Any injury that a person suffers will impact their life to some degree. Minor injuries usually require limited medical treatment and some additional rest and time to allow your body to heal. More severe injuries often call for substantial medical intervention and have a recovery trajectory that is less certain. But what about injuries so severe that they are deemed catastrophic?
Catastrophic injuries cause permanent disability that necessitate a lifetime of attendant care, special treatments or other significant interventions. There are a range of injuries that are considered catastrophic and different medical-legal criteria are used to determine if a person qualifies. However, an insurance company ultimately decides whether an insured’s impairment will be considered catastrophic - and sometimes they reject deserving claims.
If you or a loved one has sustained a serious injury and you want to ensure that your right to receive the compensation you deserve is protected, consider speaking with a catastrophic injury lawyer at Gluckstein Personal Injury Lawyers.
What injuries are considered catastrophic?
Many catastrophic injuries result from motor vehicle accidents. Ontario’s Statutory Accident Benefits Schedule, also known as ("SABS"), will automatically consider a person to have suffered catastrophic impairment if he or she has sustained a traumatic brain injury and is:
Accepted for admission on an in-patient basis at a public hospital named in a Superintendent Guideline with positive findings on a computerized axial tomography (CAT) scan, a magnetic resonance imaging (MRI), or any other medically-recognized brain diagnostic technology indicating intracranial pathology.
Accepted for admission on an in-patient basis to a program of neurological rehabilitation in a pediatric rehabilitation facility that is a member of the Ontario Association of Children’s Rehabilitation Services.
Other injuries may also be deemed catastrophic; however, they must be confirmed by medical assessments based on specific diagnostic guidelines. These injuries include:
- Paraplegia or tetraplegia.
- Severe impairment of ambulatory mobility or use of an arm, or amputation.
- Loss of vision of both eyes.
- Traumatic brain injury (applicant 18 years of age or older at the time of the accident).
- Traumatic brain injury (applicant under 18 years of age at the time of the accident).
- Physical impairment or combination of physical impairment which results in 55% or more of the whole person.
- Mental or behavioural impairment, excluding traumatic brain injury, combined with a physical impairment which results in 55 percent or more impairment of the whole person.
- 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 functioning, due to mental or behavioural disorder.
- Certain impairment of individuals who were injured when under the age of 18, when developmental complications are considered through analogous tests.
An experienced catastrophic injury lawyer can help.
SABS provides guidelines for compensation based on the severity of the injury sustained in a motor vehicle accident.
Minor injuries, generally including whiplash associated disorders, strains, sprains and subluxations (vertebrae slightly out of alignment) are eligible to receive $3,500 for medical treatments for up to five years, and additional funds for income loss.
Non-catastrophic injuries (more severe than minor injuries but not catastrophic) can receive up to $65,000 for medical and attendant care for up to five years, and additional funds for income loss.
Catastrophic injuries are eligible for up to $1 million in medical and attendant care and more for income loss, caregivers and housekeeping over a lifetime.
As you can see, a catastrophic designation for your injury can make available a much higher level of SABS benefits to help you heal and rebuild your life.
In some cases, a catastrophic designation for your injury is obvious and undeniable. However, many serious injuries fall into what insurance companies call threshold cases. In these instances, determining whether a person qualifies for the higher benefit level that a catastrophic designation brings often comes down to the opinion of medical experts.
Insurance providers will generally accept information from your medical practitioner, but for cases involving large sums of money, they will normally want you to see medical practitioners of their choice. That is their right; you cannot reasonably refuse to see the insurance provider’s assessors. But, must you accept their diagnostic opinion - especially if it limits your claim? Absolutely not.
As experienced catastrophic injury lawyers, the team at Gluckstein Personal Injury Lawyers has handled many cases where a second or third opinion by our network of independent medical experts has tipped the scales for threshold cases. We have helped our clients build strong cases against catastrophic injury claim denials and have ensured that every avenue to help access fair compensation is explored.
When to file a tort claim.
The monetary difference between SABS benefits for non-catastrophic injuries and catastrophic injuries is substantial. But, there is another factor that must be kept in mind when an insurer attempts to deny a rightful catastrophic injury designation: time.
If you have sustained a permanent, life-altering injury, your future medical or attendant care needs will not magically disappear after your non-catastrophic injury benefits have been exhausted (or the five-year time limit to access them expires). Often, people will need to draw on these kinds of benefits for many more years or the rest of their lives. If SABS alone won’t cover your current and future needs - and frequently it doesn’t - you may need to consider a tort claim for damages to supplement this compensation.
Tort claims can be filed when your injuries are partly or fully the result of someone’s negligent actions or inaction. Beyond motor vehicle accidents, incidents which can cause catastrophic injuries include:
- Medical malpractice.
- Birth injuries.
- Acts of violence.
- Premises liability accidents.
- Product liability accidents.
To be successful with a catastrophic injury tort claim, you must prove a person or persons violated a duty of care (responsibility for your safety) due to negligent actions or inaction. Proving liability in some of these cases can be challenging; by choosing catastrophic injury lawyers who have years of experience and a proven track record for results, you can be confident in your legal representation.
With our knowledge of the laws governing catastrophic injury claims and our ability to draw on extensive legal resources, Gluckstein Personal Injury Lawyers can fight for maximum damages on your behalf. Our team can also help ensure that all notice requirements are filed in a timely manner if a government entity bears liability.
Similar to the caps on SABS benefits, Ontario law imposes certain tort damage caps that may limit a catastrophically injured person’s recovery. For example, there is a limit on damages for pain and suffering. Damages for income loss and the future cost of care (medical and related expenses) do not have a cap, however. A Gluckstein catastrophic injury lawyer can offer insight on what claims you can advance for pain and suffering, income loss, recovery of medical, rehabilitative, and attendant care following a catastrophic accident.
Gluckstein’s commitment to our catastrophic injury clients.
When Gluckstein Personal Injury Lawyers litigate or negotiate catastrophic injury claims with insurance providers we are interested in more than just how much compensation we can help you receive. We want to ensure that the compensation you receive will work best for you and your loved ones as you begin a new chapter and work towards achieving the best quality of life possible.
This commitment not only means building cases for catastrophic injury designations when possible, but helping you plan for life after the lawsuit. In our experience, when a significant negotiated settlement or court-ordered award for damages is provided for a catastrophic injury, deciding how to manage it requires well-informed thought and careful consideration.
Our legal team will explain the pros and cons of receiving a large lump sum payment or something called a structured settlement. While a one-time payment can be invested and drawn upon as you need it, these funds can also be inadvertently exhausted before your needs are fully met. A structured settlement managed by an independent organization provides reliable pay out of funds in a planned way over many years based on anticipated needs.
Ensuring you and your loved ones are respected, supported and cared for during and after the life of a legal case is part of Gluckstein Personal Injury Lawyers’ commitment to full circle care. When you or a loved one has been dealt a life-shattering blow by sustaining a catastrophic injury, you don’t have to face the future alone. Let our team of personal injury lawyers in Toronto, Ottawa, Niagara, and Barrie be your compassionate advocates for care, and your fierce defenders of your right to fair compensation.
What is Orthopaedic Trauma?Orthopaedic injuries cause damage to musculoskeletal structures in the body, including sprains, strains and tears. Blunt force trauma can cause bruising, cuts, fractures (broken bones), herniated discs, and dislocated joints.
What is considered to be a catastrophic injury?
A catastrophic injury causes significant and permanent impact or damage to a victim. However, the term catastrophic injury has a specific meaning and is defined by certain criteria when applied to Ontario's Statutory Accident Benefits Schedule (SABS) for motor vehicle accidents.
Some examples of catastrophic injuries according to SABS criteria include:
- A severe brain injury;
- Loss of a limb;
- Extreme loss of vision; and
- Paralysis, among other injuries.
How can the traumatic brain injury lawyers at Gluckstein Personal Injury Lawyers help prove another person's negligence during a motor vehicle accident?
Although severe head trauma tends to have more catastrophic consequences than other types of personal injuries, the standard for proving liability in an ensuing civil case remains the same. To get a settlement or court judgment in their favour, the plaintiff in a TBI claim must prove that another person’s negligent actions or inaction directly caused them to suffer harm. One of our expert trial lawyers can assist an injured plaintiff in proving the opposing party’s fault for causing an otherwise avoidable TBI.
What are some signs and symptoms of severe head trauma?
Each brain injury is a unique event with a unique set of effects, there are some common difficulties arising from severe head trauma, including:
- Full or partial paralysis;
- Blurred vision or tired eyes;
- Ringing in the ears;
- Bad taste in the mouth;
- Fatigue or lethargy;
- Changes in sleep patterns;
- Behavioural or mood changes;
- Trouble with memory, concentration, attention, or thinking;
- Repeated vomiting or nausea;
- Convulsions or seizures;
- Inability to awaken from sleep;
- Dilation of one or both pupils of the eyes;
- Slurred speech;
- Weakness or numbness in the extremities;
- Loss of coordination;
- Increased restlessness or agitation.
What is the second thing I should due if I sustained a traumatic brain injury?
If you suffered a traumatic brain injury (TBI) due to someone else’s careless or negligent behaviour, after getting medical attention your next priority should be contacting an experienced catastrophic injury lawyer.
What is the first thing I should I do if I sustained a serious blow to the head during an accident?
Any accident involving a serious blow to the head should be enough to seek immediate medical care, even if you feel fine in the following hours or days. Damage to the brain does not always produce noticeable symptoms immediately, so it is best to let a medical professional evaluate your cognitive abilities and brain function after an accident.
How do our spinal injury lawyers help accident victims?
Our spinal cord injury lawyers can help an injured party pursue compensation for the losses they've suffered. Gluckstein's catastrophic injury lawyers are experienced in navigating claims, calculating an injured person’s losses, and seeking compensation from at-fault parties, both in and out of court.
How do I seek fair compensation after an automobile spinal cord injury?
Seeking compensation after a spinal cord injury often involves filing several insurance claims. If you or a loved one has suffered spinal cord damage in a car crash, you will need to file a claim through the Statutory Accident Benefit Schedule (SABS). The accident benefits system can provide direct compensation to injured accident victims for their economic losses, including lost wages, medical expenses, non-earner benefits, and caregiver benefits.
What are my rights if I've suffered a spinal cord injury as a result of another person's negligence?
Where spinal cord injuries are the result of another person’s actions, affected individuals have the right to seek compensation for their losses, including pain and suffering, the cost of past and future medical care, and income losses.
What are the time limits on filing a claim?
Acting in a timely manner is very important. There are statutory time limits to filing a civil claim for damages, and we recommend that you engage the services of an experienced paralysis accident lawyer as soon as is reasonably possible after the accident to ensure you don't miss a statutory deadline or limitation.
Why is it important to seek representation from a personal injury lawyer with experience in catastrophic injuries?
If a catastrophic injury such as paralysis or quadriplegia is due to the negligence of others, or if an insurance company does not want to adequately compensate your losses, the legal services of Gluckstein's experienced paralysis lawyers can ensure those parties uphold their obligations to restore your financial circumstances and long-term health.
What does it mean to have a catastrophic injury such as Quadriplegia?
Quadriplegia is paralysis caused by illness or injury to the spinal cord that results in the partial or total loss of use of all limbs and torso; paraplegia is similar but does not affect the arms.
How can Gluckstein Personal Injury Lawyers help me if I have been paralyzed in an accident?
Gluckstein Personal Injury Lawyers has a team of professionals experienced in dealing with seriously injured individuals and will work tirelessly to ensure that our clients’ needs are met both medically and financially.
What does it mean to have a catastrophic injury such as Paraplegia?
Paraplegia is the loss of sensation or movement in the legs and in all or part of the torso, usually caused by an injury below the neck. Many life changes follow an injury that has resulted in this type of paralysis, including:
- Regular rehabilitation, physical therapy, and medical care;
- A new profession or reduced-level employment;
- Alterations to one’s home and car to accommodate different physical needs;
- Added stress to personal relationships, including friends and family.
- Regular rehabilitation, physical therapy, and medical care;
Are there damage cap limits for someone deemed to have a catastrophic injury?
Ontario law imposes certain damage caps that may limit a catastrophically injured person’s recovery. For example, there is a limit on damages for pain and suffering, which is capped at about $370,000 as of 2020, although this amount will increase each year with inflation. Damages for income loss and future cost of care (medical expenses) do not have a cap.
Gluckstein Personal Injury Lawyers can offer insight into what claims you can advance for pain and suffering, income loss, recovery of medical, rehabilitative, and attendant care following a catastrophic accident.
How can Gluckstein Personal Injury Lawyers help me if I believe my injuries should be deemed catastrophic?
Our lawyers are well aware of the long-term implications of many catastrophic injuries. The full impact of the injury may only appear as the person ages. We take that into consideration in advocating for the long-term welfare of our clients. For example, a person who becomes paralyzed due to spinal trauma may have to pay for emergency medical treatment immediately after their accident as well as future rehabilitative treatments, attendant care, and physical therapy.
For catastrophic injuries, what are some recoverable damages in a tort claim?
If catastrophic injuries were caused by the negligent or intentional act of another person, a successful civil claim is critical to the victim’s quality of life going forward. Medical treatment and rehabilitation expenses as well lost income will have huge financial implications throughout the lifetime of a catastrophically injured person.
Why is it important to ensure your injury is fairly assessed?
Outside of the context of statutory accident benefits, these same injuries will often entitle a plaintiff to higher damages in a tort claim stemming from a motor vehicle collision or other type of accident.
What benefits can I access if my injury is deemed catastrophic?
If you are determined to have a catastrophic impairment in your statutory accident benefits claim, the benefits available for medical and rehabilitation, attendant care, and housekeeping increases significantly - up to $1 million or more if you have purchased optional insurance coverage.
When is an injury considered catastrophic?
Catastrophic injuries involve severe, devastating loss of functioning that is life-altering. In the context of statutory accident benefits, the definition of “catastrophic impairment” are injuries that result in:
- Total loss of vision;
- Acquired brain injuries;
- Significant or extreme mental, neurological, and behavioural disorders;
- Traumatic brain injury;
- Spinal cord injury;
- Severe burns.
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