What is a catastrophic injury? The term “catastrophic” is seemingly common sense, and yet for many Ontario residents fighting for their rights in the legal world, it is a term which they are measured against but one that is often left shrouded in mystery.
Any injury could potentially be “catastrophic” if it impairs your life severely enough to strip away useful functioning. Most commonly, the term “catastrophic” is used in the Accident Benefits process. There, “Catastrophic Impairment” is a category, the third and final one, which requires the injured individual to undergo assessments by a team of medical professionals to satisfy one of eight criteria. If any of the eight criteria are satisfied, and the insurer’s assessors agree, the individual is deemed “Catastrophically Impaired” and is entitled to substantially higher compensation.
If the insurer’s assessors do not agree, the matter is disputed before the License Appeal Tribunal where a personal injury lawyer can help you present the best case possible and pursue compensation within the Catastrophic Impairment category.
While explaining each of the eight categories under which an individual can be found catastrophically impaired is too broad a topic to cover in an article, here are some best practices to keep in mind which will help explain the term “catastrophic”:
- It is all about functionality: People often have an instinct to focus on the injury rather than the functional impairment. If you are simply providing a list of your injuries, this list will rarely suffice to meet the standard of catastrophic on its own. Instead, focus on what activities or tasks those injuries functionally impair you from doing. Focus on how those injuries have changed the way you function as compared to before the accident. A lack of function in one area often creates functional impairments in other areas as a consequence. Consider the interactions.
No detail is too small, do not focus on the big picture: It is human nature to focus on the one problem that overshadows the rest, but this often leads to underreporting just how impactful an accident has been to your daily life. Each detail you provide to a medical professional about the things you can no longer do, or the things you are no longer able to do as effectively, can be utilized to inform one of those eight Catastrophic Impairment criteria.
Injuries are summarized into three categories: Your injuries will fall into either the physical, psychological, or cognitive realm. Take some time to make a list of the injuries you sustained in those three categories and then think about how they functionally impair your day to day life. Anything that is no longer how it was before the accident should make it onto the list. Thinking about your injuries in this way will help you communicate the right things to the right medical professional and ensure that your reporting is complete.
Opening up is uncomfortable but necessary: The functional impairments which are most often found to be catastrophic are usually personal and embarrassing in nature. Most people are uncomfortable telling their lawyer or medical professional that as a result of the accident they cannot shower, be intimate with their partner, or get easily frustrated with their loved ones. Many individuals who ought to be classified as catastrophically impaired fall short of the mark because they did not open up to their lawyers or medical professionals.
There are more case-specific best practices that a personal injury lawyer can canvass with you, but the takeaway is this: Any injury can be catastrophic if it impairs your functioning sufficiently, but usually, a constellation of less severe injuries interact to impair overall functioning to the point of catastrophic impairment.
If you believe you have suffered a catastrophic injury or are catastrophically impaired as a result of an accident, consider the four best practices above and speak to a personal injury lawyer as soon as you can. Put the experts to work for you. Campisi LLP – Champions with heart!
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