Key takeaways.
- Rule out red flags first. ER or 911 if any are present. Everything else can be sorted from home.
- Report the crash to ICBC within 24 hours if you can. You get a claim number — that number unlocks pre-approved physiotherapy.
- See a physiotherapist in the first 7 days. No GP referral required in BC for physio under Enhanced Care.
- Move within comfort. Full bedrest beyond a day or two slows recovery for most soft-tissue and whiplash injuries.
Hour 0 to 24 — rule out anything that needs the ER.
Most crashes in Metro Vancouver do not produce a serious injury. A small proportion do, and the difference is what matters in the first 24 hours. The red flags to watch for are listed by HealthLinkBC and broadly mirrored in international concussion guidance.
Call 911 or go to the nearest ER — Lions Gate Hospital on the North Shore is closest for most of our patients — if you have any of these in the hours after the crash: loss of consciousness, repeated vomiting, worsening headache, slurred speech, confusion or memory gaps that get worse rather than better, weakness or numbness in an arm or leg, neck pain with neurological symptoms, or any new bowel or bladder problem.
In the absence of red flags, the right move is to rest, monitor for new symptoms, and start the paperwork.
Day 1 — report the crash and get a claim number.
Report the crash to ICBC as soon as you reasonably can. You can do this online at icbc.com/claims/report-and-track-a-claim or by phone at 1-800-910-4222 (toll-free in BC). The report itself takes about 10 to 15 minutes. ICBC issues a claim number immediately, in most cases.
The claim number is the single most useful piece of information you will need for the next 12 weeks. It is what lets a clinic confirm your coverage, bill ICBC directly, and book you without you paying anything upfront.
If you cannot get the claim number on day one — for instance the online form is backed up, or the crash happened late at night — book physio anyway. We can usually start the first session before the claim number is finalised, then catch up the paperwork.
Day 1 to 3 — the symptoms that show up late.
Most whiplash and soft-tissue injuries feel worse on day 2 or 3 than they did at the roadside. This is normal. The Quebec Task Force on Whiplash-Associated Disorders describes the typical pattern — neck stiffness, headache, jaw tightness, and upper back pain that develops gradually as the initial adrenaline wears off and the inflammatory response peaks.
Write down what you feel and when. Time-of-onset matters for the clinical picture and for ICBC. A short note in your phone — "day 2, woke up with neck stiff turning left, headache behind the right eye" — is enough.
Avoid the two common mistakes. First: a 3-day weekend on the couch will usually leave you stiffer, not better. Move gently within whatever range is comfortable. Second: do not bypass the early assessment because you "feel fine." The pattern of symptoms unfolds over a week.
Day 3 to 7 — book the first physiotherapy visit.
The first appointment should happen within 7 days of the crash for most uncomplicated cases. The 2016 OPTIMa Collaboration clinical practice guideline on whiplash recommends early reassurance, early education, and early active rehabilitation — not prolonged rest or open-ended passive care.
The job of the first visit is straightforward. Confirm the diagnosis. Rule out anything that needs a different referral pathway. Get started on the early loading that the literature consistently shows produces better 6-week and 12-week outcomes than waiting.
Red flags — when the ER is the right call.
These signs change the plan. If any apply, do not go to a physiotherapy clinic first.
- Loss of consciousness at the scene or after.
- Worsening or severe headache that is not eased by rest and fluids.
- Repeated vomiting after the crash.
- New confusion, slurred speech, or memory loss that worsens.
- Weakness, numbness, or tingling in an arm or leg.
- Neck pain with any neurological symptom.
- Loss of bowel or bladder control after a spine injury.
- Severe focal pain that you cannot bear weight through.
What to bring to your first appointment.
- ICBC claim number, if you have it.
- The date and a brief description of the crash.
- Your symptom timeline so far — what hurt, when it started, what has changed.
- Any imaging or ER paperwork from the past 7 days.
- Photo ID and your BC Services Card. ICBC pre-approval does not require MSP, but we cross-check the claim with ICBC before the first session.
- Clothing you can move and be assessed in.
Common questions.
Should I go to the ER or wait and see how I feel?+
Go to the ER (or call 911) if you have any of these: loss of consciousness, worsening or severe headache, repeated vomiting, confusion, slurred speech, weakness or numbness in an arm or leg, neck pain with neurological symptoms, or any new bowel or bladder problem. Otherwise it is reasonable to monitor for 24 hours and see your GP or a physiotherapist in the first few days.
Do I need a referral from my GP to start physiotherapy under ICBC?+
No. Under Enhanced Care, physiotherapy is pre-approved for the first 12 weeks after a reported crash. A GP referral is not required to start.
How quickly should I see a physiotherapist?+
Earlier is generally better. Most clinics can fit a new ICBC patient in within the first week. The first visit clarifies the diagnosis, rules out red flags, and starts the right early loading rather than waiting for stiffness to set in.
Will pain that starts 3 days later still count as crash-related?+
Yes. Whiplash and soft-tissue injuries commonly feel worse 24 to 72 hours after the collision. Tell your physiotherapist and ICBC adjuster when the symptoms began. Delayed onset is documented and well recognised.
Related reading
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Send it over — we'll confirm coverage with ICBC and book you in this week.
This page is for general information only and does not constitute medical or legal advice. ICBC coverage details, treatment allotments, and claim rules change — confirm the current terms with ICBC or a legal adviser before relying on them. Treatment suitability is determined case-by-case during clinical assessment. Physiotherapy at Medstar Sport Physio & Health is provided by physiotherapists registered with the College of Physical Therapists of British Columbia (CPTBC).