Insurance doctors
Insurance medicine
As a company, it's crucial to look after the well-being of your employees. Our insurance medicine services are specially designed to help you effectively manage the consequences of work-related accidents and illnesses. Our medical experts assess your employees' needs, propose customized rehabilitation plans, and provide advice on how to optimize their return to work. In collaboration with you, we implement preventive and curative measures to reduce risks and improve the overall health of your workforce. Take advantage of our expertise to guarantee rapid and appropriate care, while ensuring compliance with current regulations.
Everything you need to know about insurance medicine in Quebec
Employers, HR Managers, Insurers and Lawyers — Detailed answers to the most frequent questions about disability management and CNESST files in Quebec.
Visit Insurance medicine is a continuous medical file management service — disability follow-up, accommodations, addiction screening, CNESST cost management.
L'Medical expertise is a one-time assessment commissioned by a third party for an independent medical opinion. Clinique Omicron offers both services, often complementary.
Any third party with a legitimate interest may appoint a medical advisor:
- Employers (HR Director, Management, OHS Managers)
- Insurers (Short-term/Long-term salary protection, group insurance)
- Lawyers in labor law or civil liability
- Public organizations CNESST, SAAQ, IVAC, Retraite Québec
- Trade unions seeking a second medical opinion
Two main levers
- Allocation of liability (Articles 328-329 LATMP): If a pre-existing personal condition prolonged the injury, the medical advisor writes the medical opinion to request cost-sharing with the general fund.
- Dispute of the consolidation date If the disability is prolonged beyond what is justified by the condition, the medical advisor documents the elements to contest via the BEM.
Visit consolidation is reaching a rehabilitation plateau—the point at which no further treatment can improve the worker's condition. It triggers:
- Assessment of Permanent Sequelae (APIPP)
- The determination of the definitive functional limitations
- The establishment of suitable employment or the right to rehabilitation
- The end of Income Replacement Benefits (IRBs)
- Receiving the mandate: The medical advisor receives the medical documents and the specific question posed by the client.
- Employee Meeting: Clinical examination in a clinic, with no therapeutic relationship with the insured.
- File analysis: Review of primary care physician and specialist reports.
- Written report: Structured medical opinion responding to the mandate's questions.
The doctor acts independently — a neutral expert bound by the CMQ's code of ethics.
Short term (ST): generally the first 17 weeks. Inability to perform usual duties.
Long-term (LT) : beyond the CT period. The definition becomes more restrictive — unable to engage in any gainful employment for which the person is reasonably fitted. Poorly documented CT to LT transition is one of the most frequent sources of litigation.
Dependency constitutes disability within the meaning of the Quebec Charter. The employer must accommodate the employee, within limits. Our consulting physician intervenes to:
- Medically document the problem of addiction
- Establish a clinical treatment and follow-up program
- Implement a random screening protocol defensible in court
- Document situations of excessive strain
Yes—a work-related psychological injury may be recognized if it is caused by a traumatic event at work or by exposure to abnormal conditions (harassment, violence, documented excessive stress).
Our medical advisor can assess if the condition is genuinely work-related, request a partial allocation if a pre-existing personal condition contributes, or dispute the recognition if the criteria are not met.
Yes, provided the report is written to CMQ standards
- Declaration of Independence and Absence of Conflict of Interest
- Response to the precise mandate without going beyond
- Record of expertise held for a minimum of 10 years
Our medical advisors can also testify as an expert in front of the TAT, TAQ, and civil courts.
Ref: CMQ – Expert Medicine: EMI, June 2021The consulting physician is subject to medical secrecy and the CMQ code of ethics :
- He only shares the information with parties authorized by the mandate.
- He obtains the employee's consent before any clinical examination
- He only transmits the report to the designated client
Clinique Omicron treats all information through a secure and encrypted portal, in accordance with Law 25.
Ref.: Code of Ethics for Physicians, Arts. 20-22 — Professional SecrecyYes. According to the'Article 38 of the LATMP, an employer can designate a doctor to receive medical information regarding their employees' workplace injuries. This designated doctor receives CNESST files, provides medical opinions, and represents the company's medical interests.
Contact us to establish an agreement tailored to your case volume.
Rates vary depending on the nature and complexity of the assignment. To find out the current rates, consult our pricing section you contact our team at 514 606-3350.
Do you have a specific question for your file?
Our medical advisors are available to discuss the specifics of your situation — complex CNESST file, insurance dispute, or disability management.
What type of case are you involved in?
Each treatment plan follows its own legal and medical rules. Our medical advisors are experts in the specifics of each case—CNESST, salary insurance, SAAQ, or civil litigation.
CNESST Files & Workplace Injuries
LATMP — Law on Accidents at Work and Occupational DiseasesWorkplace accidents and occupational illnesses often generate cases that extend beyond their medically justified duration. Our consulting physician provides objective opinions on consolidation, functional limitations, and fitness for return to work.
Services included
- Assessment of lesion consolidation date
- Opinion on functional limitations (temporary or permanent)
- Permanent Impairment Evaluation
- Request for Cost Apportionment (Articles 328-329 LATMP)
- Designated physician according to Art. 38 LATMP
- Workstation Visit & Suitable Employment Evaluation
- Representation before the Administrative Labour Tribunal (TAT)
Legal Framework & Key Terms
Reached a rehabilitation plateau — no further progressive treatment possible. Triggers the calculation of permanent deficits.
LATMP arts. 2 & 57Loss of bodily functions associated with the injury. They define the suitable employment accessible to the worker.
LATMP Art. 166-176The higher the costs attributed to your company, the more your CNESST premium increases over several years.
CNESST Funding RegulationsDisability insurance (short and long term)
Group and individual insuranceCT and LT files require rigorous management to avoid unjustified extensions. Our consulting physician assesses fitness for work and supports the decisions of insurers or self-insured employers.
Services included
- Independent Medical Evaluation (IME) for insurer or employer
- Opinion on ability to occupy usual position or any employment.
- Analysis of primary care physician and specialist reports
- Support with progressive return to work procedures
- Review of required accommodation measures
- Opinion on the definition of disability applicable to the contract
Legal Framework & Key Terms
CT: Inability to perform one's usual work. LT: Inability to perform any remunerative work for which the person is reasonably suited.
Examination by a physician with no therapeutic relationship with the insured. Neutral opinion usable by the insurer or employer.
CMQ — Medical Expertise Guide 2021The employer must accommodate an employee with a disability up to undue hardship — our doctor documents the limitations.
Quebec Charter art. 10SAAQ, IVAC & RRQ — Disability
Public compensation schemesSAAQ, IVAC, and RRQ files require precise and documented medical opinions. Our consulting physicians assist employers, insurers, and lawyers in managing and contesting these files.
Services included
- Medical opinion on SAAQ diagnoses and anatomo-physiological deficits
- Medical fitness to drive (SAAQ — license)
- Evaluation of permanent sequelae IVAC
- Medical report - Accidental disability pension
- Representation before the Administrative Tribunal of Quebec (TAQ)
Legal Framework & Key Terms
Measurement of Permanent Loss of Physical Function — Basis for Calculating SAAQ Compensation for Permanent Impairment.
Condition required for certain long-term benefits. Medical evaluation is decisive for eligibility.
LAA — Automobile Insurance ActPaid to contributors unable to perform any work on a regular basis. A structured medical report is essential for approval.
Québec Pension Plan ActMental health, addictions & behavioral disorders
Complex workplace dossiersCases involving mental health or addiction are often the most costly. They require an approach that is medical, humane, and legally defensible.
Services included
- Overall assessment of the file (primary care physician, psychiatrist, psychologist)
- Coordination with mental health stakeholders
- Random Screening Program (Alcohol, Drugs, Medication)
- Opinion on accommodation measures and gradual return
- Follow-up of clinical evolution in the medium and long term
- Collaboration with legal counsel in case of litigation
Legal Framework & Key Terms
A recognized mental disorder can constitute a disability under the Charter. The employer must accommodate up to undue hardship.
Quebec Charter & CDPDJA medically supervised protocol is defensible in court—with the right documentation.
LATMP & LSSTRecognized by the CNESST if caused by a traumatic work-related event (harassment, assault, documented excessive stress).
LATMP art. 2Civil & Medico-Legal Disputes
Civil liability & court-appointed expert assessmentsIn the context of legal disputes, our medical advisors act as experts, providing opposable reports and testifying before the competent courts.
Services included
- Independent Medical Examination (IME) report usable as evidence
- Opinion on the causal link between the event and the sequelae
- Permanent Total and Partial Disability Assessment
- Report according to CMQ standards for judicial use
- Expert testimony in civil courts and administrative tribunals
- Second look at the opposing expert's report
Legal Framework & Key Terms
The medical expert must be independent of the client. His report clarifies matters for the court; he does not defend a party.
CMQ - Expert Medicine, June 2021The expert physician must demonstrate that the consequences are, according to the balance of probabilities, caused by the event in dispute.
Civil Code of Québec art. 1457Any physician acting as an expert must keep a record of the IME assignments for a minimum of 10 years.
Record Regulations — CMQ
Expert support
Get a second medical opinion
Our insurance medicine services also include the possibility of obtaining an impartial second medical opinion. If you or your employees have any doubts about a diagnosis or treatment plan, our experienced specialists are on hand to provide an independent, objective assessment. This service allows you to make informed decisions with confidence. Whether it's a question of work-related injury or illness, a second medical opinion can clarify the options available and ensure that every decision taken is based on the highest level of medical expertise.
Reducing disability costs: The economic argument of the medical advisor
A poorly managed disability file costs on average 2 to 5 times more than a file handled quickly with a medical advisor.
What an unmanaged folder really costs
CNESST apportionment sharing (articles 328-329 LATMP)
A financial lever often overlooked by employers—which our medical advisors have mastered perfectly.
If a pre-existing personal condition contributes to extending the disability, the employer may request cost-sharing, reducing their CNESST contribution.
Our medical advisor Document and write the medical opinion necessary for the request for sharing, with arguments admissible by the court.
The impact on the cumulative experience rate often represents a significant return on investment from the very first case.
«A single managed dependency file without a medical advisor can cost 2 to 3 times more in salary insurance, CNESST contributions, and productivity losses than structured support from the outset.»
— Employer perspective, disability management in QuebecCase handling process
From receiving the mandate to the final written report — rigorous, confidential management in compliance with the obligations of the Collège des médecins du Québec (CMQ).
Mandate received
Secure transmission of medical documents via encrypted portal — compliant with Law 25.
SecureFile analysis
Complete Study: Medical Record, History, Diagnostics, Treatments, and Functional Limitations.
IndependentMedical assessment
In-clinic or remote appointments. Diagnostic tests as needed (ECG, blood tests).
In the clinicWritten report
Clear and documented recommendations. Target timeframe: 10 to 15 business days.
ActionableTracking & representation
Continuous support — up to the representation at the TAT or in civil court if necessary.
TribunalWho can appoint a medical advisor?
Frequently Asked Questions — Insurance Medicine
Employers, HR managers, insurers, and lawyers — detailed answers on insurance medicine, disability management, CNESST files, and medical assessments in Quebec.
Visit Insurance medicine is a continuous occupational health record management service including disability monitoring, accommodations, substance abuse screening, and CNESST cost management. The'Independent medical expertise (IME) is a one-time assessment commissioned by a third party to obtain a neutral medical opinion on a specific case. Clinique Omicron offers both services, which are often complementary depending on the nature of the mandate.
- Employers (HR Director, Management, OHS Managers)
- Insurers (Short-term/Long-term salary protection, group insurance)
- Lawyers in labor law or civil liability
- Public organizations CNESST, SAAQ, IVAC, Retraite Québec
- Trade unions seeking a second medical opinion
Two main levers can reduce the financial impact of a CNESST file. First, the Apportionment of fault (Articles 328-329 LATMP) : If a pre-existing personal condition prolonged or aggravated the injury, the medical advisor shall draft the necessary medical opinion to request cost-sharing with the CNESST general fund. Then, the challenge to the consolidation date If the disability is prolonged beyond what the worker's condition justifies, the consulting physician documents the elements to contest through the Medical Evaluation Office (BÉM).
Ref.: LATMP arts. 328-329 — Sharing and transfer of imputationVisit consolidation is reaching a rehabilitation plateau—the point at which no further treatment can improve the worker's condition. This is a critical stage as it triggers the assessment of permanent impairment (APIPP), determination of definitive functional limitations, establishment of suitable employment, and cessation of income replacement benefits (IRR). Our medical advisor may dispute a perceived premature date of medical stability or, conversely, document that it was reached earlier than recognized.
Ref.: LATMP art. 2 — definition of «consolidation»The EMI takes place in four stages: mandate receipt with the medical documents via secure portal, meeting with the evaluated person in a clinical setting (clinical examination without a therapeutic purpose), Full file analysis including reports from the attending physician and specialists, then report writing Responding precisely to the questions in the mandate. The physician acts as a neutral expert, bound by the CMQ's code of ethics. Target turnaround time: 10 to 15 business days.
Visit short term (ST) generally covers the first 17 weeks: inability to perform one's usual job. The long term (LT) applies beyond this period with a more restrictive definition — inability to perform any occupation for which the person is reasonably suited by training and experience. The poorly documented CT → LT transition is one of the most frequent sources of litigation between employees and insurers. Our medical advisor secures this transition with a strong medical opinion.
Dependency constitutes disability within the meaning of the Charter of Human Rights and Freedoms — The employer has an obligation to accommodate up to undue hardship. Our medical advisor intervenes to medically document the issue, establish a treatment and clinical follow-up program, implement a random screening protocol defensible in court, and document situations where accommodation reaches its legal limits.
Yes—a work-related psychological injury can be recognized by the CNESST if it is caused by a traumatic event or by exposure to abnormal working conditions (harassment, violence, documented excessive stress). Our medical advisor can assess the real origin of the condition, request a shared attribution if a pre-existing personal condition significantly contributes to the disability, or contest the recognition if legal criteria are not met.
Ref.: LATMP art. 2 — psychological occupational injuryYes, provided that the report is drafted according to the CMQ standards for medical expert opinions: declaration of independence and absence of conflict of interest, strict adherence to the mandate, and a record of expert opinions kept for a minimum of 10 years. Our consulting physicians can also testify as an expert before the Administrative Labour Tribunal (TAT), the Administrative Tribunal of Quebec (TAQ), and the civil courts.
Ref: CMQ – Expert Medicine: EMI, June 2021The consulting physician is subject to professional secrecy and the CMQ code of ethics. It only shares information with parties authorized by the mandate, obtains the consent of the evaluated person before any examination, and only transmits the report to the designated client. Clinique Omicron processes all information via a secure and encrypted portal, in accordance with Law 25 on the protection of personal information.
Ref.: Code of Medical Ethics Arts. 20-22Yes. According to the'Article 38 of the LATMP, An employer may designate a physician to receive medical information related to their employees' work-related injuries. This designated physician receives CNESST files, provides medical opinions, and represents the company's medical interests in the CNESST process. Contact us to establish an agreement tailored to your file volume.
Ref.: LATMP Art. 38 — Physician Designated by the EmployerRates vary depending on the nature and complexity of the mandate—a simple EMI doesn't have the same cost as a case requiring representation before the TAT. For current rates, consult our pricing section or contact our team directly at 514 606-3350. The fees are to be paid by the principal (employer, insurer, lawyer).