If you’ve suffered severe injuries in a car accident in Ontario, you may be eligible for enhanced accident benefits under the “catastrophic impairment” designation. Navigating this system can be complex, but this guide will shed light on the key aspects.
What is Catastrophic Impairment?
In Ontario, a catastrophic impairment refers to a severe and lasting injury that significantly impacts your life and ability to function. The Statutory Accident Benefits Schedule (SABS) outlines specific criteria for determining if an injury qualifies as catastrophic. These criteria include:
- Paraplegia or quadriplegia
- Amputation of an arm or leg
- Loss of vision in both eyes
- Traumatic brain injury resulting in specific impairments
- Other injuries causing a 55% or greater whole person impairment (WPI)
Why Does Catastrophic Impairment Matter?
If your injuries are deemed catastrophic, you become eligible for enhanced accident benefits, including:
- Medical and Rehabilitation Benefits: Up to $1 million in lifetime coverage for medical expenses, rehabilitation therapies, attendant care, and other necessary treatments.
- Attendant Care Benefits: Coverage for the cost of a personal support worker or caregiver if you require assistance with daily living activities.
- Income Replacement Benefits: Up to $400 per week if you’re unable to work due to your injuries.
- Other Benefits: You may also be eligible for additional benefits such as housekeeping and home maintenance, caregiver benefits, non-earner benefits and transportation expenses.
How is Catastrophic Impairment Determined?
The process for determining catastrophic impairment involves a comprehensive medical assessment by healthcare professionals. Your insurance company may also request additional assessments or evaluations. If you disagree with their determination, you can appeal the decision through the License Appeal Tribunal (LAT).
Applying for Catastrophic Impairment Benefits
If you believe your injuries meet the criteria for catastrophic impairment, inform your insurance company as soon as possible. You will need to provide detailed medical documentation and other supporting evidence to substantiate your claim. It’s strongly recommended to seek guidance from a personal injury lawyer experienced in accident benefits to ensure your rights are protected throughout this process.
Key Considerations
- Time Limits: Strict deadlines apply for submitting your application and supporting documentation.
- Medical Evidence: Your claim’s success relies heavily on comprehensive medical evidence demonstrating the severity and long-term impact of your injuries.
- Legal Assistance: Navigating the catastrophic impairment process can be overwhelming. A personal injury lawyer can advocate for your best interests, gather evidence, and handle communications with your insurance company.
Seeking Support
A catastrophic impairment can drastically alter your life, but you’re not alone. Ontario offers various support resources and organizations dedicated to helping individuals and families cope with the physical, emotional, and financial challenges. Connect with support groups, rehabilitation centers, and advocacy organizations for assistance and information.