Catastrophic SABS Amendments: How Catastrophic Are They?

On June 1, 2016, significant changes to the Statutory Accident Benefits Schedule (SABS) came into effect.

These changes include:

1. Cutting the combined limit for attendant care benefits and medical rehabilitation benefits from $2,000,000.00 to $1,000,000.00;
2. Cutting off non-earner benefits after 2 years;
3. Eliminating the GCS criterion for catastrophic impairment;
4. The introduction of diagnostic imaging and the Glasgow Outcome Scale Extended (GOSE) as a CAT criterion;
5. Requiring a marked impairment in 3 domains (rather than 1) to qualify as catastrophic under Chapter 14 of the AMA Guides; and,
6. New “Kid-CAT” criteria for brain injury victims under the age of 18.

This paper will seek to explain these changes in detail, as well as provide strategies and coping mechanisms for health care workers who will face a host of new challenges as a result of these amendments.

Before delving into the ramifications of the legislative amendments, it is worth taking a moment to consider the cause of these changes. These drastic cuts were brought about at the behest of the Insurance Bureau of Canada (arguably the most powerful lobby group in Ontario). Somehow, the Insurance Bureau of Canada convinced our self-styled “social justice Premier” that Ontarians with catastrophic brain injuries should have their med/rehab benefits slashed in half. Moreover, the Premier decided to cut these benefits without holding a single meaningful consultation with brain injury survivors, their treatment providers or their lawyers. It is imperative, that those who are concerned for the well-being of Ontarians living with brain injuries, speak up to ensure that in the future, their voices are heard.

View full paper: Catastrophic SABS Amendments: How Catastrophic Are They?

Appendix A: New CAT definition as found in the revised SABS

Appendix B: Statutory Accident Benefits Schedule Summary Chart

Appendix C: GOSE Structured Interview

Appendix D: Complete List of Ontario Association of Children’s Rehabilitation Services Facilities in Ontario

Lawyers David Payne & Adam Tanel from @thomsonrogers at BIA #Niagara Conference #TRspeaks Presentation material: https://t.co/ER3hS0Pduo pic.twitter.com/Nsm8lZ7O1Z

— Thomson Rogers Lawyers (@thomsonrogers) October 27, 2016