Occupational Therapist Complaints, Investigations and Discipline in Ontario

When COTO Contacts You

This page is for occupational therapists practising in Ontario, in hospitals, community and home care, schools, mental health, or private practice providing assessments for insurers and lawyers. COTO hears from clients and families, employers, other OTs and health professionals, insurance companies and police. Complaint investigations usually come from clients; Registrar’s investigations most often come from employer or other mandatory reports.

Who Investigates and Who Decides

Regulator

The College of Occupational Therapists of Ontario, established, under the Occupational Therapy Act, 1991. Its complaint, investigation and discipline procedures come from the Health Professions Procedural Code, Schedule 2 to the Regulated Health Professions Act, 1991 (“the Code”), which applies to every regulated health profession in Ontario. The title “occupational therapist” is restricted to members (s. 7).

Who investigates

COTO’s Professional Conduct team. In a Registrar’s investigation you must co-operate fully (Code, s. 76(3.1)).

Who decides at the investigation stage

A panel of the Inquiries, Complaints and Reports Committee (ICRC) (Code, s. 26). COTO publishes regular summaries of ICRC outcomes, which show that most matters end in remediation, undertakings or advice rather than discipline.

Who holds hearings

The Ontario Occupational Therapists Discipline Tribunal (OOTDT), COTO’s Discipline Committee, using the Health Professions Discipline Tribunal’s Rules of Procedure. Panels of at least three OTs and public members decide, sometimes with an experienced adjudicator.

Psychotherapy by OTs

OTs may perform the controlled act of psychotherapy only in accordance with the regulations; failing to do so is professional misconduct under the Act itself (Occupational Therapy Act, 1991, s. 3.1).

Key timelines in the Code

• The Registrar must notify you within 14 days of receiving a complaint or report (Code, s. 25(6)).
• You may make written submissions to the Inquiries, Complaints and Reports Committee within 30 days of receiving that notice. The committee can shorten that time if it believes, on reasonable and probable grounds, that your conduct exposes or is likely to expose clients to harm or injury (Code, s. 25.2).
• Complaints are expected to be disposed of within 150 days. If that is missed, the Registrar must give the complainant a new expected date no more than 60 days later (Code, s. 28).
• With both your and the complainant’s consent, the Registrar can refer a complaint to alternative dispute resolution, but not if it involves an allegation of sexual abuse or has already been referred to discipline (Code, s. 25.1).

Common Issues in Occupational Therapist Investigations

What Can Happen Next

1. Complaint or Registrar’s investigation

   After considering the investigation and your submissions, a panel of the Inquiries, Complaints and Reports Committee (ICRC) may take no further action; give advice or recommendations; require a specified continuing education or remediation program (SCERP); require you to appear to be cautioned; refer specified allegations of professional misconduct or incompetence to the Ontario Occupational Therapists Discipline Tribunal; or refer you for incapacity proceedings (Code, s. 26). Matters are also sometimes resolved through an undertaking, such as an agreement to restrict or monitor your practice. If the panel considers a complaint frivolous, vexatious, made in bad faith, moot or an abuse of process, it must give notice and allow 30 days for written submissions before declining to act (s. 26(4)–(5)).

2. Interim order

   If the committee believes your conduct exposes or is likely to expose clients to harm or injury, it can suspend your certificate or impose terms, conditions or limitations while the matter continues (Code, s. 25.4(1)). You must normally receive notice and at least 14 days to make written submissions first, unless the risk is urgent (s. 25.4(6)–(7)). The order lasts until it is varied or the matter is finally resolved (s. 25.4(4)).

3. Discipline hearing

   A panel of the Ontario Occupational Therapists Discipline Tribunal hears evidence and decides whether professional misconduct or incompetence is proven (Code, ss. 51, 52). If misconduct is found, it may revoke or suspend your certificate, impose terms, conditions and limitations, order a reprimand, or order a fine of up to $35,000 (s. 51(2)). Findings of sexual abuse carry mandatory orders, including revocation for the conduct listed in s. 51(5).

4. Review or appeal

   HPARB review: you or the complainant may ask the Health Professions Appeal and Review Board to review an ICRC decision on a complaint, except a referral to discipline or for incapacity proceedings (Code, s. 29(2)). The request must be made within 30 days after receiving the notice of the right to request a review that comes with the decision (s. 29(3)), and HPARB cannot extend that time by more than 60 days (s. 29(4)).

   Divisional Court: discipline and fitness to practise decisions can be appealed on questions of law, fact or both (Code, s. 70). Orders based on incompetence, incapacity or certain sexual abuse findings, and orders in matters where an interim order was in place, take effect immediately despite an appeal (ss. 25.4(5), 71, 71.1).

Checklist: Responding to a COTO Complaint or Report

Frequently Asked Questions