FAQ for Occupational Therapists

Occupational therapists play a critical role in treating injuries, providing care for people with disabilities, and aiding patients in their path to recovery. As health care practitioners, occupational therapists must meet licensing requirements.

State laws and regulations dictate the standards for becoming a licensed occupational therapist. In general, occupational therapists must hold a master's degree, NBCOT certification, and a state license through an accredited program.

While it can take years to gain the certification necessary to become an occupational therapist, you can lose your certification at a moment's notice. Many occupational therapists have their certifications suspended or revoked for committing prohibited offenses.

If you face disciplinary action from a certification board, you likely have many questions. Attorney Joseph D. Lento has spent years defending occupational therapists and protecting their certifications. Below, the Lento Law Firm answers some common questions to guide you through this difficult process.

What offenses can lead me to lose my certification?

Local licensing agencies and the National Board for Certification in Occupational Therapy (NBCOT) restrict occupational therapists from certain behaviors. The NBCOT Code of Conduct outlines the standards that occupational therapists must meet to retain their certification.

Although local licensing rules vary by state, many have the same basic rules as the NBCOT. Examples of specific offenses that can lead to a loss of certification include:

  • Fraud. Failing to provide accurate and truthful information on exams, certification renewal applications, renewal audit forms, or character reviews.
  • Criminal convictions. Being convicted of a serious crime may lead an agency to revoke your certification.
  • Failure to disclose criminal convictions. The NBCOT requires you to disclose criminal, legal, and other disciplinary matters within 60 days.
  • Failure to cooperate. You must comply with disciplinary reviews and investigations by responding to requests for relevant information.
  • Dishonesty. Inaccurate or untruthful communication with clients, employers, or regulatory agencies may constitute a violation of your certification.
  • Harmful behavior. The NBCOT prohibits conduct that poses a potential health or safety threat to patients.
  • Drug/alcohol use. You cannot engage in occupational therapy while under the influence of an intoxicant, including alcohol and legal or illegal drugs.
  • Disclosing patient records. Any violation of HIPAA rules can also lead to certification issues. For example, revealing personal health information that reveals your client's identity.

What other penalties are possible?

A violation of NBCOT or local licensing rules does not always lead to a loss of certification. In many cases, the certification board will choose to invoke different sanctions. The punishments vary depending on the circumstances and the severity of the violation. Examples include, but are not limited to:

  • Ineligibility. The board may choose to bar you from certification for a duration of time.
  • Reprimand. A private expression of disapproval that goes on your file.
  • Censure. A formal reprimand that the board publicly announces.
  • Probation. You receive restrictions and must also meet specific conditions to keep your license active. Examples of conditions include fulfilling education, supervision, or counseling requirements.
  • Suspension. Losing your certification for a duration of time. You must apply for reinstatement to become certified again.

While these sanctions are less severe than a loss of certification, they can damage your career. Not only can they prevent you from doing your job in the short-term, but they can threaten your long-term reputation. Many of these sanctions are public and can prevent patients or employers from using you.

I am under investigation. What should I expect?

While every agency has different procedures for disciplinary action, they often follow a similar framework. Many local agencies use a similar process to the NBCOT investigation process. Your attorney can provide you with information on the investigation rules in your area.

If you face an investigation from NBCOT, it will follow this path:

  • Complaint. The NBCOT receives information that you violated its Code of Conduct. Staff will review evidence to determine whether to dismiss the case or propose a sanction.
  • Notification. If the NBCOT believes there is evidence supporting the allegation, they must notify you in a sanction agreement letter. The letter includes a description of the violation and sanctions. You have 30 days from the date of receipt to respond.
  • Response. Once you receive your sanction agreement letter, you can either accept or deny the proposed sanctions. Accepting the sanctions will waive your right to a hearing. If you deny the sanctions, you can request a hearing. You must submit the request for a hearing in writing and cite reasons supporting your position. Failing to respond within 30 days of receipt of the letter means the proposed sanctions take effect.

What happens at a board hearing?

A board hearing provides you an opportunity to refute accusations. During the hearing, a board panel will review arguments from both sides and decide on a final determination. You can submit materials and evidence to the board that you believe strengthens your position.

Board hearings ultimately decide your fate. If you wish to challenge an accusation, you should enlist the services of an attorney. Certification boards allow occupational therapists to use legal counsel during hearings. An attorney can help you build a defense and present a path to success. They can also help you file an appeal after the board renders their decision.

In many cases, hearings have strict deadlines. The NBCOT requires you to provide evidence no less than 30 days before the hearing date. They also require you to file an appeal within 30 days of the board's decision. An attorney can move quickly to ensure you meet all deadlines and rules related to your case.

Should I voluntarily surrender my certification?

The certification board may offer you the chance to voluntarily surrender your certification. The board will generally offer this option if they believe there is enough evidence to deem you responsible for the violation. If you accept the surrender, you admit that you are guilty of the offense.

The benefit of voluntarily surrendering your certification is that you can seek reinstatement. You can regain your certification after fulfilling designated requirements. The downside is that the decision is final. If you voluntarily surrender, you lose your ability to appeal decisions.

Depending on the facts of your case, this may not be the best option. Speak with your attorney before making any final decisions. They can advise you on whether voluntarily surrendering is in your best interest.

Should I hire an attorney?

You should always hire an attorney when facing disciplinary action from a certification board. Losing your certification can have a devastating impact on your career. If the NBCOT revokes your certification, you can no longer identify yourself as an OTR or COTA. Not only can this put your career on hold, but there's also no guarantee that the board will reinstate your certification.

You have the right to communicate directly with the board during investigations. In most cases, this is not in your best interest. Many occupational therapists wrongly believe that the board exists to protect them. In reality, certification boards look out for the interests of patients. The NBCOT states that it adopted its Code of Conduct to “protect the public from those practitioners whose behavior falls short of these standards.”

Since certification boards serve patients first and foremost, the burden of proof is often on the occupational therapists to discredit allegations. Any communication you have with investigators could harm your case's outcome. An attorney can help you avoid pitfalls and protect you from incriminating yourself during investigations.

Your occupational therapist certification is a legally binding agreement between the board and the state. When the board takes disciplinary action that impacts your certification, it is a legal matter. You wouldn't represent yourself in a courtroom during a criminal trial. You should treat a board complaint or investigation the same way you would treat a legal proceeding.

An experienced attorney understands the intricacies of disciplinary proceedings. They can navigate the system to work to your advantage. By using an attorney, you will improve your chances of a successful outcome.

Do I need an attorney when my certification isn't at risk?

Just because your certification isn't at stake does not mean you are off the hook. Even minor sanctions can derail your career. For one, many sanctions require that you fulfill requirements for your certification to be in good standing. If the board puts you on probation, you may have to take courses or counseling. These requirements take time and effort that otherwise could be spent advancing your career.

Even worse, board sanctions can damage your reputation as an occupational therapist. Sanctions are public record, which means that any patient or potential employer can see them. The NBCOT keeps a running list of disciplinary actions taken against occupational therapists on its website.

It can take years to rehabilitate your image. You may never regain the trust of employers, patients, and colleagues. Your best option is to hire an experienced attorney any time you face disciplinary action. An attorney will work to reduce or dismiss charges and get your career back on track.

What kind of attorney do I need?

There are many different kinds of attorneys, so don't feel discouraged if you can't find quality representation right away. Many attorneys will say they can assist you in your case, but few have the specialized knowledge necessary to help you with your case.

Your best bet is to use a licensed defense attorney with experience in administrative law. A professional license defense attorney understands the intricacies of certification laws and how they impact you. They will know how to push back against certification boards and negotiate to achieve a favorable outcome. Ask your potential attorney if they have experience with occupational therapist cases. They should have a track record of successfully negotiating with the NBCOT or certification agencies in your state.

Can an attorney help me reinstate my certification?

Yes. If the board chooses to revoke your certification, they may provide terms for reinstatement. You will have to meet all of the board's requirements to regain your occupational therapist certification.

Your attorney can help facilitate the reinstatement process by doing the following:

  • Assist in completing the renewal application
  • File paperwork by designated deadlines
  • Ensure you pay necessary fees, such as fines and renewal application fees
  • Help provide the board background information, character reviews, and other renewal information
  • Represent you in communication with the board
  • Submit evidence of renewal requirements during audits
  • Negotiate terms of reinstatement with the board

What happens if I don't cooperate with an investigation?

Failing to cooperate with an investigation is an easy way to lose your certification. Since it is a violation of rules, board members treat this as a new offense. The NBCOT automatically suspends your certification for up to three years if you fail to respond to investigative inquires promptly. Whether they temporarily or permanently revoke your certification, failing to cooperate will have a long-term effect on your career.

What should I do if the board sends an investigator to speak with me?

Meeting with an investigator without your attorney could end up costing you your certification. While you may think you have nothing to hide, investigators can use any information you give them against you.

Few occupational therapists know that they have the right to legal counsel in board investigations. If an investigator reaches out, kindly request to speak with them when your attorney is present. Your attorney can protect your rights if the investigator pushes you to speak without legal assistance.

Should I tell my patients that I am under investigation?

If you face a board investigation, you should carry on with your business as usual. You can continue to operate as an occupational therapist unless the board decides to suspend or revoke your license. While sanctions are on public record, the board keeps open investigations private.

Whether you tell your patients about an investigation is up to you. In general, it's in your best interest to avoid giving out specifics about the allegations during investigations. Giving away too much information may do more damage than good. It's a good idea to check your employer's policies and procedures. Many employers require occupational therapists to divulge complaints and investigations, so make sure you follow your company's rules.

How should I deal with patients if I lose my certification?

As an occupational therapist, it's important to serve the best interests of your patients. If you fear that you may temporarily or permanently lose your certification, you should prepare. Being proactive can help your patients avoid a lapse in care. Not only is this an ethical thing to do, but it can also help you retain their services should you reinstate your certification.

It's a good idea to set up a referral system so that your patients receive quality care in your absence. Speak with a fellow occupational therapist and check if they have the capacity for more patients. You can explain the circumstances and see if they are open to taking referrals. This is a great way to create a contingency plan in case the board takes action against you.

When should I contact an attorney?

You shouldn't wait to consult an attorney. Contacting an attorney as soon as possible will give you the best chance at a favorable outcome. Certification boards often have deadlines for handling complaints and investigations. Failing to cooperate with investigations or respond to complaints can negatively impact your case.

The sooner you contact an attorney, the sooner they can begin defending you. Getting an attorney involved at an early stage will give you a greater chance at negotiating terms and reducing your charges.

What are the benefits of using an attorney?

You must protect your certification and your reputation as an occupational therapist. Disciplinary action can threaten to undo years of hard work in an instant. With such high stakes, you must do everything in your power to defend yourself.

An administrative law attorney increases your chances of success. Not only can they represent you during interactions with the board, but they can also negotiate for a reduction or dismissal of sanctions. They can prove instrumental should you pursue a disciplinary hearing. An experienced attorney will prepare evidence, witnesses, and documents to refute accusations.

As experts on licensing law, administrative attorneys can also identify any infringement of your rights that impact your case. The board may treat you as guilty until proven innocent. An attorney will ensure that you receive a fair hearing and an opportunity to clear your name.

Your future as an occupational therapist hinges on the outcome of your case. Don't wait to contact an attorney. Hiring a professional license defense attorney gives you a chance at retaining your license, protecting your reputation, and advancing your career.

Attorney Joseph D. Lento has spent many years defending licensed professionals in New Jersey, Pennsylvania, and New York. He has the knowledge and case experience to push back against allegations and defend you against the board. If you're an occupational therapist at risk of sanctions, contact the Lento Law Firm at 888-535-3686 today to schedule a consultation.

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