Ontario Catastrophic Injury Lawyers

Actions have consequences. Unfortunately, when certain people engage in negligent behaviour, they rarely take the time to consider the potential consequences of their wrongful actions, nor do they think about how other people’s lives could be negatively impacted by their misconduct.

In the time it takes to look away from the windshield to glance at a cell phone notification, an accident victim’s entire world could be shattered. They could lose their senses, their mobility, their independence, their ability to support their families, and the overall quality of life to which they had previously been accustomed.

Anyone who has been injured as the result of a motor vehicle accident should be able to receive insurance coverage in the form of no-fault accident benefits. Accident benefits should be made available to anyone who sustained injuries in a motor vehicle collision, regardless of who was at-fault. Since catastrophic impairments can have profound, life-changing effects on an accident victim’s life, people who have sustained these kinds of impairments in a motor vehicle collision should be entitled to higher amounts of insurance coverage than collision survivors who have sustained non-catastrophic impairments.

In Ontario, all basic auto insurance plans include the following coverage:

• $3,500 in medical and rehabilitation benefits for accident victims who sustained minor injuries
• $65,000 over 5 years for the combined total costs of medical, rehabilitation, and attendant care benefits for accident victims who sustained non-minor, non-catastrophic injuries
• $1 million for life in combined medical, rehabilitation, and attendant care benefits for accident victims who sustained catastrophic injuries

While the benefits available to catastrophically impaired accident victims might seem like a substantial amount of money, in reality, the cost of a lifetime of medical treatment and attendant care can be significantly higher. In fact, according to research available through the National Library of Medicine, a single Canadian’s estimated lifetime expenses resulting from a severe spinal cord injury are between $1.5 and $3 million.

If your accident was the result of someone else’s negligence, you might be able to recover additional compensation by filing a civil claim against the at-fault party. By working with an Ontario catastrophic impairment lawyer, you might be able to pursue compensation for both economic and non-economic damages.

Economic damages refer to the quantifiable costs associated with your injuries. These could be expenses you have already been required to pay out of pocket, as well as expenses you might incur in the future. Economic damages can be calculated by tabulating the total income that will be lost as a result of the injuries sustained in the collision. Non-economic damages, on the other hand, are more difficult to quantify. These damages are awarded for intangible concepts that do not have a firm price tag. And while no one can put a price on something like pain and suffering, for catastrophically injured accident survivors, the overall impact of the non-economic damages they have incurred are often just as impactful as their monetary losses, if not more so.

With assistance from our catastrophic injury lawyers serving Ontario, you may be able to recover compensation for:

• Pain and suffering
• Lost wages due to missed work
• Medical expenses
• Physiotherapy
• Mobility aids, assistive medical equipment
• Prescriptions
• Home modifications to accommodate newly acquired disabilities
• Ambulance services
• Mileage expenses to and from medical appointments
• Housekeeping services
• Psychological counselling
• Reduced future earning capability
• And possibly more

To learn more, contact Preszler Injury Lawyers today to book a free initial consultation.

The Definition of “Catastrophic Impairment”

Although catastrophic injuries can occur in many ways, the term “catastrophic impairment” is used in the context of motor vehicle accident claims in Ontario. Under the current legislative regime in Ontario, the term “catastrophic impairment is defined by the province’s Statutory Accident Benefits Schedule (SABS).

According to the SABS, an adult is considered to be catastrophically impaired if they have developed at least one of the following criteria as the result of a motor vehicle accident:

• Paraplegia or Tetraplegia
• Severe impairment of ambulatory mobility or use of an arm; or Amputation
• Loss of Vision of Both Eyes
• Traumatic Brain Injury (TBI) meeting the Glasgow Outcome Scale-Extended (GOS-E) criteria
• Physical Impairment or Combination of Physical Impairments (which results in 55% or more of whole person)
• Mental or Behavioural Impairment (excluding Traumatic Brain Injury) Combined with a Physical Impairment (which results in 55% or more impairment of the whole person)
• Marked impairment in three or more areas of function that precludes useful functioning; or an Extreme impairment in one or more areas of functioning due to mental or behavioural disorder

In order to receive accident benefits commensurate with the severity of their injuries, catastrophically injured accident survivors must submit a completed OCF-19 form to their insurer. This Application for a Determination of Catastrophic Impairment should be filled out by the claimant’s attending physician or any other physician who can best attest that their patient’s injuries meet the threshold of catastrophic impairment.

Unfortunately, insurance companies rarely agree with the recommendations made by accident survivors’ physicians. If the accident benefits insurer disagrees and believes that a claimant’s injuries do not actually fit the definition of catastrophic impairment, they will request an independent medical examination (IME) to be conducted by an independently contracted healthcare professional. Upon completion of the IMEs, the insurer will either accept the application or deny it.

Defining Criteria for Catastrophic Brain Injuries

The physical effects of a traumatic brain injury (TBI) can be painful, confusing, and disruptive to an accident survivor’s daily life. But for catastrophically impaired accident victims, the human cost of their TBI can be overwhelming and disastrous. People who have sustained catastrophic brain injuries should have access to enhanced accident benefits and receive higher payments than collision survivors whose medical conditions are less impactful and severe.

The Glasgow Outcome Scale Extended (GOS-E) is a tool used to assess the long-term outcomes of TBIs. The GOS-E measures several categories of functioning, including consciousness, independence, the ability to work, the ability to travel locally without assistance, the quality of interpersonal relationships, the ability to participate in social and leisure activities, and the ability to return to normal life.

The GOS-E determines 8 possible outcomes for adults with TBIs. These are:

• Death
• Vegetative state
• Lower severe disability
• Upper severe disability
• Lower moderate disability
• Upper moderate disability
• Lower good recovery
• Upper good recovery

According to Ontario’s SABS, in order to meet the threshold of catastrophic impairment, adult survivors of motor vehicle accidents whose collisions resulted in a TBI must meet the criteria for one of the following outcomes:

• Vegetative state (assessed at least 1 month following the date of injury)
• Upper or lower severe disability (assessed between 6-12 months following the date of injury)
• Lower moderate disability (assessed 12+ months following the date of injury)

Additionally, the injured motor vehicle accident survivor must show positive findings of a TBI on a medically accepted brain imaging scan (such as CT scan or MRI)  in order to qualify for a catastrophic impairment designation.

Unfortunately, even if an accident survivor’s neuropsychologist believes that their patient’s TBI should qualify for a catastrophic impairment designation, the insurance company may still deny the application.  And for people suffering from the effects of catastrophic brain injuries, the process of fighting for fair treatment and fair insurance coverage can be confusing, disheartening, and overwhelming.

Contact Our Ontario Catastrophic Injury Lawyers Today

No one deserves to pay the price of someone else’s negligence. And no one should be forced to take on a large insurance company on their own.

Our Ontario catastrophic injury lawyers have experience advocating for the rights of motor vehicle accident survivors. For more than 60 years, Preszler Injury Lawyers have fought against the unfair tactics used by insurance providers to undermine the claims of injured victims. Our catastrophic injury lawyers also have a history of representing our clients’ best interests in civil claims against the negligent persons whose wrongful actions behind the wheel resulted in permanent physical and/or cognitive impairments.

If your overall quality of life has deteriorated because of catastrophic injuries you have sustained as a result of another party or entity’s wrongful actions, our Ontario catastrophic injury lawyers may be able to help you get the compensation you deserve. To review the details of your case and learn about the legal assistance we may be able to provide, schedule your free initial consultation with our Ontario catastrophic injury lawyers today.