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Income Replacement Benefits and the Minor Injury Guideline > Accident Benefit Changes in Ontario – Part 7

The new SABS (Statutory Accident Benefits Schedule) in Ontario, introduced in September, 2010, is found here.

The Minor Injury Guideline is found on the FSCO (Financial Services Commission of Ontario) website here.

Given that the focus and purpose of the Minor Injury Guideline is to guide claimants to maximal medical recovery within the $3,500 hard cap, query whether this will affect the application of the income replacement benefits issue across the board.

Under the Minor Injury Guideline, there is approximately $1700 worth of treatment anticipated in the initial 3 blocks of treatment.  If further treatment is required, then this has to be submitted for consideration.  In total, the purpose of the Guideline is to stop treatment (and expenditures) at $3,500, at which time presumably the person has reached maximal medical recovery.

Appendix “A” to the Minor Injury Guideline encourages and teaches people to try and distinguish “hurt” vs. “harm” when dealing with whiplash pain arising from a car accident.  That is, it encourages people to live and work through pain, as it states that pain is not necessarily indicative of further harm but rather pain can simply be part  of the overall healing process.

When dealing with the income replacement benefit test, which is “a substantial inability to perform the essential tasks of that employment” (for which you were employed at the time of the accident), query whether evidence of having reached maximal medical recovery – i.e. exhausting your medical/rehabilitation benefits under the Minor Injury Guideline – is evidence supporting your ability to work or at least to satisfy the essential tasks of your work.

The need for cost control in the industry is continuously weighed against the broad need to help those involved in car accidents outside the OHIP system.

People involved in car accidents should realize that the new legislation will end their treatment at the $3,500 hard cap, if they fall inside the Minor Injury Guideline.

Then, they should further realize that the evidence of their having been discharged from the Minor Injury Guideline system (whether or not they feel healthier) may be used as evidence to re-consider their claim for ongoing income replacement benefits.