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Tips for Filling Out the OCF-19: Application for Determination of Catastrophic Impairment
After being involved in a motor vehicle accident, the last thing you will want to do is tackle a mountain of paperwork. Unfortunately, insurance companies do not always make it easy for the injured survivors of motor vehicle collisions to access the accident benefits they should be owed. The process of filing a claim for accident benefits can be overly bureaucratic, complicated, and confusing, especially for people who have sustained catastrophic injuries.
Sustaining a catastrophic injury can have profound consequences for an accident survivor’s life, as well as their livelihood. People whose injuries meet the threshold of catastrophic impairment often rely on the insurance coverage available to them as a vital source of income in the wake of a debilitating accident. That is why it is so important to ensure that all necessary insurance forms are completed thoroughly, accurately, and within the required time limitations.
Motor vehicle accident survivors who have sustained catastrophic impairments as the result of their collision are entitled to higher amounts of accident benefits than people whose injuries are less severe. In order to qualify for these higher benefits amounts, accident survivors whose medical conditions meet the defining criteria for catastrophic impairments must submit a completed OCF-19 form to their insurance provider. Once received, this Application for Determination of Catastrophic Impairment will be assessed by the insurance company who will then decide whether the claimant’s condition meets the threshold for catastrophic impairment.
Our Ontario accident benefits lawyers appreciate how confusing the process of applying for insurance coverage can be. Here are some tips for completing and submitting your OCF-19 form:
Tip #1: Assess Your Eligibility
Ontario’s Statutory Accident Benefits Schedule (SABS) applies several criteria to the definition of the term “catastrophic impairment.” In order to qualify for accident benefits commensurate with catastrophic injuries, you must meet at least one of the following criteria:
- Paraplegia or Tetraplegia
- Severe impairment of ambulatory mobility or use of an arm; or amputation
- Loss of Vision of Both Eyes
- Traumatic Brain Injury meeting the Glasgow Outcome Scale-Extended (GOS-E) criteria
- Physical Impairment or Combination of Physical Impairments (which results in 55% or more of whole person)
- Mental or Behavioural Impairment (excluding Traumatic Brain Injury) Combined with a Physical Impairment (which results in 55% or more impairment of the whole person)
- Marked impairment in three or more areas of function that precludes useful functioning; or an Extreme impairment in one or more areas of functioning due to mental or behavioural disorder
Tip #2: Consult with Your Physician
Applications for the determination of catastrophic impairments must be completed by a healthcare professional. Typically, the OCF-19 form is filled out almost entirely by an injured accident victim’s primary physician. If the patient is applying for a catastrophic impairment designation because of a traumatic brain injury (TBI), the OCF-19 form can be filled out by their primary neurologist or neuropsychologist.
Your physician should be familiar with your condition and qualified to opine on the severity of the injuries you sustained as a result of your collision. It is important to speak to them about your potential health outcomes and provide them with all necessary insurance forms in a timely manner so that you can begin planning for your future.
Tip #3: Understand the Benefits Available to You
The SABS outlines the amounts of accident benefits available to injured survivors of motor vehicle collisions. These amounts are based upon the severity of injuries sustained by individual claimants. The minimum amounts of coverage included in all basic auto insurance plans throughout Ontario are as follows:
- Minor injuries: $3,500 for medical and rehabilitation benefits.
- Non-minor, non-catastrophic injuries: $65,000 for combined medical, rehabilitation, and attendant care benefits over 5 years.
- Catastrophic injuries: $1 million for combined medical, rehabilitation, and attendant care benefits for life.
If you have purchased additional insurance coverage, you might be entitled to even higher amounts of accident benefits. To learn more about your individual policy and the benefits to which you might be entitled, consult with your insurance broker.
Tip #4: Speak to a Lawyer ASAP
For more than 60 years, our Ontario accident benefits lawyers have helped injured survivors of motor vehicle collisions get the compensation they deserve. By taking advantage of our legal advice and assistance, injured car accident victims can feel secure knowing that their insurance claims will be submitted thoroughly, accurately, and in the mandated time period. To learn more about how Preszler Injury Lawyers may be able to help you with your insurance claim, click here to contact us today.
