Examples: 
    • Muscle spasm, restricted ROM, neurological signs 
    • Observed postural shifts or wincing during assessment 
    • Measured decrease in strength or endurance 
  • Use functional outcome measures like: 
    • Neck Disability Index (NDI) 
    • Oswestry Low Back Disability Questionnaire 
    • QuickDASH (for upper limb function) 
    • Pain diagrams 
  • Record work status and recommendations at each visit (this is so important!): 
    • “Continues off work” 
    • “Modified work not feasible due to nature of occupation” 
    • “Next reassessment in 7 days to evaluate RTW readiness” 

5. Ongoing Reassessment and Communication

Insurers may approve benefits for 30 days, then request updates.

At each stage:

  • Provide written progress updates when requested. 
  • If the patient remains disabled, complete an updated clinical note or letter: 
    • “Patient continues to experience moderate lumbar pain with sitting >15 minutes. Return to work remains contraindicated.” 
  • If the patient can return with modifications, state what those are: 
    • “Can resume light duties with 10 lb lifting limit and ability to alternate sitting and standing.” 

You may be asked to submit a Narrative Report or Attending Treatment Provider Letter—these can be powerful tools to explain:

  • Current impairments 
  • How the injury impacts occupational tasks 
  • Progress to date and prognosis 

Modified Work: How to Address It

Insurers often ask whether the patient can do modified or light duties.

Be thoughtful:

  • If light duties aren’t available, say so. “Employer does not offer alternate work.” 
  • If patient could do limited duties, outline restrictions: 
    • Time limits (e.g., “no more than 15 minutes standing at one time”) 
    • Functional limits (e.g., “no overhead reaching”) 
    • Cognitive/emotional limits (e.g., “difficulty concentrating due to medication”) 

Make clear that modifications must be realistic and align with the injury.

When Symptoms Aren’t Easily Measurable

For symptoms like headaches, vertigo, fatigue, or chronic pain:

  • Use standardized tools (e.g., Fatigue Severity Scale, PHQ-9). 
  • Document: 
    • Triggers and patterns, 
    • Impact on ADLs and work, 
    • Medication effects and side effects. 

Avoid vague statements. Instead of:

  • “Patient feels tired,” Say: 
  • “Patient reports afternoon fatigue requiring 2-hour naps; cannot complete an 8-hour workday without rest.” 

Mental Health Considerations

If the injury causes psychological distress affecting return to work:

  • Refer to a psychologist or counsellor for formal assessment. 
  • Document symptoms such as: 
    • Avoidance of driving 
    • Panic in traffic settings 
    • Depressive symptoms interfering with concentration 
  • Use validated tools like: 
    • GAD-7 (for anxiety) 
    • PHQ-9 (for depression) 

Charting Checklist for Wage Loss Support

Chart Element Best Practices
Work status noted at each visit “Patient remains off work due to pain with prolonged sitting.”
Subjective report tied to function “Pain 7/10 with standing >10 minutes; prevents cashier work.”
Objective findings documented “Reduced cervical flexion 40°, tenderness at C5-C6.”
Functional measures included “NDI score 38/50 – severe disability.”
Notes align with disability certificate Don’t say “mild” in notes if AB-3 states “unable to work.”
Clear RTW updates “RTW possible with seated duties only; no lifting.”
Treatment plan supports return to function “Focus on increasing sitting tolerance and core strength.”

Sample Phrases for Charting (and Insurer Communication)

Here are a few sample notes that help support a wage loss claim:

Subjective: “Client reports lower back pain 6/10 that worsens with prolonged sitting, standing, and lifting, which are core job functions as a warehouse supervisor.”

Objective: “Palpable lumbar spasm, positive seated slump test, reduced lumbar flexion to 50%. Gait guarded. Unable to transition from standing to sitting without support.”

Assessment: “Continued inability to meet occupational demands. Current status remains incompatible with return to regular work duties.”

Plan: “Reassess in 7 days. Continue targeted therapy. Will monitor for functional improvements needed for work resumption.”

Final Thoughts

As a treatment provider, your role in supporting a wage loss claim goes beyond hands-on care. Insurers rely on your clinical records, disability certificates, and honest professional opinions to evaluate whether your patient qualifies for wage loss benefits.

Clear, consistent, and functionally-focused documentation—paired with thoughtful communication and use of standardized tools—will give your patient the best chance of having their claim accepted and their recovery supported.

For information on this subject, check out our previous article: Supporting a Car Accident Injury Victim in the First 90 Days: A Guide for Treatment Providers