Decision-Making Checklist for Orthoses
Authority and Responsibility
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EAW
HAB
Off-the-shelf orthoses under $100
Off-the shelf orthoses over $100
All custom-made orthoses
All repairs
Eligibility Criteria
Who is eligible?
Clients who are eligible for general health supplements [see Health Supplement Summary table].
Requested item must meet the following:
 General Requirements for All Orthoses;
and
 Specific Requirements for each individual type of Orthoses.
Complete this checklist and attach to the service request:
GENERAL REQUIREMENTS (must meet all):
Y
N
REQUIREMENTS
No other resources available to pay the cost of or obtain the item?
Ministry is the payer of last resort? All other available resources must first be considered:
 Other government programs (e.g. PharmaCare, Health Authorities, ICBC,
WorkSafeBC, Veterans Affairs Canada)
 Private insurance
The item is the least expensive, appropriate orthosis?
Only one orthosis per part of the body may be considered.
Item prescribed by medical practitioner or nurse practitioner?
Item pre-approved by ministry prior to purchase?
Item is medically essential to achieve or maintain basic functionality?
Item is required for one of the purposes:
 To prevent surgery
 For post-surgical care
 To assist in physical healing from surgery, injury or disease
 To improve physical functioning that has been impaired by a neuro-musculo-skeletal
condition
If the item is a replacement, then item meets replacement period [see OLR policy on
Medical Equipment – Orthoses]
SPECIFIC REQUIREMENTS:
Y
N
TYPE
Off-the-Shelf Orthopaedic
Footwear
Off-the-Shelf Footwear
Knee Brace
Upper Extremity Brace
Cranial Helmet
Torso or Spine Brace
REQUIREMENTS
 The cost of one pair must not exceed $250; and
 “off-the-shelf orthopaedic footwear” means footwear
intentionally designed to accommodate a medical
condition; and
 Meets replacement period of 1 year
 The cost of one pair must not exceed $125; and
 Must be required to accommodate a custom-made
orthosis; and
 “off-the-shelf footwear” means conventional, nonorthopaedic footwear; and
 Meets replacement period of 1 year
 The medical practitioner or nurse practitioner who
prescribed the knee brace must recommend that the
knee brace must be worn at least 6 hours per day.
 The upper extremity brace must be intended to provide
hand, finger, wrist, elbow or shoulder support.
 Must be a helmet prescribed by a medical practitioner
or nurse practitioner and recommended for daily use in
cases of self-abusive behaviour, seizure disorder, or to
protect or facilitate healing of chronic wounds or cranial
defects.
 Must be intended to provide pelvic, lumbar, lumbarsacral, thoracic-lumbar-sacral, cervical-thoracic-lumbarsacral, or cervical spine support
REQUIRED DOCUMENTS (must include both written prescription and quote):

DOCUMENTS
Written prescription with diagnosis from a medical practitioner or nurse practitioner.
Quote from supplier.
Supplier may include: a pharmacy, hospital, orthopaedic appliance supplier, or orthotics
supplier.
Note:
1. The following items are non-eligible items:
a. A prosthetic and related supplies
b. A plaster or fibreglass cast
c. A hernia support
d. An abdominal support
e. A walking boot for a fracture