Ontario’s SABS Failing to Support Seriously Injured Victims
Ontario’s Statutory Accident Benefits Schedule (SABS) was designed to provide financial support and benefits to individuals injured in motor vehicle accidents, regardless of fault. However, the current structure of SABS often leaves those with serious or catastrophic injuries without sufficient coverage to support their recovery and ongoing needs.
Structure and Limits of SABS Benefits
SABS divides accident victims into three categories based on the severity of injury:
- Minor Injury Guideline (MIG): Covers minor injuries such as sprains and whiplash, with a maximum medical and rehabilitation benefit limit of $3,500.
- Non-Catastrophic Injuries: For injuries not considered minor but not catastrophic, the combined limit for medical, rehabilitation, and attendant care benefits is $65,000, available up to five years post-accident.
- Catastrophic Injuries: These are severe injuries, such as brain or spinal cord injuries, with benefit limits higher than non-catastrophic claims, but recent reforms have reduced the available combined funding and narrowed eligibility criteria.
In addition to these categories, SABS may offer income replacement benefits if the injured party cannot return to work, non-earner benefits for those who weren’t employed at the time but can no longer live a normal life, and attendant care benefits for those requiring daily assistance due to their injuries.
Challenges for Seriously Injured Victims
Recent reforms to SABS have reduced the maximum available benefits significantly. For example, the combined limit for medical, rehabilitation, and attendant care for catastrophic cases is now lower than in previous years, which often proves insufficient for long-term, serious injuries requiring ongoing care.
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Impact on Access to Other Social Support Programs
For those whose injuries result in long-term disability, programs like the Ontario Disability Support Program (ODSP) may be available. Recent changes mean that if an accident victim receives a personal injury settlement for pain and suffering, there is no longer a $100,000 exemption cap for ODSP eligibility. All pain and suffering awards are now fully exempt from income and asset calculations, allowing injured individuals to access ODSP without their settlement disqualifying them.
While this is a positive change, ODSP itself offers limited financial support, usually covering only basic living expenses, which does not compensate for the shortfall created when SABS benefits are insufficient for long-term, high-cost care. Many accident victims are thus forced to use lawsuit settlements or personal funds to pay for ongoing medical and support needs.
Conclusion
The recent changes to ODSP eligibility have eased some financial pressures on accident victims by exempting all pain and suffering awards from income and asset calculations. However, ODSP’s limited benefits often fall short of covering long-term care costs, forcing many to rely on settlements or personal funds. Navigating these complexities requires careful planning and professional advice to ensure adequate support.
Frequently Asked Questions
How have ODSP eligibility rules changed for personal injury settlements?
Previously, only the first $100,000 of pain and suffering awards were exempt. Now, all such awards are fully exempt, making it easier to qualify for ODSP.
Do personal injury settlements affect ODSP eligibility?
Post-reform, pain and suffering awards do not affect ODSP eligibility, but other settlement components may still impact benefits based on ODSP rules.
Why are ODSP benefits often insufficient for long-term care?
ODSP primarily covers basic living expenses, offering limited financial support for costly medical care, leading many to use personal funds or settlements.
What should accident victims do if they can’t afford long-term care?
Consulting a legal expert can help explore options like lawsuit settlements or additional support programs to fund necessary care.
