Catastrophic Impairment Designation Will Greatly Help Our Client
By Albert Conforzi | November 8, 2013
Toronto personal injury lawyer Albert Conforzi: I have been busy working on behalf of my clients and achieving some remarkable results.
One such result is the decision of DB and Economical Insurance which was released October 2nd by Arbitrator Judith Killoran of the Financial Services Commission of Ontario, following a lengthy arbitration held in May and June of this year. The appeal period has now expired and it is appropriate to discuss the case.
I teamed up with my colleagues Alex Voudouris and Susanne Young to deal with the complicated issues of Catastrophic Impairment. Our client – whom we’ll call DB – was a middle-aged woman who was involved in a terrible head-on motor vehicle accident. She suffered severe injuries, including a shattered leg below her knee. This injury required 5 surgeries. Her recovery was complicated by an infection that set into the fractures, which resulted in a permanent non-union of her lower leg just above the ankle joint.
We argued that our client, who weighed over 330 lbs, was wheelchair bound. This was supported by the evidence of medical experts and occupational therapists. The only people who doubted that she was unable to walk on her broken leg were Economical and their doctors.
It came to light under cross-examination that one of the examiners, a psychiatrist, was using non-peer reviewed tests as part of his examination.
Economical had its doctors assess the client. They concluded, in essence, that all the client required was to amputate her leg and she would be fine. They went on to assess her as an amputee, even though her leg was still attached, and even though the AMA Guides state that one is to be assessed as they are, not as they may become. After assessing her in this way, they gave our client a WPI rating for her leg of 20%, thus falling well short of being considered Catastrophically Impaired. The insurance doctors also minimized, and in some cases wholly ignored, the other injuries sustained by our client. This further denied her a finding of Catastrophic Impairment.
It came to light under cross-examination that one of the examiners, a psychiatrist, was using non-peer reviewed tests as part of his examination. He knew these tests to be unreliable. During his assessment of DB, this particular doctor had his secretary knock on the door to the assessment room. When our client – who was on opiates at the time, weighed in excess of 330 pounds and was wheelchair dependent – did not jump up at the sound of the knocking, the doctor concluded she was not suffering from posttraumatic stress disorder.
The Artbitrator justly saw things our way, and found DB to be catastrophically impaired on a number of different bases. This finding will allow her to advance a claim for support and services which she requires. These include up to $1 million in medical and rehabilitation benefits, an additional $1 million in attendant care benefits, and ongoing housekeeping and home maintenance benefits. The next phase of this matter will be to get the insurer to agree with our assessment of the financial support that will be required to take care of her for the rest of her life.
This is the second reported case in a little over a year where a Catastrophic Impairment designation has been obtained for our clients. This will help them get the help they need. It is always a team effort here at Pace Law Firm, where we put our clients’ best interests ahead of everything else.