Catastrophic impairment definition should not include combined physical and psychological conditions
The expert panel appointed by the Financial Services Commission of Ontario to define “catastrophic impairment” says that combining physical and mental/behavioural conditions cannot be achieved in a valid and reliable way with the currently available methods of impairment crossrating.
The panel agreed that a catastrophic impairment is an extremely serious impairment or combination of impairments that is expected to be permanent and which severely impacts an individual’s ability to function independently.
The panel said that overall, catastrophic impairment is not a medical entity; rather, it is a legal entity which defines a point along the medical spectrum of impairment severity.
In assessing impairments that involve both a physical and mental/behavoural aspect, the panel said it could not find sufficient evidence that these combined impairment ratings are more clinically meaningful than using separate criteria.
“While 55% physical impairment establishes paraplegia as a prime example of catastrophic impairment, we did not find evidence for an equivalent threshold when physical and mental/behavioral impairments are combined,” the report says.
“The Panel had difficulty understanding how combinations of physical impairments and psychological conditions that independently do not meet the criteria outlined in the revised version of 2(e) and 2(f) could be equated to a severe injury to the brain or, spinal cord or to blindness. Further investigation of this area is needed. Specifically defining a clinically comparable combined psycho-physical whole person impairment threshold that corresponds to the currently accepted physical threshold is needed.”
The panel concluded that until there is more scientific evidence, it recommends that separate criteria and methods of evaluation be used for the determination of catastrophic impairment and that physical and psychiatric impairments not be combined for the purpose of catastrophic determination.
The panel discussed the meaning of “catastrophic impairment” as part of the province’s auto insurance reform review. It has just released its draft report, which can be viewed in full on the FSCO website (PDF). Comments can be submitted to FSCO by May 13. There are three options for submitting your comments:
- Send an e-mail to expertpanel@fsco.gov.on.ca and include “Catastrophic Impairment Report I Consultation” in your e-mail’s subject line.
- Mail your comments to the following address:Sivan Raz
Senior Policy Analyst
Auto Insurance Policy Unit
Financial Services Commission of Ontario
5160 Yonge Street Box 85
Toronto ON M2N 6L9 - Send a fax to (416) 590-7265 and include “Catastrophic Impairment Report I Consultation” in your fax’s subject line.
