Be informed when buying your custom-made orthotics

November 3, 2018

To ensure you get a suitable custom-made orthotic, it’s important to ask questions and keep yourself informed throughout the purchasing process.

Under the OSSTF Benefits Plan, your coverage for casted, customer-made orthotics is: up to a maximum of $750 per plan year (an approved diagnosis from either a physician or a podiatrist/chiropodist is required.) The plan year is September to August.

Who’s authorized to prescribe and complete an assessment?

Custom-made orthotics are prescribed by specific health-care professionals, which include physicians, podiatrists and chiropodists. They will diagnose whether or not an orthotic would be beneficial to your situation. The prescribers and providers are licensed and governed by either a provincial or national body, and are subject to standards of practice. This, along with each body’s Code of Ethics, helps ensure their accountability and your protection.

For all Canadian provinces, except Quebec*, podiatrists, chiropodists, pedorthists are recognized as foot care specialists.

After being prescribed an orthotic, you’ll need to visit one of the providers listed above for an assessment. A provider will guide you through an extensive evaluation to ensure an orthotic is the best option and that it’s properly designed. You should expect the orthotic provider to perform the following:

Medical history review: A complete investigation and documentation of your medical history, symptoms and previous injuries. The provider will also take into consideration your lifestyle (occupation and activities) as well as your current and past footwear (fit, style, wear and pattern).

Examination: A hands-on evaluation of the lower limbs including foot structure, alignment, strength, range of motion, soft-tissue damage as well as identifying any abnormalities.

Gait analysis: The provider will observe you walking to identify accommodations or abnormalities (e.g. whether you favour one leg or the other).

Orthotic evaluation: The provider will determine treatment options and explain how the treatments will address your specific needs.

Casting: A proper cast is essential to create a truly custom-made orthotic as it ensures that your orthotic is made with all of the contours and structure of your foot. Casting techniques include: foam box casting, plaster of paris slipper casting, contact digitizing and laser scanning.

Manufacturing: For an orthotic to be claimed under your benefits plan, it must be constructed from scratch and fabricated directly from your mould. You can expect at least one week between your initial assessment and your fitting appointments. Orthotics that are not manufactured specifically to your needs can result in pain by overstressing your muscles, bones and joints.

Dispensing: Custom-made orthotics should be fitted specifically for you and your footwear. The provider should evaluate how you walk while wearing the orthotics. You should also be offered a follow-up appointment within 2-6 weeks of receiving your orthotics.

Education: The provider should educate you on things like breaking in your new orthotics, lifespan, and how they should fit. You should also be made aware of any warning signs that the orthotics are not working properly and instructed to return if you experience any problems.

Here are some things to be cautious of when buying an orthotic:

• For all Canadian provinces except Quebec*, prescribers and providers should have the following designations in their titles:
  • Physician – M.D.
  • Podiatrist – D.P.M.
  • Chiropodist – D. Ch. or D. Pod. M.
  • Pedorthist – C. Ped. (C). or C. Ped. (M.C.)
  • Orthotist – C.O. (C) or C.P.O. (C)
• Under the OSSTF Benefits Plan, casted, custom-made orthotics must be recommended by a physician or podiatrist/chiropodist.
• Question a provider who strongly recommends you see a doctor of his or her choosing for a referral instead of your family physician.
• Question a provider who recommends your whole family could benefit from orthotics without having seen or assessed them individually.
• Be suspicious of any provider that can’t answer your questions clearly or gives vague and ambiguous answers.
• Having your footprint taken on an inkpad or using your shoe size to provide a prefabricated insole is not considered casting and does not qualify as custom-made.
• Some providers will supply what’s called a “best fit” foot bed. These are prefabricated inserts that are matched to your cast; however, the cast is never used in the actual manufacturing of the orthotic. These are not considered custom-made and would not qualify under your benefit plan.
• A provider should have the capacity to modify your orthotic.
• Exercise caution when considering the purchase of orthotics from exhibits at trade shows, home shows or sportsman shows. If there’s a problem with the orthotic, returning it could be a problem, not to mention they probably aren’t custom-made. Exercise caution when considering the purchase from kiosks or booths in malls, department stores or over the internet for the same reasons.
• Be wary of people who come to your home, or conduct group screenings of employees or family members without a proper evaluation.
• “Two for the price of one” deals or “free giveaways” with your purchase are not allowed under the code of ethics that regulated providers and dispensers are bound by. Some providers will use these “freebies” to inflate the price of an orthotic.
• Custom-made orthotics for children under five are highly uncommon. Skeletal or soft tissue injuries that require orthotic treatment don’t usually present themselves until a person is older. If for some reason they do need an orthotic, a medical doctor or pediatric specialist must prescribe it.
• If you feel pressured to purchase additional products or are uncomfortable with the business practices of the provider, consider another provider.
• Don’t ever give the provider a signed claim form.

Please note that some of the examples listed above may not pertain to your benefits plan. Consult your benefits booklet for details.

*For the province of Quebec a foot orthotist or an orthotist prosthetist working in a laboratory accredited by the Québec Ministry of Health and Social Services and who is a member of the Order of Professional Technologists of Quebec and a podiatrist are the eligible providers of orthotics.

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The information in this document is provided by OSSTF Benefits for general information only. OSSTF Benefits endeavours to have all information current and accurate. We make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, or suitability of the information included. All information is subject to change without notice.

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