What Is Considered A Catastrophic Impairment?

Under the revised provisions of the Statutory Accident Benefits Schedule after June 1, 2016, some changes have occurred with regard to the classification of “catastrophic impairment”.

What is catastrophic impairment (CAT)?

In short, catastrophic impairment covers exceptional cases of grave and serious injury to claimants and helps ensure that they are adequately covered under their insurance policy. Qualifying for a CAT classification can mean a large difference in the quantum of insurance damages available and awarded.

SABS Section 3.1(1) describes an impairment of catastrophic where the following occurs:

1. Paraplegia or tetraplegia.
2. Amputation or severe impairment of ambulatory mobility.
3. Loss of vision.
4. Traumatic brain injury.
5. 55% whole person impairment.
6. 55% whole person impairment (physical and mental or behavioural impairments combined).
7. Class 4 marked impairment in three or more areas of function that preclude useful functioning or class 5 extreme impairment in one or more areas of function that precludes useful functioning, due to mental or behavioural disorder.

The assessment of this section is a primarily medical one. The statutory language now sets out specific medical tests that must be met in order to qualify under the new revised definition of a “catastrophic impairment”. Furthermore, there are several case law examples of how the courts and tribunals have interpreted these medical judgements. We highly recommend speaking with legal professionals such as Grillo Law, as we understand the case law and have well established relationships with designated catastrophic assessment medical experts who can work in tandem to help you understand where your injuries may fall on the assessment scale to help you prove your case.

What does this mean for me?

If you or a loved one falls under the CAT designation, the scope of damages awarded could be significantly greater than a non- catastrophic injury. Subject to the changes after June 1, 2016, for example, your medical and rehabilitation benefits could be up to $1,000,000 versus a non- CAT maximum of $65,000. Monthly attendant care benefits for a catastrophic impairment are $6000 versus $3000 for a non- CAT injury. Additional benefits under transportation, home maintenance, and caregiver benefits are also available for catastrophic injuries exclusively.

We here at Grillo Law will work with your insurers and treatment providers to ensure that anyone with severe injuries receive the best level of treatment that can be afforded to them. If you feel that your injuries or that of a loved one are severe and catastrophic, do not hesitate to contact us.