Getting your medical expenses covered after you have been involved in a motor vehicle accident is important but it may not be enough. What if your injuries mean that you need help with some basic tasks like washing your hair or transferring from a wheelchair to your bed? For these types of expenses, you may be entitled to receive Attendant Care Benefits under the Statutory Accident Benefits Schedule .
This is the last installment in our series of discussions on No-Fault Benefits in Ontario.
What are Attendant Care Benefits?
Attendant Care Benefits are designed to cover certain personal care expenses incurred by an injured motorist after a car accident. These expenses are paid to the aide, attendant or long-term care facility that is hired to perform the daily activities or tasks that the injured person would have been able to complete themselves had they not been involved in the accident. Examples of some of the tasks a person may need help with might include things like feeding, dressing, bathing, administrating medication, transfers or being able to respond to an emergency situation.
How do I apply for Attendant Care Benefits?
In order to receive Attendant Care Benefits, you will need to submit a completed Application for Accident Benefits and Disability Certificate to the insurance company. In addition, you will need to arrange to have an Assessment of Attendant Care Needs (Form 1) completed. This form must be completed by either an Occupational Therapist (OT) or a registered nurse. In order to complete the form, the OT or nurse will carry out an assessment to determine what type of assistance you require and how often.
How much Attendant Care is payable?
The OT or nurse who completes the Form 1 will calculate a monthly hourly amount of assistance you require for each of the three different types of Attendant Care Benefits available (routine personal care, basic supervisory functions and complex health/care and hygiene function). This hourly amount is then multiplied by the maximum hourly rate (established under the Guidelines of the legislation) for each type of benefit to come up with a monthly Attendant Care amount.
However, that is not the end of the story.
The monthly Attendant Care benefit payable is subject to the following limits (assuming a Standard Policy is in effect):
- No Attendant Care Benefit is payable for a Minor Injury
- The maximum monthly amount payable is $3,000.00 for a non-minor, non-catastrophic injury
- The maximum monthly amount payable is $6,000.00 for a catastrophic injury
- Attendant Care Benefits are available for 2 years following the motor vehicle accident for non-minor, non-catastrophic injuries to a maximum of $36,000.00
- For catastrophic injuries, there is no time limit and the maximum payable is $1,000,000.00
If you have been involved in a car accident and are struggling with some basic personal care tasks, there is a good chance you are entitled to receive help which will be covered by the Attendant Care Benefits available under your insurance policy. To ensure you are receiving all of the benefits you are entitled to or to get help arranging an Attendant Care assessment, it is important to speak with someone knowledgeable in the area of Accident Benefits.
Our team of experienced Ontario personal injury lawyers have the expertise to ensure you are accessing all the benefits available to you and would be pleased to sit down with you for a free initial consultation.