When a loved one suffers a brain injury, it can be an overwhelming experience. The effects of a brain injury can profoundly change the lives of the injured person and their family, and you may find yourself asking whether your loved one is entitled to any financial compensation. The short answer is, yes.
In Ontario, there are a few different options for seeking financial compensation when a person suffers a brain injury as a result of an accident.
STATUTORY ACCIDENT BENEFITS SCHEDULE (SABS)
If your relative's brain injury resulted from a motor vehicle accident, whether as a driver, a passenger, a cyclist, or a pedestrian, they are entitled to accident benefits under the Statutory Accident Benefits Schedule (SABS).
These benefits are provided under Ontario's no-fault automobile insurance system, which means that individuals can access these benefits regardless of who caused the accident.
Accident benefits under the SABS can cover medical expenses, rehabilitation costs, attendant care, income replacement, and other related expenses.
The SABS has three different categories of injury designations, each of which provides varying amounts of financial compensation:
- Minor Injury Guidelines,
- Non-Catastrophic, and
- Catastrophic.
If your relative's brain injury is considered “catastrophic” — the most serious class of injury — they may be eligible for enhanced benefits, including higher limits for medical and rehabilitation expenses.
It is important to review the specific terms and conditions of the insurance policy to understand the available entitlements, which may be more than what is provided with the minimum required coverage.
CIVIL LAWSUIT (TORT CLAIM)
If your relative's brain injury was caused by another person's negligence, whether in a motor vehicle accident or in some other way, your relative may be able to commence a lawsuit against that person. Family members may also be able to claim compensation for their relative's injuries at the same time.
You should speak with a personal injury lawyer to help you decide whether you have a case and to guide you through the litigation process.
LONG-TERM DISABILITY BENEFITS
If your relative has long-term disability insurance — such as through their employer — they may be eligible for benefits to cover a portion of their income if their brain injury prevents them from working.
It is important to review the terms of the policy carefully, as some policies provide coverage where the injured person cannot work at all, while others cover situations where the injured person cannot work at their specific job.
WORKPLACE SAFETY AND INSURANCE BOARD (WSIB) BENEFITS
If your relative's injury happened while they were at work, they may be able to make a claim for benefits under the Workplace Safety and Insurance Board (WSIB).
If their claim is accepted, they may be eligible for wage-loss benefits, medical coverage, and other supports to help them get back to work.
It is important to review your relative's employment contract because WSIB coverage does not apply to all types of work and not all employers are required to carry it.
It is also important to understand that your relative may not be allowed to bring a lawsuit for their injuries if they pursue a WSIB claim.
GOVERNMENT PROGRAMS OTHER THAN WSIB
Your relative may also be eligible for government support programs such as Ontario Disability Benefits Program (ODSP) or Canada Pension Plan Disability Benefits (CPP-D). These benefits can provide financial assistance to individuals who meet certain criteria and are unable to work due to a disability.
In order to see if your relative qualifies for these programs, you can visit their respective websites or consult an injury lawyer who can help guide you through the process.
Even if you think you cannot afford legal advice, options for advice may be available to you and it is worthwhile contacting an experienced injury lawyer.
CONCLUSION
There are several options for seeking compensation after a person is injured, but variations in eligibility, benefits, and application processes can be difficult to navigate.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.