Injury Claims

How Do I Determine Injury Severity?

Justin Macfayden, JD
Law and Claims Analyst

When you are injured and seeking compensation for your injuries, understanding how the severity of your injuries will affect your compensation is important. Each province, and each insurer may have a different legal classification of your injuries; the Statutory Accident Benefits Schedule in Ontario or Accident Benefits in British Columbia for example. Because we help create assessments in each Canadian province (except Quebec), we use a standard 5 stage system for determining the severity of your injuries with 1 being the lowest severity and 5 being the high severity.  

  1. Mostly recovered, short lived or minor impact
  1. Partially Recovered, Lasting but not severe Impact
  1. Little to no recovery, lasting with moderate impact
  1. No Recovery, permanent with high impact
  1. No Recovery, permanent with catastrophic impact

This PainWorth severity scale, used for every injury, measures the impact of each injury on your life, and this will determine the amount of "pain and suffering" damages included in your assessment.  

How does injury severity affect my recovery amount?  

Generally, the more severe your injuries, the higher your financial recovery should be. That said, your ultimate award amount can vary greatly due to a variety of other factors. Injury severity is important to determine for each of the injuries you suffer, including psychological or mental injuries.  

Whether your injury is considered minor or catastrophic under the law will determine how much are owed by the responsible insurance company, or a court of law. In many provinces there are minor injury caps, meaning that if your injury is considered minor under the legal definition, your recovery cannot exceed a certain number. When you fill out your Painworth assessment, these caps are automatically calculated and applied to your claim based on your injuries.  

What makes an injury “minor”?

The definition of a “minor injury” varies from province to province, but generally a minor injury is a physical or mental injury that does not result in a serious impairment or a permanent serious disfigurement of the claimant.

Examples of minor injuries

Some examples of minor injuries include:

  • Abrasions
  • Contusions
  • Lacerations
  • Sprain
  • Strain
  • Minor pain
  • Temporary psychological conditions
  • Concussion (not resulting in incapacity)
  • TMJ disorder.  

If you have one of these injuries and it does not result in permanent serious disfigurement or serious impairment, then you likely have a minor injury.  

Serious impairment/ permanent disfigurement exceptions

If you suffer one of the injuries listed above, but it has resulted in serious impairment or permanent disfigurement, then your injury is not considered minor, and your damages can exceed the minor injury cap.

A “permanent serious disfigurement” is permanent disfigurement that significantly detracts from the claimant’s physical appearance and a “Serious impairment” means a physical or mental impairment that is:

  • Not resolved within 12 months (or another prescribed period - possibly 6 months) AND  
  • The impairment prevents you from performing the essential tasks of regular employment, occupation, profession, training, or education, despite reasonable efforts to accommodate, or activities of daily living; AND
  • The impairment is primarily caused by the accident and has been ongoing since the accident; AND  
  • The impairment is not expected to substantially improve.

What makes an injury “catastrophic”?

Like minor injuries, the definition of a “Catastrophic injury” varies from province to province, but generally a catastrophic injury is a severe injury to the brain, spine or spinal cord, skull or spinal column resulting directly or indirectly from violent trauma in an accident.  

Examples of catastrophic injuries  

Examples of catastrophic injuries include:

  • Paraplegia or tetraplegia
  • Quadriplegia
  • Traumatic brain injury
  • Blindness or a loss of vision of both eyes
  • Amputation or severe impairment of the ability to move or use one arm or to walk independently
  • Physical impairment or a combination of physical impairment that results in 55 percent whole person impairment
  • Severe mental/behavioral disorder in three or more areas of function (or extreme impairment due to a mental or behavioural disorder)
  • Permanent loss of the ability to walk independently

Note that, for brain injuries, a catastrophic injury is different for children than adults. This is because a brain injury in children may not be immediately noticeable.

Mitigation

Whether your injury is minor or catastrophic, you are required to mitigate your damages to be compensated. Mitigating your damages means seeking medical help when it is reasonably necessary, and not letting your injuries get worse due to your own neglect. Seeking medical help and quickly attending to your injuries as you become aware of them will    

Different Provinces have their own definitions of what is considered minor or catastrophic, so be sure to check your local regulations. While this seems complicated, PainWorth makes it easy. You only need to tell us which injuries you suffered, pick a severity for each injury, and we do the rest.

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