New FSCO Panel report on Catastrophic Impairment.

April 17, 2011, Kitchener, Ontario

Posted by: Robert Deutschmann, Personal Injury Lawyer


The Catastrophic Impairment Expert Panel to the Superintendent of FSCO has just released its report entitled Recommendations for Changes to the Definition of Catastrophic Impairment. The report provides for a significant change in the definition and assessment of Catastrophic Impairment under automotive insurance legislation.
Click here for the link to the full report.
Some noted aspects of the report include:
1.       Eliminating the use of the Glasgow Coma Scale because of its questionable ability to predict long term outcomes.   The panel recommends the use of the Extended Glasgow Outcome Scale (GOS-E) for the determination of catastrophic impairment secondary to brain injury.
2.       Introduction of an Interim catastrophic impairment classification to permit those with traumatic head injury to obtain access to substantial rehabilitation to maximize recovery in the period following the accident.
3.       Separate definitions needed to determine the presence of catastrophic impairment related to the upper limb versus the lower limb. The AMA guidelines should continue to be used for the assessment of upper extremity impairment. With respect to lower limb mobility, the report recommends trans-tibial or higher amputation of one limb; or severe and permanent alteration of prior structure and function involving one or both lower limbs resulting in a period of in-patient rehabilitation and the injured person will have a permanent inability to walk independently requiring bilateral ambulatory assistive devices.
4.       Paraplegia / Tetraplegia.  Application of the American Spinal Injury Association (ASIA) for the determination of catastrophic impairment secondary to spinal cord injuries. As noted, “The ability of the ASIA system to predict the ambulatory capacity of patients with spinal cord injuries provides a useful system for tracking the evolution of these injuries in the first year after the trauma.”
5.       Recommendation for the creation of an Expert Pediatric Working Group. The panel clearly struggled in this area, particularly with traumatic brain injury in children given that the final outcome may not become apparent of years or even decades after injury. 
6.       Interim catastrophic impairment status for individuals who meet the 55% whole person impairment threshold (physical injuries) 3 months or more after the accident. Accurate determination of final outcome should not be made before two years. The Interim classification permits access to health and rehabilitation resources necessary to assist with recovery without delay.
7.       The panel agreed that physical and mental or behavioural impairments could not be combined in any consistent manner using the AMA Guides 4th edition. With the exception of traumatic brain injury impairments, mental and/or behavioural impairments are excluded from the rating of physical impairments.
Posted under Accident Benefit News, Amputation and Disfigurement, Brain Injury, Car Accidents, Catastrophic Injury, Paraplegia, Spinal Cord Injury, Treatment

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