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Articles Posted in Catastrophic Accident (CAT)

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The July 1st Canada Day Long Weekend is fast approaching. People are excited to celebrate Canada Day.

Having practiced in the field of personal injury law in Ontario for over 2 decades, I can tell you that there are patterns for car accident cases.

Would it surprise you if I told that that our office sees a spike in car accident; and other accident related claims shortly after a long weekend? While I cannot single out the Canada Day Long Weekend in particular; what I can say is that we see a spike in accident calls shortly after a long weekend.

There are very good reasons for this.

For starters, many people are on the move over a long weekend. They are all out and about. Going on a trip, driving off to see friends, headed camping or to a beach to relax. Either way you slice it, more people are on the move over a long weekend, compared to a normal weekend.

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Car accidents happen. They are unpredictable and don’t discriminate based on age, gender, religion and socio-economic status. They happen to poor people, rich people, middle class people, retired people, disabled people and gainfully employed people. There isn’t any method to the selection of an accident victim. It’s completely random. Serious car accidents happen to good people who are simply in the wrong place, at the wrong time. They fall victim to fate, time and circumstance. Some accidents are avoidable. While others are not.

This Toronto Injury Lawyer Blog Post will tell the tale of Brian Goldfinger and the Catastrophic Car Accident.

The term “catastrophic” is a very important legal term when it comes to car accident law in the Province of Ontario. In plain English,catastrophic” is a word used to describe sudden and very serious damage; as having a very significant impact.

But at law, the term “catastrophic” means something different altogether. Under the SABS and in the Insurance Act, the term “catastrophic” is used as a definer to establish an accident victim’s injuries are very serious. Being deemed “catastrophic” by your car insurer means that your injuries have met a medico-legal definition. Once that definition is met, the catastrophic car accident victim is entitled to a wider variety, and an greater amount of benefits then another accident victim whose injuries have not been deemed catastrophic. For example, a catastrophic accident victim is entitled to case management services. A non-catastrophic accident victim is not. A catastrophic accident victim is entitled to a combined attendant care and med/rehab limit of $1,000,000 for treatment and services deemed to be both reasonable and necessary. The limits for a non-catastrophic car accident victim are either $3,500 under the Minor Injury Guideline; or $65,000 under the regular guidelines.

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After a serious motor vehicle accident, you will need a lot of help.

You will need help from doctors, nurses, personal support workers. occupational therapists, massage therapists, chiropractors, surgeons, internists, nutritionists, speech language pathologists, social workers, psychologists, psychiatrists, lawyers, accountants, friends, family and more!

Some of these services are FREE because they’re covered by OHIP.

But most services are not free and need to be paid for by an insurance company, or out of your own pocket. The cold hard truth is that most rehab services which don’t fall under the heading “doctor” are NOT covered by OHIP and cost a lot of money. If the insurance company won’t pay, or if you don’t have the means to pay for these services on your own; chances are you won’t get these much needed rehabilitation services.

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OCF-19 Catastrophic Claims

There are special legal connotations when injuries from a car accident are deemed to be “catastrophic“. This is a term of art; meaning the term “catastrophic” has a special legal meaning.

Catastrophic is defined under the insurance act as an injury which meets one of the following criteria:

  1. Paraplegia or Tetraplegia;
  2. Severe impairment of ambulatory mobility or use of an arm, or amputation;
  3. Loss of Vision of Both Eyes;
  4. Traumatic Brain Injury (applicant 18 years of age or older at the time of the accident);
  5. Traumatic Brain Injury (applicant under 18 years of age at the time of the accident);
  6. Physical Impairment or Combination of Physical Impairment which results in 55% or more of whole person (there are additional criteria which aren’t included in this instalment of the Toronto Injury Lawyer Blog);
  7. 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. (there are additional criteria which aren’t included in this instalment of the Toronto Injury Lawyer Blog); and/or
  8. 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 (there are additional criteria which aren’t included in this instalment of the Toronto Injury Lawyer Blog).

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Being involved in a motorcycle accident is very serious.

No bumpers. No airbags. No re-inforced steel or plastic to absorb the impact of a serious collision. Add to that the proximity to the hard road and the impact falling off the bike can have. A thousand and one other bad things can happen after a motorcycle accident.

The weight of the motorcycle landing on its driver or passenger.

Not having a seat belt to keep you in place which can lead to the driver or passenger going flying off the bike and landing who knows where.

Helmets work. But how much will a helmet protect its wearer when a collision takes place at high speed.

There is still a negative stigma against motorcylists in many communities. The preconceived notion that bikers are rebels with bad attitudes hasn’t gone away and can work against an innocent accident victim where liability is an issue. This is particularly important when the evidence of independent witnesses is important. This is also important when the police aren’t on the biker’s side in determining fault for the motorcycle accident.

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There are few moments in life where a person receives a million dollar lump sum of money. Here are but a few which come to mind.

A good investment.

Winning the lottery.

A very wealthy family member who left you a sizable inheritance.

Cashing in stock options which have appreciated over the years.

Sale of a real estate asset.

A successful personal injury claim.

In all of these scenarios, except for ONE; the money is yours to use as you please; notwithstanding applicable taxes.

The lone exception are the personal injury cases. There is fine print behind those million and multi million dollar settlements which we would like to share with you today.

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Winning a car accident case in Ontario is difficult.

It’s not enough to have been involved in a car accident, and that accident is not your fault.

A Plaintiff also has to establish injuries/damages. The Plaintiff must also establish that his/her damages are related to the subject car accident. This is called causation.

At the end of the day, these are called personal injury cases for a reason. There must be an injury, otherwise there will be no compensation.

What makes things particularly difficult in Ontario, is that regardless of fault, the injuries are subject to two giant legal hurdles meant to defeat the Plaintiff’s case and limits their recovery.

The first hurdle is the threshold. Your injuries need to defined as a serious and permanent impairment of an important bodily function. If the injuries are not permanent, then you get zero. If the injuries are not deemed serious, then you get zero. If the injury just lasted 8 months, and then you made a full or close to full recovery, the you get zero.

All of this seems unfair; and I agree with you if you feel this way.

The second hurdle is the deductible. The insurer is entitled to a secret credit on all damages for pain and suffering. The first $38,818.97 of your award vanishes! It’s credited directly to the insurer. Is that fair? No it’s not, but this is the laws that personal injury lawyers have to work with for car accident cases in Ontario.

What’s even more disturbing is that if it’s a jury trial, your personal injury lawyer cannot mention the concept of the threshold or deductible to the jury. If your personal injury lawyer mentions these concepts, the defendant insurer will likely move for a mistrial and seek their legal costs.

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People who have been very very very seriously hurt in a motor vehicle accident need to know the ins and outs of the OCF-19 Application for Determination of Catastrophic Impairment Form.

If your insurer deems your injuries to be “catastrophic” your benefits will skyrocket from $3,500 under the minor injury guideline, or $65,000 up to $1,000,000 or $2,000,000 (depending on when your accident took place). Not only does the dollar amount of your benefits skyrocket, but so does the duration, along with the types of benefits which are available to catastrophically injured accident victims, vs. non-catastrophically injured accident victims.

The first step to being deemed catastrophic is having your doctor or treating specialist complete the OCF-19 Application for Determination of Catastrophic Impairment Form.

Finding the form can be a bit tricky. It’s not a typical form that insurance companies include in the standard Accident Benefit Package which is sent to injured accident victims.

Your personal injury lawyer will know how to find the form. You can also find the form on the website of the Financial Services Commission of Ontario, link here. 

When printing off the OCF-19, make sure that you are printing off the right form.

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Goldfinger Injury Lawyers represents clients who have sustained catastrophic injuries as a result of a serious motor vehicle collision.

The term “catastrophic” isn’t thrown around lightly by personal injury lawyers.

The term “catastrophic” has special legal meaning under the Insurance Act. It would be defined as a term of art which carries with it a special medico legal definition.

Under the Insurance Act, a “catastrophic injury” is defined as:

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This is Part 1, of our 2 part series on getting to know your Rehab Team following a serious accident in Ontario. We have to do this feature in two parts on account of its length and we didn’t want to miss anybody. The second part will be released next week.

After a serious accident (car or otherwise), you will be exposed to a variety of medical and rehabilitation professionals. Some you will see in hospital or rehab facility. Some you will see at home. Others you will see at their office.

Either way, understand who these medical professionals are, and what their role is will help you better understand the rehabilitation process.

This installment of the Toronto Injury Lawyer Blog will introduce you to your rehabilitation team following a serious accident (catastrophic accident, brain injury, orthopaedic injury etc.).

The reality is that money is often the main driver of most anything in our society. These doctors and rehab professionals do not work for free. Some are paid through the OHIP system. Some are paid by a private health insurer. Some are paid directly by car insurers. Some get funded through crowd sourcing! Some will defer payment and get paid upon settlement. Understanding how these doctors and rehab professionals are financed will help innocent accident victims better understand some of the finer financial aspects of their case. Continue reading →

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