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Concerns and Complaints: Frequently Asked Questions (FAQ)

Types of Complaints

Anyone – that includes patients, clients, their family members, colleagues of an occupational therapist, an employer and others.

By law, it is the College’s duty to review all complaints about occupational therapists who are registered to practice in Ontario, and to give serious consideration to each matter.



As a regulatory body, the College holds its members accountable. Complaints can touch on a wide range of issues related to conduct or practice.

This can include concerns that the occupational therapist has:

  • ignored the basic rules of the profession;
  • failed to maintain the standards of practice;
  • provided inappropriate care;
  • sexually abused a patient/client (sexual intercourse or other forms of sexual relations; and touching, behaviour or remarks of a sexual nature); and,
  • a physical or mental condition or disorder that interferes with their ability to practice.

Essentially, people can complain about an occupational therapist’s capabilities, conduct, safety and ethics. The College has its own terms for possible issues, including misconduct, incompetence and incapacity.



No. The College addresses issues about professional conduct and practice, which doesn’t include fees or financial arrangements for occupational therapy services or products.



No. The College does not have the required statutory authority to force an OT to change his or her opinion or report.



No. The College has jurisdiction over registered occupational therapists. It does not have jurisdiction over clinics or non-OT employers.



Yes. The College has the authority to investigate cases where someone who is not registered is using the title “occupational therapist” or “OT Reg. (Ont.)” or holding themselves out as an occupational therapist.



The College can only address the conduct and abilities of OTs registered in Ontario. For issues that are outside the College’s mandate or jurisdiction, the College will often direct complainants to the appropriate regulatory body, tribunal or court.




Before Making a Complaint

If you are comfortable doing so, you can certainly raise the issue directly and try to resolve your concerns without making a formal complaint.



You can contact the College to ask about any issues regarding an OT’s conduct or practice. Staff can help you understand the standards of practice that OTs must follow, and discuss the level and quality of care you can expect to receive.

Please contact practice@coto.org or call 416,214.1177/1.800.890.6570 x240. Calls are confidential.

You may also contact the College’s investigation staff at investigations@coto.org or 416.214.1177/1.800.890.6570 x234 to discuss the complaints process before making a complaint, without having to identify yourself.

College staff cannot provide legal advice or recommend whether or not you should make a complaint.

While College staff can advise you on the level and quality of care you can expect to receive, staff cannot comment on whether or not the care you actually received from an occupational therapist was appropriate or inappropriate. Only the Inquiries, Complaints and Reports Committee and Discipline Committee can make this determination.



No, complaints cannot be made anonymously.

However, you can anonymously contact the College with concerns or to report information. Callers are not required to identify themselves when doing this.

If you decide to make a complaint – but not before – you will be required to identify yourself.



No. People wishing to make a complaint can take time to gather the necessary information and can raise concerns about something a long time after it happened.




Reviewing and Investigating Complaints

The Inquiries, Complaints and Reports Committee (ICRC). This Committee of the College includes members of the public and occupational therapists. College staff are not members of the ICRC or involved in the decisions it makes.



ICRC members are trained to review complaints objectively. No member of the panel can participate in a review if they have a bias or an appearance of bias, or a conflict of interest. The panelists who are occupational therapists bring that perspective to interpret and apply the standards of the profession. All members of the panel, public and professionals, have the same duty to protect the public interest.




  • The College may contact the complainant to clarify their concerns.

  • The College will send a copy of the complaint to the OT, who has 30 days to respond in writing. When the College receives the OT’s response, it will be sent to the complainant who then has 15 days to send additional information (if desired).

  • If the complainant decides to send more information that raises new concerns, the OT will be asked to respond.

  • An ICRC panel then reviews the material and decides if it requires additional information before making a decision. To do this, the panel may ask a College staff member to obtain more information about the nature of the complaint, ask a lawyer or other expert to comment on the case, or engage an investigator.


No. The ICRC does not invite either the person making the complaint or the occupational therapist to its meetings. The ICRC reviews complaints based on the information provided in the form of paper or electronic records.



Sometimes a complaint is filed by someone other than the patient/client. the College never gathers information about the patient/client who is part of the complaint without that person’s knowledge of the complaint and usually will not gather information without their consent.



If a patient/client is the one making the complaint, that very fact allows the occupational therapist to release information to the College, including a copy of the chart for that individual.

Where a third party makes the complaint, the complaint itself is not sufficient to authorize the disclosure of confidential patient/client information. In those cases, the College will try to obtain consent.



Some people do seek advice to assist them during the process, but the College does not require it.



The College does not have the authority to direct anyone one way or another about whether to continue contact with the occupational therapist.

If you are no longer comfortable working with the occupational therapist and need help finding another occupational therapist, please contact the College at 416.214.1177/1.800.890.6570 x236 or info@coto.org.



The College investigates every complaint brought to its attention except those that are considered frivolous or vexatious (having no merit), made in bad faith, not relevant, or an abuse of process. In such cases, the ICRC panel will notify all parties of its intention to take no action.



No, not every complaint is resolved by the ICRC. If the complaint does not concern allegations of sexual abuse, at any point, the ICRC panel may determine that a neutral, external third party may help in resolving the concerns. If that’s the case, and if the Registrar agrees, the complainant and the OT will be invited to participate in mediation. This is a voluntary process and cannot proceed without the consent of all parties involved.




Timing of Decisions

The ICRC panel tries to make its decision within 150 calendar days. Often, that deadline isn’t possible. If so, you’ll be notified in writing about the delay, what the College is doing to investigate, and when the complaint will likely be scheduled for review by the ICRC.

The College appreciates that this time can be stressful for everyone involved. However, to be fair to both parties it is necessary that the ICRC panel has all relevant information before it makes a decision.



The ICRC conducts its reviews in panels. Usually every 4-6 weeks, a panel will meet to review and discuss the complaint information submitted to the College. The ICRC usually meets as an entire committee 2-3 times per year.



Staff can provide an update and answer procedural questions about the complaint or investigation process, but cannot discuss the content or merits of the complaint.




Decisions of the Inquiries, Complaints and Reports Committee (ICRC)

The ICRC’s focus is on whether the occupational therapist’s conduct or practice has met the standards of the profession. The panel has the power to make one or more of the following decisions:

  • Decide not to investigate because the complaint is frivolous or vexatious (no merit), made in bad faith or is an abuse of process.

  • Decide the OT’s conduct was appropriate and take no action.

  • Issue advice or make recommendations, if the ICRC believes that will help the OT to understand how to conduct himself or herself in the future and avoid difficulties.

  • Request that the OT participate in self-study or practice monitoring, with assistance available from the College in developing an educational plan with follow up from the College to ensure the OT has addressed the needs identified.

  • Require the OT to appear before a panel of the ICRC to be cautioned-in-person regarding specific aspects of his or her practice, professionalism or conduct. For investigations initiated on or after January 1, 2017, a summary of the decision to caution-in-person will be posted to the OT’s profile on the public register at Find an Occupational Therapist.

  • Request or accept the OT's undertaking to improve his or her practice or to restrict his or her practice, which may include education, supervision, and/or monitoring, and may require further evaluation upon completion. The College monitors compliance and for investigations initiated on or after January 1, 2017, the terms of the undertaking will be posted to the OT’s profile on the public register at Find an Occupational Therapist.

  • Direct the OT to complete a specified continuing education remediation program (SCERP) in order to improve skills or change practice. The College monitors compliance and for investigations initiated on or after January 1, 2017, a summary of the decision will be posted to the OT’s profile on the public register at Find an Occupational Therapist.

  • Request or accept an undertaking from the OT to resign and to never apply for reinstatement, which is posted to the OT’s profile on the public register at Find an Occupational Therapist.

  • Take other appropriate action not inconsistent with the Regulated Health Professions Act, 1991 (RHPA).

  • Refer allegations to the Discipline Committee for a hearing, if the concerns related to conduct or competence are very serious and cannot reasonably be addressed through one of the other options.

  • Refer the OT to another panel of the ICRC to make health inquiries.

  • Refer the case to the Fitness to Practise Committee for a hearing if the ICRC believes the therapist may be mentally or physically unable to practice.

  • Where a referral is made to the Discipline Committee or Fitness to Practise Committee and the ICRC is of the opinion that the conduct of the OT exposes or is likely to expose patients to harm or injury, it may request the Registrar to suspend or restrict the OT’s ability to practice.

 

Except where a referral to the Discipline or Fitness to Practise Committees is made, a document setting out the decision and explaining the ICRC’s reasons will be sent to the complainant and the occupational therapist.



The Discipline Committee considers the most serious cases where an occupational therapist may be incompetent or have committed an act of professional misconduct. The Fitness to Practise Committee hears concerns about the physical or mental health of an OT, which may affect his or her ability to practise safely and effectively.

You will be advised of the referral, be provided with a summary of the allegations, and receive additional information related to the hearings process.



No. The ICRC cannot address such monetary matters.



No. The ICRC cannot force an OT to apologize.



No. The ICRC is a screening committee not a hearings committee. Only a hearings Committee (the Discipline Committee or the Fitness to Practise Committee) has that authority.



No. The law that governs the College (and all health colleges) states that no documents related to a complaint may be used in lawsuits, criminal proceedings, arbitration or hearings before another tribunal.



The contact information of the Health Professions Appeal and Review Board (HPARB) will be included with the ICRC’s written decision.

Any party who is dissatisfied with the ICRC’s investigation and/or decision may request a review by HPARB, which is an independent government body operated by the Ministry of Health and Long Term Care. HPARB cannot review decisions to refer allegations to the Discipline Committee or to the Fitness to Practise Committee.

HPARB will invite both you and the occupational therapist to present information as to why they think the decision was reasonable or unreasonable, or the investigation was adequate or inadequate. You have the option of not attending the review or you may participate in person or by telephone.

After reviewing a decision, HPARB can confirm all or part of it, make recommendations to the ICRC, or require the ICRC to take further action under the Occupational Therapy Act, 1991 and the Health Professions Procedural Code.




Publicizing Complaints and Decisions

The College is governed by a strict duty of confidentiality. It may only disclose information to the extent necessary to perform its regulatory functions. For example, when asking a witness for a statement the College can alert that individual that a complaint has been made. The ICRC is conscientious about the privacy of individuals during the investigation process, and doesn’t gather more information than necessary.

The ICRC will know the names of the parties involved and details about the complaint. If the ICRC uses an investigator, expert or lawyer to assist, these parties will be made aware of the complaint. In cases where an ICRC decision is appealed, the Health Professions Appeal and Review Board will also be aware of the complaint.

All complaints are held in confidence by the College, its staff and any person working on its behalf. The information does remain on file at the College.

For complaints filed on or after January 1, 2017, the College will make a summary of certain decisions public by posting them under Find an Occupational Therapist on the College’s website. This includes decisions where the ICRC imposes a:

  • SCERP (specified continuing education remediation program);
  • caution-in-person; or
  • undertaking (agreement by the OT to improve or restrict his or her practice),

Information on referrals to the Discipline Committee or Fitness to Practice Committee will also be published under Find an Occupational Therapist.



Currently, all decisions made by the ICRC about complaints remain confidential, and are not available to the public unless the matter is referred to the Discipline Committee or Fitness to Practice Committee for a hearing. In those cases, the fact of the referral are made public and in the case of a referral to the Discipline Committee, the list of allegations are also made public.

Any findings by the Discipline Committee are public information too. This information may be found on the College website by using Find an Occupational Therapist or reviewing the summaries of the Discipline Committee decisions under Discipline on the website.

For complaints filed on or after January 1, 2017, the College will make public summaries of certain ICRC decisions:

  • SCERP (specified continuing education remediation program);
  • caution-in-person; or
  • undertaking (agreement by the OT to improve or restrict his or her practice),