Catastrophic Injury Lawyer Toronto

A serious injury can derail your life, leaving you and your loved ones to deal with a permanent disability, high medical bills, lost income, and other damages associated with catastrophic motor vehicle accidents. Our catastrophic injury lawyers have many years of experience in helping accident victims to recover fair financial compensation, and we are ready to help you.

The Statutory Accident Benefits Schedule defines catastrophic impairment or catastrophic injury as a debilitating injury that permanently alters the victim’s ability to function normally and live independently. These are the ways an injured person can be deemed catastrophically injured or impaired. The Statutory Accident Benefits Schedule outlines criteria for catastrophic impairment. These include:

Severe Spinal Injury

Spinal cord injuries can drastically impact your sensation, strength, and other key bodily functions below the injury level. A severe spinal cord injury can cause partial or complete paralysis of your arms and legs and even sensation loss in different areas of your body. It can also cause excruciating pain, muscle spasms, and loss of bladder and bowel control. The following spinal injuries are classified as catastrophic injuries.

Paraplegia

A complete spinal cord injury causes paralysis below the injury area. That means there’s no feeling and voluntary movement – your sensory and motor function is lost completely below the injury point. Paraplegia is classified as a complete spinal cord injury. It is paralysis that partially or completely affects the trunk, pelvic organs, and legs.

Paraplegia is often caused by significant spinal cord damage, particularly in the mid-back (thoracic) and low-back lumbar or sacral region.

Quadriplegia

This spinal cord injury is also known as tetraplegia and affects the hands, arms, trunk, legs, bladder, and bowel. It is often caused by damage to the spinal cord, particularly in the neck between the 1st and 4th vertebrae. Quadriplegia is associated with severe functional limitations, such as complete or partial paralysis of the trunk, arms, and legs and could cause breathing difficulties.

Severe Impairment of Ambulatory Mobility

This refers to any impairment that causes permanent loss in your ability to walk independently. To be considered a catastrophic impairment, your personal injury lawyer must show that the injury has caused significant loss of use in your arm or severely affected your ability to walk. Such injuries may result from partial amputation, complete amputation, extensive burns, crushing of a limb, and other injuries.

Blindness or Loss of Vision

Total blindness or significant loss of vision can be considered a catastrophic injury. However, your personal injury lawyer must show that the motor vehicle crash or any other accident reduced the victim’s visual field to about 20 degrees or lower. Remember, visual acuity is assessed based on the Snellen chart or an equivalent option.

Traumatic Brain Injury

A traumatic brain injury refers to a severe medical issue that negatively affects how your brain works. The injury can be classified as either a penetrating traumatic brain injury (an object pierces your skull and causes damage to your brain) or a blunt traumatic brain injury (an object hits your head hard enough that the brain twists around or bounces inside your skull).

A brain injury can be classified as a catastrophic injury in different ways. First, you must have a positive imaging of the brain injury. That means if a CT scan or MRI shows a significant injury to your brain, you may be eligible for catastrophic injury benefits. Experienced personal injury lawyers understand these requirements better and can help you get the ‘catastrophic injury’ designation.

55% of Whole Person Impairment

Part of a Statutory Accident Benefits claim involves assessing the victim’s level of psychological and physical impairment as a result of the accident. Whole Person Impairment refers to the assessment process that determines whether your post-accident condition meets the ‘catastrophic’ definition. This evaluation is based on the table found in the 4th edition of the Guide to the Evaluation of Permanent Impairment.

How is the 55% Calculated?

A professional and licensed physician will assess the severity of all the injuries sustained from an accident. This process is referred to as a Whole Person Impairment assessment. According to Ontario law, it can be done by a surgeon, family doctor, or any other licensed physician. This assessment can be done after two years (from the time of the accident).

However, the assessment can be done any time after three months (from the time of the accident), particularly if your injuries caused 55% or higher impairment and this condition is unlikely to improve. During the assessment, the physician will combine all your injuries (associated with the accident) into a percentage.

Each injury will be given a percentage value of how it impairs your ‘whole person.’ If the sum of all the impairment percentages is 55% or higher, then the physician will deem your post-accident condition as a catastrophic impairment.

Who can Perform the Assessment?

Remember, all medical professionals can perform the assessment and award the catastrophic impairment designation. Therefore, it’s in your best interest to seek legal assistance from a personal injury law firm that can help choose a licensed medical professional to perform this assessment.

Psychiatric Catastrophic Impairment

There are several ways to qualify for the catastrophic injury designation, particularly under a mental or behavioural disorder. A licensed psychiatrist’s assessment is required for your mental-related injuries to qualify as catastrophic.

The psychiatric assessment should happen two years after the accident. However, it can happen earlier if the psychiatrist’s evaluation shows that your mental impairment is unlikely to improve over time. Remember, your psychiatrist will assess your mental or behavioural disorder or impairment in four different spheres. Each sphere represents a specific aspect of your life that can be affected by mental impairment. These spheres include:

• The limitation in daily living activities, like your ability to move and communicate effectively
• Social functioning – assessment of your ability to communicate and participate in group activities.
• Concentration, persistence, and pace – this test focuses on whether you can focus and complete a task.

The last sphere is the deterioration or decompensation in work-life settings. This assesses your ability to comprehend and remember workplace processes, develop and sustain concentration, and the ability to adapt in stressful situations. Your psychiatrist will assess your ability to handle these different situations.

Note that your impairment could be caused by conditions such as psychotic disorder, depression, and post-traumatic disorder (PTSD) associated with an accident. Your mental impairment score (based on the psychiatrist’s score) will determine whether your impairment is catastrophic or not. The designation of catastrophic injuries is different for children compared to that of adults concerning spinal cord injury symptoms.

The impact of a catastrophic impairment extends far beyond the physical wounds you may have suffered in an accident. While the visible scars may heal over time, the effect of such injuries can persist, affecting various aspects of your life. These aspects include physical and psychological well-being, financial stability, and lifestyle.

Understanding these multifaceted impacts is crucial in providing adequate support for both the survivors and their families. Besides, your lawyer can use this information to support your personal injury claim and help you get the amount of compensation you legally deserve.

Impact on your Physical Health

Physical disabilities, debilitating pain, and impaired mobility are some of the physical aspects of catastrophic injuries. The immediate aftermath of such personal injuries often involves extensive medical treatment, surgeries, and rehabilitation efforts aimed at restoring functionality and mobility. However, for many survivors, achieving full recovery may not be possible. This leads to long-term or permanent physical impairments.

These limitations can significantly impact your ability to engage in daily activities, independence, and overall quality of life. From navigating stairs to performing routine tasks, victims of catastrophic injuries often face numerous challenges in their daily lives. That’s why they need ongoing support to cope with their physical limitations.

Psychological Impact

Beyond the physical pain, catastrophic impairment often results in profound psychological distress. Depression, anxiety, and post-traumatic stress disorder (PTSD) are common among survivors. This is because they struggle to come to terms with the sudden and life-altering changes associated with the serious injuries they sustained.

The emotional trauma from the incident, coupled with the challenges of adapting to a new reality, can lead to feelings of helplessness, isolation, and loss of self-esteem. Besides, the psychological impact extends beyond the survivors themselves. It affects their families and caregivers, who may also experience high levels of stress, guilt, and emotional strain as they navigate the complexities of caring for their loved ones.

Financial Challenges

The financial burden is another significant challenge faced by individuals and families affected by catastrophic injuries. The cost of medical care, rehabilitation, assistive devices, and ongoing therapies can quickly accumulate. This places a strain on even the most stable financial foundations.

Also, the potential loss of income due to disability or the need for caregivers to reduce their work hours to provide care further exacerbates the financial strain. The victims’ families often find themselves grappling with mounting bills, navigating insurance claims, and seeking alternative sources of financial support to meet their needs.

The financial impact of catastrophic impairment can last years. It requires careful planning and resource management to ensure the ongoing well-being of the survivors and their families. Luckily, our catastrophic injury lawyers can help you seek compensation from your insurer to ease the financial impact of the injuries.

Lifestyle Changes

Living with catastrophic injuries often necessitates significant lifestyle adjustments. While therapy and rehabilitation programs can help individuals regain some level of functionality, adapting to life with physical limitations requires ongoing support. Modifying living spaces to improve accessibility and acquiring assistive devices and technology to aid in daily activities may be necessary.

Also, accessing community resources and support networks are essential steps in facilitating the transition to a new way of life. Individuals may need to explore new hobbies, recreational activities, and social opportunities compatible with their abilities and interests. This can foster a sense of purpose and fulfillment despite the challenges they face.

The term ‘catastrophic’ is more than just a descriptor of the most severe injuries associated with motorcycle accidents, vehicle accidents, slips and falls, and more. This term is also a legal definition with significant repercussions for your personal injury claim. Your personal injury lawyer will help you understand all your legal options when it comes to seeking compensation.

Insurance Accident Disability Benefits

Under Ontario’s personal injury law, injured individuals may be eligible for no-fault accident benefits. That means you can claim benefits from your insurance company. If you’re not insured as a driver, your personal injury lawyer can help you claim under the insurer of the driver involved in the car accident or even a family insurance cover.

Note that these accident benefits are clearly outlined under the Statutory Accident Benefits Schedule SABS – part of Ontario’s Insurance Act. These accident benefits are considered ‘no-fault benefits’ because the application process doesn’t change regardless of who was responsible for the accident.

Benefits Application Process

The application process for these benefits can be complex – it requires accurate information and must be filed within a specified period. Besides, factual errors and omission of crucial information can harm your claim. Therefore, it’s in your best interests to work with an experienced personal injury lawyer to handle the claim application process successfully.

Beyond the usual steps involved in the application process for car accident benefits, catastrophic injury victims are required to submit OCF-19 (Application for the Determination of Catastrophic Impairment). This form must be filled out by a professional and licensed physician.

In most cases, the physician requires input from other medical professionals who treat you. The professionals may include neurologists, orthopedic surgeons, and other medical professionals involved in your care.

How much Compensation can you get?

There are three levels of accident benefits depending on the severity of your injuries. Individuals whose injuries fall under the minor injury guideline may be entitled to a maximum of $3,500 for their medical bills and rehabilitation expenses. If your injuries are considered non-catastrophic, you may get up to $65,000 for your medical expenses, rehabilitation needs, and attendant care expenses.

If you suffered severe injuries that caused you catastrophic impairment, you may be eligible for the following benefits:

• Up to $1,000,000 in medical and rehabilitation benefits

• Maximum of $6,000 monthly payments and up to $1 million in attendant care benefits

• Up to $100 weekly pay for housekeeping and home maintenance benefits

• Caregiver benefits – weekly payments of up to $250 and $50 for every extra dependent

• Educational expenses – maximum of $15,000 for students that may not continue with their education programs due to catastrophic impairments

• Death and funeral benefits for the surviving family members – up to $25,000 for a spouse and a maximum of $10,000 for every child

While the SABS benefits may be available through an insurance company, the entire process of pursuing a claim successfully is complex. You must have carefully documented medical evidence, file the claim within a specified period, and ensure your claim worth is accurately calculated.

Tort Action

When you suffer catastrophic injuries due to another person’s negligence, you have the legal right to pursue compensation through a tort claim. This avenue for seeking damages applies to various types of accidents, including but not limited to car accidents, slips and falls, unsafe products, motorcycle accidents, and recreational accidents.

In many cases, victims and their families can work with a personal injury lawyer to negotiate a settlement with the negligent party’s insurance company. If the settlement negotiation is successful, there’s no need for a trial. However, if a fair settlement cannot be reached through negotiation, pursuing a lawsuit may become necessary to secure appropriate compensation.

Damages in a Tort Claim

The damages sought in a tort claim for catastrophic impairment can cover various losses and expenses incurred as a result of the injury. These may include:

• Income loss

• Loss of future income-earning potential

• Costs associated with attendant care and future care needs

• Expenses related to housekeeping and home maintenance

• Special damages for specific financial losses incurred

• General damages for pain and suffering, as well as loss of enjoyment of life

• A family law award for loss of companionship and guidance for family members affected by the injury

In Ontario, there may be caps or limits on certain types of damages. For instance, there is a cap of $310,000 for general damages for pain and suffering, with adjustments expected over time to account for inflation. This maximum amount is typically awarded to individuals surviving with quadriplegia, reflecting the severity of their injuries.

The Financial Amount at Stake

If you suffered catastrophic injuries, you may be eligible for up to $1 million in accident benefits. Thus, there’s a lot of money at stake for your insurer. Considering the amount to be paid may increase substantially, there’s so much at stake for the insurance company. That’s why the company’s legal representatives will try hard to ensure the ‘catastrophic impairment designation’ isn’t reached.

Your insurer may even get their doctors to perform medical assessments that they feel will support their argument. The insurer’s legal team may not allow that designation to come by easily. Having an experienced lawyer on your side makes it possible to fight your insurer’s attempts to lowball your injury claim. The lawyer can work with licensed and experienced medical professionals to ensure your injuries are detailed and documented accurately.

Insurer Assessments

Insurance policy providers that are obliged to pay accident benefits have the right to insurance assessments under Section 44 of the Statutory Accident Benefits Schedule. This allows the insurer to choose a health professional to assess an insured individual. Unfortunately, an insurer may have this medical assessment performed by a social worker or kinesiologist. However, these aren’t members of the health profession and may not provide an accurate medical assessment.

Additionally, insurers are legally required to make reasonable efforts to arrange the assessment. The day, time, and location of the examination should be convenient to the individual being examined. There are also conditions, limits, and restrictions on what your insurer can and cannot do concerning insurance examination. Having catastrophic injury lawyers on your side ensures the insurer plays by the law and doesn’t prejudice your claim.

Our personal injury lawyers play a crucial role in guiding individuals through the complex process of pursuing a catastrophic impairment claim. Here’s how we can help you.

Investigating the Accident

Our lawyers thoroughly investigate the circumstances surrounding the motor vehicle accident that caused your injuries to determine liability. They will gather evidence, such as witness statements, car accident reports, and expert opinions, to identify all potentially responsible parties.

Assessing Damages

After establishing liability, our lawyers work with experts to calculate the full extent of damages you suffered. This includes current and future medical expenses, lost wages, rehabilitation costs, pain and suffering, and other injury-related costs.

Negotiating with Insurance Companies

Indeed, our lawyers are skilled negotiators who will advocate for you when dealing with insurance companies. The professionals strive to achieve a fair settlement that will adequately compensate you for the damages you suffered due to the motor vehicle accident.

Filing a Lawsuit

If a satisfactory settlement cannot be reached through negotiation, the lawyer may file a personal injury lawsuit on your behalf. They construct a compelling legal argument and represent you in court proceedings.

Navigating the Legal System

Personal injury lawyers are well-versed in the intricacies of the legal system. They understand court procedures, deadlines, and legal requirements, ensuring that your rights and interests are protected throughout the process. Whether your claim is settled out of court or proceeds to trial, we will ensure you get the compensation you deserve.

Schedule a free consultation and learn more about how our experienced Toronto personal injury lawyers can help recover more substantial accident benefits.