Benefits in the form of money or assistance provided to persons injured in a motor vehicle accident, regardless of who is at fault. Types of accident benefits include: medical and rehabilitation expenses such as equipment, treatment, or therapy, attendant care, income replacement benefits, housekeeping expenses.
A formal, detailed recording of an event documented from the scene of the incident by an authority figure, like a police officer or hospital staff member.
Acquired Brain Injury (ABI)
An acquired brain injury is damage to the brain that occurs after birth and is not related to a congenital or degenerative disorder, such as Alzheimer’s disease. The damage may be caused by a traumatic (physical) injury to the head or it may be due to strokes, tumours, infections, allergic reactions, anoxia or hypoxia (no or reduced oxygen), or metabolic disorders.
Activities of Daily Living (ADL)
Routine activities carried out for personal hygiene and health (including bathing, dressing, feeding) and for operating a household.
Act of God
An accident or event resulting from natural causes without human intervention or assistance; the act could not have been prevented by reasonable precaution or care; for example, damage from floods, lightning, earthquake, or storms.
One who investigates insurance claims or claims for damages and recommends an effective settlement.
Alternative Dispute Resolution
The use of methods other than litigation to resolve a legal dispute, such as mediation and arbitration. See arbitration and mediation.
Ability to walk.
A formal written response to a legal complaint filed by a defendant; a legal response.
Loss of the ability to express oneself and/or to understand language caused by damage to the brain.
To ask a higher court to reverse the decision of a trial court when one party does not agree with the decision; petition for a higher court to examine the decision in hopes of getting it overturned.
Inability to carry out a complex or skilled movement not due to paralysis, sensory changes or deficiencies in understanding.
A process for deciding a legal dispute out of court; a substitute for an ordinary trial. It is often considered a more efficient, faster, and cheaper route than litigation.
Assignment of Benefits
A transfer of the benefits provided by an insurance policy to another party; it can only be done with the written consent of the insured. Most often, this takes the form of a person assigning their medical benefits to a hospital or doctor, so that they can be paid directly.
A problem of muscle coordination caused by a brain lesion. Can interfere with a person’s ability to walk, talk, eat, and perform other self-care tasks.
The wasting away or decrease in size of a cell, tissue, organ or part of the body due to lack of nourishment or loss of nerve supply.
Attendant Care is any action to assist a person with a disability in accomplishing activities of daily living. These cover a broad spectrum of activities including bathing, dressing, feeding, toileting, transferring, mobility, cooking, cleaning, laundering, dispensing of routine medications and similar tasks. Primarily, these are tasks that the individual is unable to physically perform or has a great deal of difficulty doing.
An assertion filed by an insured person against their insurance provider for unreasonably denying or delaying their claim, or for refusing to pay out a full insurance claim without cause; usually filed when a person’s claim was denied, but they feel it should have been covered.
For legal purposes related to personal injury law, a benefit is financial assistance that a party receives from an employer, insurance company, or social program (such as social security) in a time of sickness, disability, or unemployment. When a person receives financial compensation for their wages or when a person’s surgery is covered by the insurance company and paid directly, both are considered benefits.
Any damage to a person’s body; for example: bruises, burns, cuts, poisonings, broken bones, nerve damage, etc. Bodily injury may result from an accident, negligence, or an intentional act. Causing bodily injury on purpose is a crime (assault, battery, etc.) while accidental and negligent harm may result in a lawsuit.
Burden of Proof
The obligation to prove one’s claim is accurate and true; whoever has the burden of proof must show their claim to be factual. In a personal injury claim, the plaintiff has the burden of proof–to show a driver was negligent, to show that a claim was made in bad-faith, etc.
Case Manager (CM)
A rehabilitation professional who coordinates rehabilitation services following an injury.
The most serious of personal injuries. Examples include: quadriplegia; paraplegia; amputation of arm or leg or impairment causing the total and permanent loss of use of an arm or leg; total loss of vision in both eyes; injuries resulting in an impairment of 55% or more of the whole person; brain impairment measured by a score of 9 or less on the Glasgow Coma Scale; marked or extreme mental or behavioural impairment; and severe disability from brain injury measured using the Glasgow Outcome Scale. A person having a catastrophic impairment becomes entitled to maximums of $1,000,000.00 for medical/rehabilitation needs, plus $1,000,000.00 for attendant care plus housekeeping expenses, payable over the lifetime of the injured person.
To make something happen; the act or process of causing something. In a negligence case, the plaintiff must show that their injury was directly caused by something the defendant did (or failed to do).
The portion of the brain (located at the back) which helps coordinate movement.
A civil action relating to the physical or mental harm suffered by the plaintiff, or on behalf of the injured victim, due to negligence of the defendant; a request to the insurance company by the insured requesting coverage and payment for damage or injury.
Closed Head Injury
Trauma to the head which doesn’t penetrate or fracture the skull but which damages the brain.
The conscious process of knowing, becoming or being aware of thoughts or perceptions, including understanding and reasoning.
A state of unconsciousness from which the patient cannot be aroused, even by powerful stimulation.
The first document filed with the court by a person or entity claiming legal rights against another party; the official document that starts a lawsuit. Includes what wrongdoing the plaintiff feels the defendant did.
A traumatic brain injury from a violent blow or jolt to the head that alters the way your brain functions. It’s commonly associated with a loss of consciousness, however this is not a prerequisite for the syndrome. Often causes nausea, dizziness, disorientation, and headaches, among other medical issues. Multiple concussions can be life threatening. See Post-Concussion Syndrome
Any fee for services provided where the fee is only payable if there is a favorable result.
A region of injured tissue or skin in which blood capillaries have been ruptured; medical term for what is more commonly called a bruise.
A series of x-rays taken at different levels of the brain that allows the direct visualization of intracranial structures.
The losses the plaintiff has suffered because of the defendant’s conduct. These losses can take many forms including compensation for pain and suffering; loss of past, present and future income; health care costs; loss of social or familial relationships; etc.
A clause in an insurance policy that relieves the insurer of responsibility to pay the initial loss up to a stated amount.
A person and/or corporation that is being sued by a Plaintiff. Examples of defendant corporations include an insurance company, a leasing company, a municipality, a tavern, a property owner, a hospital, etc. Most defendants in personal injury lawsuits are insured. A defendant’s insurer will usually appoint a lawyer to act on behalf of the defendant.
Out-of-court question and answer session under oath; testimony given under oath, recorded in an authorized place outside of the courtroom and usually documented by a court reporter; the questions will be asked by the opposing attorney, with the party’s attorney present, in order to have an official, written account of what happened
Diffuse Axonal Injury (DAI)
A shearing of large nerve fibres in many areas of the brain rather than one specific location.
Rather than asking clients to pay up front, disbursements are expenses incurred by the law firm to handle your case. More specifically fees for photocopying, mailing and requesting your clinical notes and records. These expenses are incurred on an ongoing basis in order to advance your case. Disbursements are paid when your matter is over.
The release of documents and other information requested or otherwise sought by the opposing party; to divulge information that is relevant to the case.
Not knowing where you are, who you are or the current date.
The practice of driving a motor vehicle while engaged in another activity causing one to lose focus from the road and tasks of driving; may include: talking on a cell phone, using a navigation system, text messaging or emailing, eating, grooming, adjusting the audio system.
A procedure that uses electrodes on the scalp to record electrical activity of the brain.
Examination For Discovery
Also known as “examination of discovery,” is an important step in the litigation process. It is not a trial but a process that allows counsel for both parties to examine (question), under oath, the opposing party orally before trial.
Testimony given by someone who is qualified to speak with authority about scientific, technical, or professional matters. For example, an attorney may bring in a neurologist to testify about their client’s brain damage so that the court can hear the information directly from an expert.
Front part of the brain; involved in planning, organizing, problem solving, selective attention, personality, and a variety of higher cognitive functions.
Glasgow Coma Scale (GCS)
A medical test used to determine brain impairment resulting from an accident. It is based on a scale of 3 to 15, with a lower score often indicating a more serious injury. A score of 9 or less usually results in the person being deemed to have sustained a catastrophic impairment.
Glasgow Outcome Scale (GOS)
A system for classifying the outcome of head injury survivors. Relates to functional independence and not residual deficits.
Conditions that increases the probability of damage or injury, like a crack in a sidewalk, a spill in the aisle, a work truck without proper lighting, or inadequate lighting on steps in front of a business.
Health Care Expenses
A category of tort entitlement that includes goods and services for medical expenses, rehabilitation, and attendant care.
Weakness on one side of the body.
New definition of “incurred” requires the claimant to pay or promise to pay the expense and requires that the service provider provide the service in the course of the employment, occupation or profession, in which he/she would have normally been engaged, but for the accident, or that the person has suffered an economic loss in order to provide the service.
Also known as a Section 44 Assessment, The insurer may appoint health care professionals of their choosing, to perform assessments in order to determine whether to pay a benefit.
Process of forming an opinion, based on an evaluation of the situation at hand in comparison with personal values, preferences and insights.
Legal responsibility for one’s acts or omissions; an obligation one is bound to by law to perform, typically involving the payment of monetary damages. One of the most significant words in the field of law.
License Appeal Tribunal (LAT)
The LAT makes decisions on applications and resolves disputes concerning compensation claims and licensing activities
A time period after which a lawsuit cannot be brought. When a person suffers an injury, the law imposes a time limit in which to issue a Statement of Claim. If one fails to issue the Claim within the time allotted, all rights to compensation are lost.
The process of taking legal action and/or filing a lawsuit.
The monetary value assigned to an injury or damage in a personal injury claim, including: pain and suffering, past and future income, future medical care, at-home assistance, current medical bills, etc.
Loss of Earnings
A situation where the injured person has had to take time off work, change jobs, or give up work due to their injury resulting in decreased or no income, impacting their financial situation.
Negligence or misconduct by a professional person—such as a lawyer, a doctor, a dentist, or an accountant—who has failed to meet a standard of care or standard of conduct; situation becomes malpractice when a client or patient is injured or damaged because of error, negligence, or rarely, intent.
Command from a court directing the enforcement of a judgment, sentence or decree.
Outside help settling a dispute; a non-binding method of resolving a case in which a neutral third party, agreed upon by both parties, helps the disputing sides to reach a mutually agreeable settlement. The job at mediation is to bring both parties together to bring forth a settlement.
An act or omission by a health care provider which deviates from accepted standards of practice in the medical community and which causes injury to the patient.
One or more of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and any clinically associated sequelae.
Failure to use a degree of care considered reasonable under a given set of circumstances; the four elements of negligence are: a duty owed to a plaintiff, a breach of that duty by the defendant, proximate cause, and an injury or damage suffered by the plaintiff; carelessness.
Area in the back of the brain whose primary function is processing visual information. Damage to this area can cause visual deficits.
Occupational Therapist (OT)
A registered healthcare professional that works to retrain those with injuries to resume the self care activities important to daily living as well as evaluation, training and adaptations to increase function in vocational role.
Additional Benefits purchased by the Insured or in some cases a family member of the Insured.
Someone trained and certified to perform any function of assistance to a lawyer including: summaries, research, investigation, and the retrieval of records; certified person who works in a law office helping an attorney prepare a case.
Complete paralysis of the lower half of the body including both legs, usually caused by damage to the spinal cord.
Damage to right lobe can cause visual-spatial deficits. Damage to the left lobe may disrupt a patient’s ability to understand spoken and/or written language.
Persons, corporations, or associations who have started a law suit, or who are defendants in a lawsuit.
Personal Injury Law
The area of law that involves persons who have been injured in an accident. Accidents include motor vehicle, slip and fall, medical malpractice, boating, assault, etc.
Physical Therapy (PT) or Physiotherapy
The treatment of physical dysfunction or injury by the use of therapeutic exercise and the application of modalities, intended to restore or facilitate normal function or development.
A registered healthcare professional who works to maintain and improve the movement and function of joints and limbs.
The party that institutes a suit in a court. The person or entity the plaintiff sues is the defendant.
Post-Traumatic Amnesia (PTA)
A period of hours, days, weeks or months after the injury when the patient exhibits a loss of day-to-day memory. The patient is unable to store new information and has a decreased ability to learn.
Post-concussion Syndrome (PCS)
A disorder in which various symptoms—such as headaches, nausea, irritability, and dizziness—last for weeks and sometimes months after the injury that caused the concussion; a form of mild traumatic brain injury.
Post-traumatic Stress Disorder (PTSD)
A mental health condition that is triggered by a terrifying or stressful event—either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event. PTSD does not only occur in those who have been involved in a war, in fact, it is quite common in people who have been involved in a serious accident or suffered severe injury.
The accident benefit insurer may request an assessment by health care professionals of its choosing, before you even apply for benefits. The injured person has the right to refuse this assessment and may do so without penalty.
The anticipated chance of recovery from an injury, based upon the symptoms and nature of the particular case; prediction of how a person will heal or recover determined by a doctor.
A physician who specializes in the prevention and management of emotional and behavioural problems with various means including the prescription of psychotropic medication.
An expert in the diagnosis, management and prevention of emotional and behavioural problems who has a doctoral level education.
Paralysis of all four limbs or of the entire body below the neck.
Quality of Life
The type of existence a person was living prior to the accident/injury or after the accident/injury. A quality of life assessment could include factors such as: activities of daily living, mobility and organization, social relationships and ability to interact, general life satisfaction, recreational or work-related activities, future prospects.
Ranchos Los Amigos Scale
A medical scale intended to assess the level of recovery of brain injury patients and those recovering from coma. It is named after the Rancho Los Amigos National Rehabilitation Center in Los Angeles.
Range of Motion (ROM)
Refers to movement of a joint and is important to prevent contractures.
The process of restoring necessary skills and normal movement for self-sufficiency after an injury, perhaps after an auto accident or slip-and-fall.
Rehab Support Worker
A rehab professional who assists or instructs injured persons in the development of independent living and personal care skills, monitoring health and safety needs and providing structured outings in the community to assist in reintegration.
Inability to recall events prior to the accident. May be a specific span of time or type of information.
Conclusion of a legal matter; negotiated agreement by opposing parties in a civil suit before or after litigation has begun but before the court hears the case, eliminating the need for the judge to resolve the controversy.
Slip and Fall
A personal injury case in which a person slips or trips and is injured on someone else’s property; usually falls under the broader category of premises liability claims. Slip and fall accidents usually occur on property owned or maintained by someone else who is then held legally responsible.
Social Worker (SW)
Expert in the social, emotional, and financial needs of families and patients. They often help locate services that are needed.
Speech and Language Pathologist (SLP)
A regulated healthcare professional responsible for the evaluation and treatment of problems with speech and language, auditory, cognitive (comprehension), attention, writing, reading and expression skills.
Statement of Claim
A document that begins a lawsuit and claims “damages” from one or more defendants based on the defendant’s acts or omissions causing loss, injury or harm to the Plaintiff. A Statement of Claim is generally prepared by the Plaintiff’s lawyer.
Statement of Defence
A defendant’s response to the Statement of Claim. It is usually prepared by the defendant’s lawyer. Often, it will deny the allegations made in the Statement of Claim.
Right temporal lobe is mainly involved in visual memory. Left temporal lobe is mainly involved in verbal memory.
A level of impairment or disfigurement that a Plaintiff must prove in order to recover certain compensation in a motor vehicle tort claim. This means that the injury must be either a permanent, serious disfigurement (like a scar) or a permanent, serious impairment of an important physical, mental or psychological function. There are many court decisions that help a lawyer specializing in personal injury law to advise you about whether your injuries “meet the threshold”.
Damage, injury, or a wrongful act done wilfully, negligently, or in circumstances involving strict liability, but not involving breach of contract, for which a civil suit can be brought. This is an area of law in which one party sues and seeks monetary compensation (money) for injuries and losses suffered because of the fault or negligence of another party. This contrasts with accident benefits (no-fault benefits) where benefits are paid without reference to fault.
Traumatic Brain Injury (TBI)
A type of injury that occurs when an external force causes brain dysfunction; usually results from a violent blow or jolt to the head or body. An object penetrating the skull, such as a bullet or shattered piece of skull, can also cause traumatic brain injury.
If negotiation and settlement cannot be reached through the mediation process the matter will proceed to a trial. A trial is when all the facts of the case are heard and a judge or jury makes the final decision regarding the matter.
A formal decision about the outcome of a case made by a judge or jury.
A claim made on behalf of the survivors or beneficiaries of a person who has died as a result of wrongful conduct—either negligent or intentional. Such claims are generally made by those who were financially dependent upon the deceased. Damages could include medical expenses prior to death, loss of earnings of the deceased during their expected natural life, and loss of consortium (depravation of a marital/sexual partner or familial relationship).