Catastrophic Impairment and Long Term Disability

Catastrophic Impairment and Long Term Disability

Catastrophic impairment and injuries can have a significant impact on someone’s life after a car accident. Examples of these injuries include amputation, brain damage, or spinal cord damage. You can also be deemed to have suffered a catastrophic injury if you’ve suffered serious psychological injuries as a result of the motor vehicle accident.

A designation of “Catastrophic Impairment” has significant consequences for an injured person. The money available to those who are injured and deemed catastrophic can reach the millions.

There are three “tiers” of injuries that govern the amount of funding available to accident victims.

  • Minor Injury Guideline (MIG):  individuals with “minor injuries” (defined as whiplash-related injuries, muscular strains/sprains, contusions and lacerations) receive up to $3,500 for their medical and rehabilitation needs.
  • Non MIG:  Those injuries that are not MIG fall into the next tier which usually provides up to $65,000 for medical and rehabilitation treatment as well as attendant care funding, lasting up to five years.
  • Catastrophic Impairment: To fall into this category, an individual’s injuries must meet one of several criteria set out in the Statutory Accident Benefits Schedule (SABS). If a person falls into this category, then their medical-rehabilitation and attendant care needs are usually funded up to $1 Million for medical rehabilitation benefits and an additional $1 Million for attendant care for their lifetime. Certain other benefits are also increased, extended or made available (such as a $100/week housekeeping benefit).

In order to become “CAT” the Statutory Accident Benefits Schedule focuses on the impairments from the injury as opposed to the injury itself. In other words, if the injury is significant. Since June 1, 2016, a Catastrophic Impairment has been defined to include 8 categories of impairments. The complete criteria can be found at section 3.1(1) of the SABS.

The 8 criteria are too lengthy to be fully reproduced in this article, but can be summarized as follows:

  1. Paraplegia or tetraplegia
  2. Severe impairment of ambulatory mobility or use of an arm or leg, or amputation of an arm or leg
  3. Loss of vision of both eyes
  4. If the person is over 18: traumatic brain injury, provided that the brain injury is confirmed by medical imaging and a Glascow Outcome Scale assessment determines that the injury results in one of the following ratings:
    A. Vegetative State, one month or more after the accident,
    B. Upper Severe Disability or Lower Severe Disability, six months or more after the accident, or
    C. Lower Moderate Disability, one year or more after the accident.
  5. If the person is under 18 years of age: a traumatic brain injury, confirmed by medical imaging, and the person has been admitted into hospital, or, the person has catastrophic impaired neurological functioning.
  6. A physical impairment or combination of physical impairments that, in accordance with the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 4th edition, 1993, results in 55 per cent or more physical impairment of the whole person.
  7. A mental or behavioural impairment, excluding traumatic brain injury, determined in accordance with the rating methodology in the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 6th edition, 2008, that, when the impairment score is combined with a physical impairment described above results in 55 percent or more impairment of the whole person.
  8. An impairment that, in accordance with the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 4th edition, 1993, results in a class 4 impairment (marked impairment) in three or more areas of function that precludes useful functioning or a class 5 impairment (extreme impairment) in one or more areas of function that precludes useful functioning, due to mental or behavioural disorder.

The aforementioned is a summary of the different ways of becoming catastrophically impaired. You can find more details about the categories in the SABS.