Someone is coming to your house to watch you live in it. Of all the appointments in a claim this is the one people dread most, because at home there is nowhere to put your face on.
An occupational therapy in-home assessment is a visit by an occupational therapist, arranged by an insurer or a board, to measure what you can and cannot manage in the place you actually live. It is not an inspection of your housekeeping. It measures your need for help, most often attendant care and housekeeping support.
The therapist is there to record function, not to judge how you keep house.
What is an occupational therapy in-home assessment?
An occupational therapy in-home assessment is an evaluation of how your injury affects daily living, carried out in your home rather than in a clinic.
You will see it called an in-home assessment, a home visit or a functional home evaluation. In an Ontario car accident claim the attendant care part is recorded on a document called the Assessment of Attendant Care Needs, commonly known as the Form 1.
It is arranged by whoever is funding your claim, which means an auto insurer, a workers' compensation board or sometimes a lawyer. The therapist writes a report for them. As with every assessment of this kind, the visitor is usually not the person treating you.
What does an occupational therapy in-home assessment measure?
Two things. How much personal help you need and how much of running a household you can no longer do.
Personal help covers dressing, bathing, toileting, grooming, transferring in and out of bed or a chair and supervision if you are at risk of falling or of harming yourself. Household capacity covers cooking, laundry, cleaning, shopping, stairs, lifting and yard or snow work.
Alongside that the therapist assesses the home itself. Doorway widths, stairs, grab bars, bathroom layout, tripping hazards and whether equipment or modifications would help. They will usually ask to see the bathroom and the bedroom, because those are where most of the difficulty lives.
Should you tidy up before an in-home assessment?
No, and this is the single most important thing on this page. Nearly everyone cleans frantically for two days beforehand. It is an understandable instinct that works directly against you.
The reason is simple. A tidied house is evidence that somebody in that house can tidy a house. The therapist is measuring what you cannot manage. If the laundry is folded, the beds are made, the sink is empty and the floors are clean, then the visible answer to what you cannot manage is nothing.
Leave it as it actually is. That includes the things that have gone undone since you were hurt. The pile on the stairs you have not carried up. The bathroom you cannot bend down to clean. The bin nobody has taken out.
This is not dishonesty and nobody is asking you to stage anything. Staging is what tidying is. The undone things are the truthful record of an injury, and they are the only part of that record the therapist can see for themselves.
If someone has been helping you, say who and how often. Help that is already happening is easy to miss, because a house kept going by a daughter three evenings a week looks the same from the doorway as a house nobody needs help with.
What happens during an occupational therapy in-home assessment?
The visit usually runs in three parts.
An interview. The therapist asks about the injury, your symptoms, a typical day and what has changed since. Expect questions about sleep, pain through the day, medication and mood.
A walk through the home. Room by room, with questions about what you do in each one and what you have stopped doing.
Watching you do things. You may be asked to climb the stairs, get up from a chair, reach into a cupboard, carry something or show how you get in and out of the bath. Do what you can safely and stop when it hurts.
How long does an in-home assessment take?
Usually 60 to 120 minutes. A complex assessment, or one covering attendant care in detail, can run two to three hours.
The report goes to whoever arranged the visit, often within two to four weeks.
What are you allowed to say and refuse at an in-home assessment?
It is your home, and that matters more here than at any other appointment.
You can have someone with you. A partner, an adult child or a friend is normal and often useful, because they see things you have stopped noticing. You can ask for a break and you can end the visit if you are unwell. You can decline to attempt a task you believe will hurt you, though it helps to say why rather than refusing flatly. You can decline access to a room, and you should expect that to be recorded, so give a reason if you have one.
You can also correct the record while it is being made. If the therapist says you manage the stairs and you manage them once a day at a cost you pay for afterwards, say exactly that in the room.
The habit that does the most damage here is the same one that damages every other appointment: answering about the moment rather than the week. Describe a bad day as well as this one and say plainly whether today is better or worse than usual.
Are housekeeping and attendant care benefits still standard in Ontario?
Not both of them, and this catches people out.
For policies entered into on or after 1 July 2026, only standard medical, rehabilitation and attendant care benefits remain mandatory in Ontario. Housekeeping and caregiver benefits became optional, along with income replacement, non-earner, death and funeral benefits.
The practical consequence is uncomfortable. You can be assessed at length for a housekeeping need that the policy responding to your claim does not cover. Attendant care is still standard. Housekeeping may not be.
Ask your insurer in writing which optional benefits sit on the policy responding to your claim and keep the answer. The full picture is on the Ontario accident benefit deadlines page, and recovering after a car accident in Ontario explains how the benefits fit together.
If your assessment was arranged by a workers' compensation board rather than an auto insurer, this change does not apply to you. Board coverage for personal care and independent living is set by the board, not by an insurance policy.
What should you record after an in-home assessment?
Write it down the same day, while you can still picture the visit.
- The date, the arrival time and the time the therapist left
- The therapist's name, profession and who arranged the visit
- Which rooms were seen and which were not
- Every task you were asked to perform and how each one went
- Anything you could not do and anything you did but paid for afterwards
- Who was present and what help they described giving you
- Anything you feel was misunderstood or written down wrongly
Then ask for a copy of the report. Reading it is the only way to know what was written about you.
The Pain and Symptom Tracker, Free Starter Edition gives you a place to record the good days and the bad ones, which an assessment based on a single afternoon cannot capture. The National MVA Recovery Guide holds the wider record of appointments, calls and costs a claim is eventually judged on.
Read next
- What happens at a functional abilities evaluation
- What happens at an independent medical examination
- Common mistakes injured workers make during a WSIB claim
Last verified August 2026. This article is general information for people in Canada and is not medical, legal or insurance advice.