Catastrophic Impairments

The term “Catastrophic Impairment” is relatively new to Ontario law. It was first used in 1996 in the context of determining what accident benefits were available to a party injured in circumstances involving the use of a motor vehicle. This includes pedestrians, drivers and passengers alike.

The phrase catastrophic impairment refers to the most seriously injured of accident victims. It is includes the obvious: paraplegia, quadriplegia, limb amputation, loss of vision and significant brain impairment. It also includes impairments that result in a “55% impairment of the whole person” (taken from the American Medical Association’s Guides to the Evaluation of Permanent Impairment) and marked/extreme impairment due to mental or behavioural disorders.

In June 2012, the Ministry of Finance released its Superintendent’s Report on the Definition of Catastrophic Impairment (in the Statutory Accident Benefits Schedule) which recommended considerable restrictions to the benefits formerly available to catastrophically injured persons. The Ontario provincial government is presently contemplating significant further restrictions to benefits for catastrophically impaired victims. Auto insurance companies have a very strong and influential lobby group working with the government.

In some of the more obvious serious cases, many Ontario insurance companies will agree with the victim that his/her injuries constitute a catastrophic impairment. However, many catastrophically injured auto victims must face a long process of multi-disciplined medical assessments for both the insurer and the lawyer representing him or her. In this scenario, the victim must go without much needed benefits until such time as the insurer’s doctors report that the injuries are catastrophic. If no such report is forthcoming, the victim’s recourse is to use the dispute resolution process of the Financial Services Commission of Ontario, a process that, to date, has been cumbersome and long.

Since 1996, the benefits available to those who are catastrophically injured include a maximum of one million dollars for health care and one million dollars for attendant care. Ontario auto insurers have, as they continually do, lobbied the provincial government in the hope that the total for these two separate benefits is limited to one million dollars. As of yet, the government has not made its’ decision on this issue.

The catastrophic injury lawyers at Walker, Head have well over 40 years of experience in the fight with insurance companies for innocent injured victims, regardless of the cause of the injury. We can assist you in expediting the application for a determination of catastrophic injury status and in access to the treatment providers, medical and otherwise, that are important for your recovery and well-being. If you or a loved one have suffered from a catastrophic impairment – contact Walker Head Lawyers today and one of our lawyers will be able to speak with you to assess whether or not you may be eligible for compensation. Call 1-877-839-4484 today!