The Legal Definition of Catastrophic Brain Injury after an Ontario Accident

Ontario’s Insurance Act outlines the definition and scope of the Statutory Accident Benefits Schedule (SABS). The SABS is crucial when determining the amount of compensation available for a victim of a motor vehicle accident, including those who suffer traumatic brain injury.

The designation of catastrophic injury – instead of “minor” or “non minor” injury – can mean a difference in hundreds of thousands of dollars in medical benefits and extended eligibility for coverage.

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The Glasgow Coma Scale and the Classification of Brain Injuries

The SABS uses the Glasgow Coma Scale when assessing and defining a brain injury in children and adults. A score of less than 9 on the Glasgow Coma Scale is classified as a catastrophic injury.

Medical specialists use three primary categories to assess an adult patient’s score on the Glasgow Coma Scale:

eye opening response;
verbal response; and
motor response.

These categories are further broken down into specific tasks and indicators of injury, with each assigned a certain number of points.

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The breakdown is as follows:

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Eye Opening Response:

4 points – Spontaneous eye opening as well as blinking.
3 points – Patient can open eyes upon verbal command, such as when responding to speech.
2 points – Eyes open in response to pain that is not applied to the face.
1 point – No eye opening response to any type of stimulus.

Verbal Response:

5 points – Patient is fully oriented.
4 points – Patient can engage in conversation and answer questions, but the conversation is confused.
3 points – The patient’s words are discernible, but the patient gives inappropriate responses to inquiries.
2 points – The patient’s speech is incomprehensible.
1 point – The patient does not or cannot provide a verbal response.

Motor Response

6 points – The patient can engage in movement upon command.
5 points – The patient can move purposefully in response to a pain stimulus.
4 points – The patient withdraws when subjected to a pain stimulus.
3 points – The patient displays abnormal/spastic flexion and a decorticate posture in which the arms are bent in with hands on the chest and fists clenched and the legs are stiff and straight.
2 points – Patient has a rigid response to stimulus and displays a decerebrate posture in which the head is arched back, limbs are held straight out from the body and toes are pointed down.
1 point – No physical or motor response to stimuli.

A score of 9 or less indicates a severe brain injury requiring substantial medical treatment and specialized care. Children ages five years and younger are subject to a different chart that assigns points based on age-appropriate responses such as smiling, crying and language use.

Doctors may also rely on other tools to diagnose the severity of a brain injury, such as MRI results and CT scans, though the Glasgow Coma Scale is prominent in classifying brain injuries for purposes of Accident Benefits. Call Preszler Law at 1-800-JUSTICE® or contact us online if you believe your loved one’s brain injury has been misclassified and for help pursuing compensation after an accident.

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