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The Role of Expert Opinion in a Claim for Catastrophic Brain Injury

Classification of injuries. Hundreds of thousands of dollars in medical and rehabilitation benefits (up to $1 million dollars) – and other compensation – are at stake for those who have sustained catastrophic brain injuries.

Expert opinion and objective verification of injuries are essential for those who wish to pursue compensation for catastrophic brain injuries. An injury claim should provide extensive medical documentation and physician statements to substantiate your right to catastrophic-level benefits.

The Financial Incentive for Proving Your Loved One’s Claim

The Statutory Accident Benefits Schedule (SABS), under Ontario’s Insurance Act, classifies accident injuries into three categories:

  • minor;
  • non-minor; and
  • catastrophic.

The SABS provides guidelines in which claimants with catastrophic injuries have access to significantly more compensation and for a longer duration. Ensuring an accurate classification of your or your loved one’s catastrophic brain injury has a substantial financial impact.

For instance:

  • catastrophic brain injuries qualify for up to $1 million in the Medical and Rehabilitation Benefit (those with minor and non-minor injuries are limited to $3,500 and $50,000, respectively);
  • minor injuries do not qualify for the Attendant Care Benefits, whereas those with a catastrophic injury may receive up to $1 million in benefits (non-minor injuries are limited to $36,000);
  • there are no time limitations on receiving the Attendant Care Benefit for those with a catastrophic brain injury (non-minor injuries are limited to 104 weeks after the accident); and
  • those with a catastrophic injury qualify for additional compensation, such as travel expenses and housekeeping.

Talk With Our Legal Team

If you have any questions and would like to schedule a call with our legal team for a FREE no-obligation consultation, contact us now. During this call you can ask any questions as it relates to your accident and/or claim and we'll discuss your options and possible outcomes.

Regardless of where you're located in Ontario – we may be able to help you. Don't delay - call us. Our lines are open 24/7.

With so much money on the line, the insurance companies demand substantial proof of injury. This includes expert opinion from medical professionals qualified to speak on the severity of your loved one’s injury.

How Expert Opinion Impacts the SABS Classification of Brain Injuries

Proving the existence of a catastrophic brain injury is particularly challenging because this injury may not visibly/physically manifest as other catastrophic injuries, such as spinal cord trauma or an amputation. Your claim must include medical evidence to illustrate the impact and extent of the injury.

The SABS use the GCS of under 9 and the Glasgow Outcome Scale (GOS-E) to determine whether a claimant has suffered what can be classified as a catastrophic brain injury.

This universal evaluation tool measures such things as:

  • a patient’s responsiveness/consciousness;
  • a patient’s ability to participate in independent activities; and
  • more.

The medical experts involved in your claim must be able to speak to your loved one’s condition and likelihood of recovery. These points are crucial when classifying an injury.

Seek qualified experts with the training and credentials to diagnose and treat traumatic brain injury. Ensure the medical team understands the legal burden of proof involved in a motor vehicle accident claim.

You should be aware the insurance company may provide its own medical experts to verify the extent of brain injury and whether it qualifies as catastrophic. You may schedule a free case evaluation with a brain injury lawyer to discuss your loved one’s case and determine how to substantiate your claim. Call the Preszler Injury Lawyers in Ontario at 1-800-JUSTICE® today.

Call us now at

151 Eglinton Ave W,
Toronto, ON
M4R 1A6
Fax: 1-855-364-7027
Toll Free: 1-888-608-2111
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Burlington, ON
L7L 4X6
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Brampton, ON
L6W 3W8
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Whitby, ON
L1N 1C4
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92 Caplan Ave #121,
Barrie, ON
L4N 0Z7
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380 Wellington St Tower B, 6th Floor,
London, ON
N6A 5B5
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East Tower Mississauga, ON
L5N 6A6
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1 Hunter St E,
Hamilton, ON
L8N 3W1
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459 George St N,
Peterborough, ON
K9H 3R9
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22 Frederick Street,
Suite 700
Kitchener, ON N2H 6M6
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352 Elgin Street,
Ottawa ON
K2P 1M8
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10 Milner Business Ct #300,
Scarborough, ON
M1B 3C6
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*consultation offices

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