The term “catastrophic injury” is not merely an adjectival or descriptive phrase. It has a definite medical and legal connotation and has implications for the injured person, their families and the compensation outcomes that they can expect.
The definition of “catastrophic” with reference to injuries sustained in an accident is a dynamic one that has undergone several changes over the years. The Financial Services Commission of Ontario (FSCO) has recently undertaken to redefine the definition of “catastrophic impairment” and the amendments have become applicable from June 1, 2016.
The earlier use of this term was to describe amputation or other impairment causing total or permanent loss of use of both arms or both legs or both arms and/or one leg. The definition also refers to brain impairment. It specified that assessments must be carried out by a physician and/or neuro-physician (in case of brain impairment).
Another definition is based on the outcomes associated with such injuries:
2. Those causing permanent severe functional disability
3. Those causing severe head or neck trauma with no permanent disability.
Such outcomes may also occur indirectly, due to systemic failure caused by certain conditions or injuries.
Importance for Accident Victims
The term has special significance for victims injured in automobile accidents. To meet the definition in accident cases, a licensed doctor must complete and submit form OCF-19 which is the Application for Determination of Catastrophic Impairment.
The problem is that many doctors are unfamiliar with the legal aspects of filling the form and may be uncomfortable with the language and terminology used in it. The tests prescribed to evaluate the injuries may also be outside their realm of experience and knowledge. Some of the tests include:
- ASIA Impairment Scale
- Spinal Cord Independence Measure
- Evaluation of urological and anorectal functions
- Evaluation of ambulatory mobility and effects of amputation
- Visual impairment assessment
- Glasgow Outcome Scale for Traumatic Brain Injury evaluation
- King’s Outcome Scale for Childhood Head Injury for victims less than 18
and several other such assessments.
In fact, it takes a multi-disciplinary team to fully assess the level of impairment and submit a consolidated report. This report has to meet the Statutory Accident Benefits Scheme (SABS) requirements for the injured person to qualify for statutory benefits in Ontario.
Impact and Outcomes
Following the new revisions in the definition and use of the term, an expert panel made certain amendments including:
Using modern evaluation scales like the American Spinal Injury Classification, Extended Glasgow Outcome Scale, Global Assessment Functioning etc.
Consulting current editions of relevant journals
Stopping the combining of physical and psychiatric impairments
Introduction of new designation: “Interim catastrophic impairment.”
The legal community is concerned about whether such amendments could actually set the clock back in terms of the understanding of the term and its application to a broad range of conditions. They may find it difficult to service their clients in the light of these new revisions to the definition of “catastrophic injury.”
Unfortunately, both insurers and lawyers have to spend large amounts on testing/assessment. For the victim, the wait can be frustrating and alarming.
An experienced accident lawyer with expertise in handling catastrophic injury claims can best advise and assist you.