Amendments to the Statutory Accident Benefits Schedule

Starting on February 1, 2014 several amendments to the Statutory Accident Benefits Schedule (SABS) will come into effect. SABS is an Ontario government formulated guideline which regulates how much accident victims are entitled to for certain types of injuries.

The amendments, as published on December 17, 2013, will impact three main aspects of SABS

1. The election of benefits
2. Attendant care
3. Pre-existing conditions under the"  Minor Injury Guideline (MIG)

One of the major alterations coming under this legislation is the addition of Subsection 19(3) to Ontario Regulation 347/13. This particular amendment limits the amount of attendant care benefits payable to individuals based on "economic loss". Prior to this amendment, "economic loss" was considered an acceptable argument for the requirement to pay attendant care benefits since it was not distinct and had little clarification. However, the new law seeks to clear up all speculation and precisely states that "if a person who provided attendant care services (the "attendant care provider") to or for the insured person did not do so in the course of the employment, occupation or profession in which the attendant care provider would ordinarily have been engaged for remuneration, but for the accident, the amount of the attendant care benefit payable in respect of that attendant care shall not exceed the amount of the economic loss sustained by the attendant care provider during the period while, and as a direct result of, providing the attendant care."

This measure is expected to make it more challenging for family members to be able to afford care for their injured relatives when skilled providers are required. Another major modification to SABS relates to the tightening up of requirements which will make an insured person more likely to avoid Minor Injury Guideline (MIG). The old law required that a health practitioner determine and provide "compelling evidence" that an insured person had a pre-existing medical condition that would prevent them from realizing maximum recovery, in order to qualify for certain benefits. The new amendment states that a pre-existing medical condition has to be "documented by a health practitioner prior to the accident and that [it] will prevent" full recovery. This means that if an insured person failed to have a doctor confirm his or her preexisting condition they will not be able to escape the MIG whether their condition is confirmed to have existed before and will prevent them from making a full recovery.