What You Need to Know About Catastrophic Impairment

#AskZevBergman

A motorcycle crash that was so bad that the 34-year-old husband and father was declared dead by police illustrates the effects a change in how Ontario law defines catastrophic impairment can have on the lives of victims and their families. As it turned out, the motorcyclist survived the crash and the premature declaration by police of his demise, but his medical condition and a new law combined to leave him on the verge of financial ruin.

After being in a coma for a month and in need of long-term rehabilitation for traumatic brain injury, multiple fractures to his limbs and hands and internal injuries, he learned his injuries did qualify as “catastrophic” under new rules in Ontario. One of the significant changes in the regulations pertaining to catastrophic impairment is a move away from the Glasgow Coma Scale to determine a trauma victim’s ability to function.

Why is a catastrophic impairment classification important?

Prior to June 1, 2016, individuals suffering a catastrophic impairment in an auto accident could receive up to $2 million in benefits. Maximum medical and rehabilitation benefits for catastrophic impairment is now $1 million, but motorists can increase their coverage for $2 million by agreeing to pay an additional premium.

For individuals who do not meet the new definition of catastrophic impairment, benefits are significantly lower as the motorcycle accident victim found out. Instead of $2 million for his medical costs and rehabilitation, he only received $86,000.

Changes in the standard accident benefits schedule in Ontario include new definitions for the following associated with catastrophic impairment:

• Amputations
• Loss of vision
• Traumatic brain injury
• Mental impairment
• Behavioural impairment

The reliance in the past on the Glasgow Coma Scale has been replaced with new criteria placing an emphasis on evaluations and assessments performed over a period of time.

Application for catastrophic impairment

An application must be submitted to have a declaration of catastrophic impairment made. The application must be supported by medical records. Catastrophic impairment requires proof of at least one of the following conditions:

• Paraplegia
• Tetraplegia
• Severely impaired ambulatory mobility of use of an arm
• Amputation
• Loss of vision in both eyes
• Traumatic brain injury
• Physical impairment resulting in 55 percent of whole person
• Mental or behavioural impairment of 55 percent of whole person
• Impairment of three or more function areas

 The complexity of these and other aspects of the changes to the standard accident benefit schedule could make it difficult for an accident victim and his or her family to understand exactly what they will be receiving. One significant provision of the law as it pertains to catastrophic impairment is a reduction of benefits payable to individuals classified as non-earners. These would be students, stay at home moms and dads, or individuals who are retired.

Non-earner benefits, which were payable for life, are now capped at two years with weekly payments of $185 for seriously injured individuals. No benefits are paid for the first four weeks.

What to do if you or a loved one is seriously injured in a car accident?

Accident victims or their relatives should consult a personal injury lawyer if there is a possible catastrophic impairment. The lawyer can advise and guide them through the application process.

Compassionate personal injury lawyers

The personal injury lawyers at Diamond and Diamond are ready to help when you or a member of your family suffers a catastrophic impairment. They have years of experiencehandling all types of accident claims. Don’t delay, contact our 24/7 injury hotline at 1-800-567-HURT or visit our website to speak to someone now about your claim. Consultations are free, and we have offices located throughout Ontario.