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TORONTO INJURY LAWYER BLOG
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Earlier this week, the Kathleen Wynne Ontario Provincial government announced unilateral cuts to all of its fees which it pays to doctors. The cuts around around 2.65% across the board for services. Ontario doctors have been without a proper contract with the Government since March 31, 2014. Contract negotiations have broken down such that the Ontario Medical Association (OMA) refuses to accept the provinces proposals; and the province refuses to give in to the OMA’s demands.

In addition to the 2.65% cut to all OHIP plan fees, the province will eliminate funding to doctors to take continuing medical education courses; will reduce the fees for walk-in visits by $1.70 to bring it in line with with the fee for regular visits to a family doctor; eliminate the premium for doctors to accept new patients who are healthy; and eliminate the number of family doctors in well-serviced areas who can join family health teams where doctors are paid by the number of patients they enroll (not fee for service).

10% of Ontario Provincial budget is devoted towards healthcare. Of that 10%; 25% is devoted towards paying doctors. I would be ok if that budget were higher on both ends, but that’s me. Now you know where I stand.

Are doctors happy with these unilateral terms imposed by the government? I haven’t spoken with a single doctor OR patient who has welcomed these changes.

Will doctors strike? No. But the reprecussions will be felt across the provincial health care system. More on that later.

How much does the Province predict they will save by these cuts and changes? Another good question. In fact, that question was so good, that Minister of Health, Dr. Eric Hoskins dodged the question when it was asked to him.

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Labour Day has come and gone. You can kiss the summer and wearing those light white beach side pants goodbye.

With the passing of Labour Day comes the arrival of the back to school season. The roads are noticeably busier across Ontario. I can tell you from experience that the morning commutes in Toronto, London, Kitchener-Waterloo and Peterborough take longer and are noticeably more congested.

Back to school brings more school buses on the roads, along with more children walking or cycling to school. This added traffic brings with it increased risk for serious accidents and serious injury. This is why this edition of the Toronto Injury Lawyer Blog will focus on the top safety tips for the Back To School Season Commute. Some obvious tips; others not so obvious. Enjoy!

  1. Signage: Those “School Zone” and “Community Safety Zone” signs really mean something. They have been installed for a reason after long road studies and traffic observations; so watch your speed and watch out for pedestrians and cyclists on their morning commutes.
  2. Stop Signs on Buses matter: School buses come equipped with their very own stop signs. They are attached to an extendable arm at the side of the bus and activate on pick ups and drop offs. These stop signs aren’t gimmicks. They have the very same force as those signs which are fixed in place on community streets.It is illegal to fail to stop for a stopped school bus that has its red lights flashing. If you don’t stop, you can be fined $400 to $2,000 and get six demerit points for a first offence. If you are convicted a second time within five years, the penalty is a fine of $1,000 to $4,000 and six demerit points. You could also go to jail for up to six months. In Ontario, school-bus drivers and other witnesses can report vehicles that have illegally passed a school bus. If you are the vehicle’s registered owner, these same fines, but not demerit points or jail time, may be applied to you.Watch for school buses near railway crossings. All school buses must stop at all railway crossings. The upper alternating red lights are not used for these stops, so be alert. If you are driving behind a stopped school bus with its flashing light extending, the Ministry of Transportation requires that you stop at least 20 meters BEHIND the stopped bus. 
  3. Use the Buddy System: If your child walks or bikes to school, it’ s a good idea for road safety and just for general safety that they not make the commute on their own. Find a friend or a commute buddy so that they can make the trip together and in proper safety. G-d forbid something should happen or they go missing. The buddy system will ensure a faster notice period should something wrong on the commute to/from school. It’s easy and just makes sense.

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One of the hardest things for people to understand in Ontario is how our No Fault system of car insurance works.

Ask 10 drivers how their no fault accident benefits work, or how no fault car insurance works, you’ll get 10 different answers. All of them will likely be wrong. Ask 10 lawyers who don’t practice in the field of persona injury law, you’ll probably get the same wrong answers! Even funnier is if you ask 10 different politicians, the ones who actually passed the laws to create no fault accident benefit insurance in Ontario, and they won’t know either.

The only people who truly know how no fault insurance and accident benefits work are personal injury lawyers, insurance defence lawyers, people who work for insurance companies and those service providers who routinely bill insurers through IEs or through OCF claim forms.

What people have a hard time understanding, is that after an accident involving the “use or operation of a motor vehicle” , they will have TWO SEPARATE CLAIMS. The first claim is the claim for no fault accident benefits. These claims are guaranteed provided there are no policy breach issues. This first accident benefit claim is against your OWN INSURER, regardless of fault. If you didn’t have car insurance at the time of the accident, then there are loss transfer provisions under the Insurance Act which create a duty to defend or respond to the claim from another insurer, or, in the last case scenario, from the Ontario Motor Vehicle Accident Claims Fund. These accident benefits will cover such things as medical/rehab benefits, attendant care benefits, non earner benefits, income replacement benefits and out of pocket expenses related to the car accident. Accident Benefits do NOT cover pain and suffering.

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There are two schools of thought when it comes to fibromyalgia.

Some doctors believe it exists, and it’s a very real illness/disabling condition.

Other doctors don’t believe it exists, and that it’s all in your head.

Insurance companies and their lawyers, tend to side with the latter. Personal injury lawyers and their clients tend to side with the former.

In any event, fibromyalgia is one of the most difficult disabling conditions for a lawyer to prove. Next to a minor brain injury which doesn’t show up on any type of x-ray, scan or MRI, it’s right up there.  It’s also one of the most difficult disabilities for somebody to explain to another person. You look fine. You don’t have any visible breaks, abrasions or wounds. So, what could possibly be wrong?

Some of the most common things our lawyers hear things from clients are complaints such as:

  • It’s hurts all over
  • I have really bad headaches
  • I’m tired all the time
  • I can’t think properly, I can’t concentrate, I can’t read, I can’t remember things, My mind is like mush
  • I’m sad
  • I cry for no reason or really easily
  • I have problems sleeping at night
  • I have little motivation to do things
  • The pills I take don’t work and make me drowsy
  • I keep to myself and don’t socialize as much anymore
  • Nobody understands what I’m going through

YOU’RE NOT ALONE!!!!  These complaints are very common.

Our law firm has helped countless fibromyalgia sufferers over the years get the compensation and medical support they deserve. We understand that communicating things which can’t be seen on any x-ray scan or MRI are difficult to explain to a lay person, friends or a family member. What’s most important is having the right legal team set up your claim properly from day #1 so that your case is set up to win.

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Uber is a really cool service. Using an App, you can get essentially get a taxi fare for a fraction of the price, with less wait time as well. The App tells you exactly what distance you’ve traveled, and how much the fare cost. The fare cost is then debited directly from your credit card to pay the driver. You can chose to tip the driver if you wish. You can also leave comments or ratings about that Uber experience and that particular driver. If one driver or vehicle has too many negative comments, then the driver won’t be allowed to use to service to provide others with rides. I must admit that all of the lawyers and staff here at Goldfinger Law love Uber and the service which it provides.

For your ordinary person looking to make a few extra dollars on the side driving people around; Uber is a blessing. Especially for those people who don’t have enough money to afford an expensive taxi license.

For those taxi drivers who have toiled with the long hard house and the red tape with respect to taxi licensing, Uber is undercutting their business. They aren’t following the same rules which apply to your ordinary taxi driver.

City Hall in Toronto has yet to sort out the details of how Uber will work on a go forward basis. Some cities have essentially regulated Uber and other ride sharing services. In Vancouver, you can’t use a ride sharing service like Uber for a fare which costs under $75. This has essentially killed Uber’s business out there where the fares tend to be short and fast ones.

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After you’ve been involved in a car accident, there are A LOT of forms to complete for the insurance company in order for you to start recovering benefits.

It’s not simple. You have to jump through a lot of hoops. The process can be long, tedious and very frustrating.

Why don’t they just make the process simple? I have no idea. The forms are created by the government, but are heavily influenced by the lobbying efforts of large insurance companies. So, the forms, along with the questions in the forms are skewed from the outset to create a bias against innocent accident victims and in favour of large, deep pocked insurance companies.

If English isn’t your first language, or you have problems completing paper work; or you have sustained a brain injury in the accident, then completing these forms will be particularly difficult. Get a lawyer to help you out.

The purpose of this Toronto Injury Lawyer Blog Post is to assist you in completing the somewhat tricky OCF-3 Disability Certificate follow a car accident.

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This Civic Holiday was a time to relax, enjoy time spent with the family, along with some nice weather….For most.

For insurers and the Ontario Government, it was a time to reign in some new changes to the Insurance Act which were swept under the rug. Unbeknownst to Ontario drivers, the value of the pain and suffering and their injuries following a serious car accident claim have been diminished yet again at the behest of large, deep pocketed insurance companies.

So; what are these changes of which I speak?

Many of you may not know this, but there is a deductible for pain and suffering claims (tort) following a car accident.

Back in the 1970’s there was no such deductible. This meant that you could sue, and recover compensation at law for large injuries and for smaller ones. If the accident wasn’t your fault, and you got injured, chances are you would be able to recover some form of compensation for your pain and suffering.

After the introduction of no fault insurance in Ontario, a deductible and a threshold were both introduced in order to limit the recovery of accident victims in the guise of saving insurers money on claims. The hope was that fewer claims would be advanced, thereby reducing the expenses for insurers. Those savings were supposed to be passed along to the consumer in the form of lower car insurance rates. That deductible has soared from $10,000; to $15,000; to $30,000.

So what’s the significance of the August 1, 2015 date?

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Here’s a call NOBODY likes to get:

This is the Social Worker from your local hospital. Your spouse has been involved in a serious car accident. They’re here in the Critical Care Unit. Their condition is stable, but you should come to the hospital right away“.

Your heart will skip a beat or two; and rightfully so. This is something you would never expect or want to happen. Millions of questions, concerns and grim scenarios are likely rushing through you head.

This first thing to do of course is to get to the hospital to be next to your spouse/loved one. Soon after the situation will stabilize and the next steps are very important. Here are some of Goldfinger Personal Injury Law’s tips on what to do if your spouse or loved one is in the hospital with a serious injury.

1. You should know that if anyone contacts you from any insurance company, you are under no obligation to speak with them. Chances are that if an insurance company has heard about this accident, they will want to get some information right away. Naturally, people want to be helpful and share information with the insurer. But, often times, the information which you are providing to an insurer without the assistance of a lawyer can damage your case right from the get go. Insurers won’t stop calling. It’s their job. I’ve actually seen adjusters arrive at an injured party’s bedside while they are medicated in a hospital bed and get them to sign forms and take a statement from them. This is all done under the guise of “information gathering”, but the reality is that they are slowly building their case at limiting their potential exposure and liability. Don’t speak with an insurer without a lawyer. You don’t have to take their calls if you don’t want to. It’s that simple.

2. Co-operate with the police. The police, much like insurers have fact gathering missions. But unlike insurers, the fact gathering missions of the police serve a much different purpose. If you’re more comfortable dealing with the police with a lawyer; then by all means, seek one out. But if the accident wasn’t your fault, then you should have nothing to hide. The police will want to bust the wrong doer just as bad as you for their negligence or bad decisions. It’s beneficial to your case to co-operate with the police as best you can.

3. Follow your doctor’s recommendations: if the doctor recommends that you stay in hospital an extra day, or get discharged to a long term care facility; then do so. Even if all you want to do is go home; or you have no interest in going to a long term care facility; the doctor knows best. Follow their advice so you can get better. It’s never good for a case, or for your health for that matter if you fail to follow a doctor’s orders. Particularly after a bad car accident.

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Sometimes, the Toronto Injury Lawyer Blog examines recent cases that we think our readership will enjoy. We do our best not to make the legal analysis too technical, because that just turns in to a snooze fest. We want to keep things light, upbeat and easy/enjoyable to read. The law can be very dry and we don’t want our blog to become a bore.

Reading the Ontario Reports this week, we came across an interesting Long Term Disability Benefits decision involving a disability claimant, Ms. Garneau; and her LTD insurer, Industrial Alliance.

The decision was taken to Ontario’s Highest Court, (just shy of the Supreme Court of Canada); to the Ontario Court of Appeal on Queen St. in Toronto.

The decision appeal decision of Garneau v. Industrial Alliance Insurance and Financial Servics Inc. 2015, ONCA 234 can be read here. The motion for a reduction in set offs at the Superior Court level can be read here. The initial decision which was being appealed can be read here.

What makes this case so interesting for our law firm? Read on and we will share with you.

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When injured accident victims think about damages, they often think of those valuations in very linear terms; as if they’re on a straight line.

Broken knee? $100,000 plus $150,000 loss of income = $250,000

Fractured wrist? $50,000 plus $25,000 loss of income = $75,000

These are very simple mathematical equations. The problem is these equations are too simple and don’t take in to consideration the whole story.

What accident victims don’t know is that often insurer are entitled to credits or set offs when calculating damages to make sure that the Plaintiff is not over paid for their injuries.

There are many examples when an insurance company is entitled to a set off. What is a set off?

Essentially, it’s a credit in favour of the insurance company. Take the example of a person who was involved in a catastrophic car accident. Prior to the car accident, they were earning $40,000/year. They will never be able to work again on account of a traumatic brain injury.

They are receiving an income replacement benefit in the amount of $400/week from their accident benefit insurer. The total amount of income replacement benefits equal $20,800/year.

If the tort insurer pays 100% of the $40,000 income loss; then the accident victim ends up with $60,800/year ($40,000 + $20,800). That would mean that the accident victim is in a better income position post accident than pre-accident. While this is great to see; unfortunately, this is NOT how the law or the Insurance Act works. In this example, the tort insurer is entitled to a credit; commonly known as a “set off” to make sure this type of over payment doesn’t happen. That set off would be for $20,800 for the income replacement benefits already paid out. Therefore, in order to make the accident victim whole, the tort insurer will pay the difference, that being $40,000-$20,800 = $19,200.

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