Catastrophic Injury Lawyer

If you were injured in a car accident, catastrophic impairment is a category under the Statutory Accident Benefits Schedule (SABS) of the Insurance Act that applies to a variety of severe and generally permanent post-accident impairments. It requires proof of at least one of the following:

• Amputation
• Paraplegia
• Quadriplegia (Tetraplegia)
• Severely impaired use of an arm
• Traumatic brain injury of sufficient severity
• Loss of vision in both eyes
• A Whole Person Impairment (WPI) rating of 55% or greater loss of overall function; or
• A Mental or Behavioural Disorder (MBD), that causes Marked Impairment in 3 or more functional areas; or an Extreme impairment in one functional area

A client’s catastrophic designation unlocks entitlement to greatly enhanced benefits. For vehicle collisions after June 1, 2016, a claimant can receive up to $1,000,000 in medical, rehabilitation and attendant care benefits, if required. The amount of available attendant care is up to $6,000 per month. Note that the factors that determine whether a victim’s injuries are catastrophic are very complex, and insurance companies often fight to avoid a catastrophic designation in order to keep the costs of your recovery down. We will work tirelessly to get you the compensation you need and deserve, and have a proven track record of success representing clients in catastrophic claims.

For more information on compensation for a Catastrophic Injury, consult our Catastrophic Injury Compensation Guide.

If your injuries and ongoing impairment fall within one of the “straightforward” categories, such as a leg amputation, your insurer might accept that you are catastrophically impaired as part of adjusting your claim. However, because each of the categories sets out specialized criteria to be met, more often they will insist that you be evaluated by doctors and therapists of their choice. For many claims, particularly ones based on Whole Person Impairment rating or Mental and Behavioral Disorders, you must apply for a determination of catastrophic impairment. In response, your insurer will schedule a series of assessments to see if you qualify.

Knowing what to do when you or somebody you love has suffered from a catastrophic impairment is difficult. Read our Compensation Sources in Ontario for more information.

WHAT HAPPENS IF MY INSURER DETERMINES THAT I AM NOT CATASTROPHICALLY IMPAIRED?

If the insurance assessors conclude that your impairments do not qualify under any of the categories, you will have to start a proceeding against your insurer and challenge the findings. It is essential that you hire an experienced and decisive personal injury law firm like Campisi LLP to represent you in this complex proceeding. Often, the insurance company will want to settle your claim on a full and final basis rather than proceed to a hearing. We will provide you with clear and prudent advice so that you can determine whether settling is in your best interest.

WHEN DO I NEED TO DISPUTE A DETERMINATION OF CATASTROPHIC IMPAIRMENT?

Generally, you have two years from the date of denial to start a proceeding with the Licence Appeal Tribunal. This does not mean you have to file for a determination of catastrophic impairment within 2 years, because in many cases, your condition will deteriorate over time. In most cases, you will already be represented by us or another reputable law firm. However, if you have taken care of your own accident benefits prior to the need for a catastrophic impairment determination, we are pleased to offer a free, no-obligation consultation so that your mind can be at ease.

Compensation for your injuries can include damages for:

• Pain and suffering;
• Loss of income and out of pocket expenses;
• Loss of enjoyment of life;
• Economic losses incurred by family members;
• Cost of future medical treatment and care;
• Cost of future attendant care;
• Loss of future ability to earn money in the job market;
• Cost of housekeeping and caregiving;
• Loss of shared family income;
• Loss of care, guidance and companionship suffered by your immediate family;
• and more.