-Catastrophic Impairments under the SABS-
*Seeking to be designated as “Catastrophic Impairments” means negotiating with the insurance company to increase the amount of benefits available to the claimant (involved in MVA) and remove the five-year limit in which the claimant can claim benefits.
The SABS provides several definitions of CAT, and s. 3.1 (1) 8., known as “criterion 8” provides:
Subject to subsections (3) and (5), an impairment that, in accordance with the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 4th edition, 1993 results in a class 4 impairment (marked impairment) in three or more areas of function that precludes useful functioning or a class 5 impairment (extreme impairment) in one or more areas of function that precludes useful functioning, due to mental or behavioral disorder.
In simple terms, the SABS uses a rating system from the AMA Guides to the Evaluation of Permanent Impairment, 4th ed. (“Guides”). The Guides provide a method to rate the severity of a person’s mental and behavioral functioning in four areas of function (“domains”) on a scale of 1 to 5 (e.g., none, mild, moderate, marked and extreme impairment, and expressed as classes 1 to 5).
The four functional areas are: (1) activities of daily living (“ADLs”), (2) social function, (3) concentration, persistence & pace, and (4) adaptation. As the ADL domain is particularly important in this matter, according to the AMA Guides, ADLs include such activities as self-care, personal hygiene, communication, ambulation, travel, sleep and social and recreational activities.
The SABS then deems a person “catastrophically impaired” if the person is rated a class 4 in three or more domain areas or a class 5 in any one domain.