Concussions are common in those who are injured in car accidents.  It is estimated that about 20% of concussions are from car accidents.   Car accident concussion patients tend to have more severe injuries, perhaps because of the high speeds involved and also because of other injuries that occur at the same time.

Lawyers help car accident patients navigate the system.  While the system’s aim is to provide impartiality and fairness, many patients feel overwhelmed with the paperwork and logistics of a car accident claim.  Lawyers can help concussion patients efficiently navigate the system and get them proper insurance settlements.  Lawyers can collaborate with insurance adjusters and medical clinics to ensure that patients are getting the required funding they need to support their post-concussion evaluations and treatments.  Most lawyers will offer a free consultation so that you can ascertain that their values and approach lines up with yours.

Car accident concussion patients will have to seek funding from their car insurance companies for services not funded by OHIP.  Concussion is technically considered a “major injury” (part of the Major Injury Guidelines as opposed to the Minor Injury Guidelines in the Statutory Accident Benefits Schedule [SABS]) which allows patients access to up to $65,000 of post-concussion funding.  The goal of this funding is to help you get better and reintegrate back to life (work, play, etc.).  How much of this funding you use generally correlates with the severity of your injury: more severe injuries need more funding.  Your lawyer will point this out to insurance companies when trying to secure a larger settlement for you.

Car accident concussion patients will need medical care.  These are ideally quarterbacked by multidisciplinary, MD-based medical clinics.  Concussion doctors have the proper training, licensure and approval by Health Canada to manage all aspects of post-concussion impairments and disability.  While physiotherapy and chiropractor therapy based concussion clinics maybe important parts of your rehabilitation (and even may be the ones most involved in your care), their licensure does not include comprehensive management of cognitive, psychological, headache, etc.

Initially, you should complete an OCF-3, which is a government approved form that states your medical injuries for the record.  Since medical doctors are uniquely positions to diagnose and manage all aspects of post-concussion care, this form is ideally completed by a concussion MD.  A concussion MD will most accurately complete this form which becomes part of your legal records.

Concussion clinics will put together a treatment plan in the form of government approved treatment plan forms for your concussion care.  You will be asked to review these forms and if you agree to the treatment plan, then you can sign it and the clinic may submit these forms to your insurance company to seek funding for your care.

Car insurance companies have 10 business days to review these requests.  Often they approve these requests and sometimes they decline them.  If they decline them, they will advise you why and next steps.  Sometimes, lawyers will get involved to negotiate more cooperation from car accident insurance companies.

The Toronto Concussion Clinic is an MD-based, multidisciplinary clinic that works with car insurance companies and lawyers in helping you recover.  Our clinic’s focus is on your medical recovery.  However, practically, it is important to cooperate with lawyers and car insurance companies too to find solutions that work for everyone.  Car insurance companies are interested in finding cost-efficient approaches, and lawyers are interested in getting you maximal monetary settlements.  And our focus on efficient and complete recovery.  In helping achieve this we offer:

• MD assessments and documentation help reflect the extent of your injury so that the consequences of your accident are not underestimated.
• We will arrange for all paper work to help fund the care that is not covered by OHIP.
• We work with several lawyers and insurance adjusters to advocate for your health and positive outcomes.
• Our dedicated rehab coordinator will help you navigate the process.
• You still have access to OHIP-Funded care too. 
• Car Insurance will be used only for uninsured concussion services like cognitive assessments and occupational therapy, etc.  This makes concussion rehabilitation more cost efficient