Following a motor vehicle collision in Ottawa or anywhere across Ontario, you may be eligible for Attendant Care Benefits through your automobile insurer’s Accident Benefits. What follows is a description of the current Attendant Care Benefits available in Ontario, as of June 1, 2016. If your collision occurred prior to this date, you would be subject to a different legislative regime.
Are You Eligible for Attendant Care Benefits?
Following a motor vehicle accident in Ontario, Attendant Care Benefits are available to you if you can prove two things:
- That your accident-related injuries are outside the Minor Injury Guideline: you must prove that you suffer from an impairment that is not predominantly a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and any clinically associated sequelae.
- That you have reasonable cause for requiring attendant care services: you must have a registered nurse or occupational therapist assess whether attendant care services are necessary and how much care is appropriate for your needs. This professional will complete an Assessment of Attendant Care Needs (otherwise known as Form 1) and submit it to your insurance provider for approval, prior to initiating the services.
What Do Attendant Care Benefits Cover?
These benefits can be used to pay for “reasonable and necessary” expenses incurred to hire someone to help you care for yourself after being injured in an accident. They cover professional services, such as in-home care from a personal aide or attendant and/or care in a long-term care facility. The benefits are designed to assist you with everyday living tasks that you can no longer perform yourself due to your injuries, such as:
- transfers
- bathing
- grooming
- dressing
- supervision
- preparing meals/eating
- using the restroom
- accompaniment to appointments/meetings
Attendant Care Benefits do not cover housekeeping or childcare.
Who Can Provide Attendant Care?
In order for Attendant Care Benefits to be paid, the person who provides the goods or services must do so in the course of his/her employment, occupation or profession in which he/she would ordinarily have been engaged, but for the accident or he/she must have sustained an economic loss as a result of providing the goods and services to you. This legislation has been crafted to eliminate claims for attendant care services provided by family members who are not normally employed in this type of occupation.
How Much Attendant Care Can You Get?
The maximum amount payable for Attendant Care Benefits depends on the severity and classification of your injuries. The limits are set out below:
Minor Injuries:
N/A
Non-Catastrophic:
Monthly Limit: $3,000 per month for up to 5 years or until the age of 28 if you were a minor at the time of the accident.
Total Limit: $65,000 for both Medical & Rehabilitation Benefits and Attendant Care Benefits (this is a combined amount).
Catastrophic:
Monthly Limit: $6,000 per month
Total Limit: $1,000,000 payable over your lifetime for both Medical & Rehabilitation Benefits and Attendant Care Benefits (this is a combined amount).
The figures listed above correspond with standard, mandatory Accident Benefits. You may have elected to pay a higher monthly premium for additional coverage. Examine your policy to determine if you qualify for higher coverage levels.
If you have been in a motor vehicle collision in Ontario, leaving you with injuries that require attendant care, please contact SG Injury Law and our Ottawa personal injury lawyers will help you navigate the complex accident benefit insurance and tort legal systems.