Foster Injury Law can represent people across Ontario with spinal cord injury and paralysis claims, including paraplegia, tetraplegia, incomplete spinal cord injury, ASIA D classification, neuro-urological impairment, chronic neuropathic pain, mobility loss, attendant care, home modification, future care, income loss, and catastrophic impairment disputes.

​

For Ontario motor vehicle accidents on or after June 1, 2016, the spinal cord injury catastrophic impairment test is found in section 3.1(1), paragraph 1 of the Statutory Accident Benefits Schedule, O. Reg. 34/10. This is the regulation’s specific test for paraplegia and tetraplegia. It uses the ASIA Impairment Scale and, where the paraplegia or tetraplegia criterion is otherwise engaged, allows an ASIA D injury in order to qualify if the additional SCIM item 12, catheterization, neuro-urological impairment, or bowel-routine criteria are met.

​

This means that insurance companies can accept that a person suffered a spinal cord injury but still dispute whether the injury is catastrophic, whether the person needs attendant care, whether bowel or bladder dysfunction is accident-related, whether home modifications are justified, or whether retained function is being overstated.

​

Our Ontario personal injury lawyers help clients and families deal with both the accident benefits file and the lawsuit against the at-fault party. We request the medical, rehabilitation, insurance, employment, and accident records needed to prove the spinal cord injury claim.

​

Contact Foster Injury Law for a free consultation about a spinal cord injury or paralysis claim in Ontario.

​

Spinal Cord Injury and Paralysis Claims in Ontario

 

Spinal cord injury cases are not limited to those who have suffered complete paralysis. Some clients have paraplegia or tetraplegia. Others suffer incomplete spinal cord injuries where they retain some movement but live with serious neurological loss, unsafe mobility, hand dysfunction, chronic neuropathic pain, spasticity, bowel or bladder dysfunction, catheterization, fatigue, falls, or loss of independence.

​

In an incomplete SCI case, an insurance company can point to a short walk, a transfer, a therapy note, or a surveillance clip and try to argue that the injury is less serious. The response usually has to come from more fulsome records which could potentially include: ASIA classification, SCIM scoring, urology records, bowel-routine evidence, rehabilitation records, attendant care assessments, home accessibility evidence, and people who can describe the daily effects of the injury outside a clinic.

​

For Ontario car accident cases, which include ATV accidents, semi-truck accidents, and snowmobile collisions, the accident benefits claim and the lawsuit need to be coordinated. Accident benefits can affect treatment, attendant care, equipment, case management, and catastrophic impairment. The lawsuit can address pain and suffering, income loss, future care, home modification, family claims, and other long-term losses.

​

The Spinal Cord Injury Catastrophic Impairment Test in Ontario

 

After June 1, 2016, the main statutory provision for Ontario SCI accident benefits claims is section 3.1(1), paragraph 1 of the Statutory Accident Benefits Schedule.

​

The provision applies to paraplegia or tetraplegia. It requires that the injured person’s neurological recovery has reached the point where the person’s permanent grade on the ASIA Impairment Scale can be determined.

​

A permanent ASIA grade of A, B, or C automatically satisfies the spinal cord injury catastrophic impairment criterion. ASIA D is treated differently. If the paraplegia or tetraplegia criterion is otherwise engaged, ASIA D can also satisfy the test if one of three additional findings is present.

​

The first is a SCIM item 12 score of 0 to 5 for Mobility Indoors, measured over a distance of up to 10 metres on an even indoor surface.

​

The second is the need for urological surgical diversion, an implanted device, or intermittent or constant catheterization to manage residual neuro-urological impairment.

​

The third is impaired voluntary control over anorectal function requiring a bowel routine, surgical diversion, or implanted device.

​

For a deeper explanation of this regulation, see our article on catastrophic impairment in spinal cord injury cases in Ontario.

​

Paraplegia, Quadriplegia and Incomplete Spinal Cord Injury Claims

​

Paraplegia and quadriplegia are very serious diagnoses. However, these claims also have to address care, equipment, home access, transportation, pressure sore prevention, bowel and bladder management, medication, rehabilitation, income loss, family disruption, and the cost of maintaining safety and independence over time.

​

Incomplete spinal cord injury claims can be harder to prove because the disability is sometimes less visible to an insurer. Someone with an incomplete SCI can look better during a short assessment than they function across a full day. They can walk indoors but still struggle with stairs, snow, curbs, uneven ground, fatigue, spasms, toileting urgency, transfers, bathing, dressing, or safe community mobility.

​

Paraplegia cases frequently focus heavily on attendant care, accessible housing, vehicle modification, equipment replacement, bowel and bladder management, and lifetime future care. A quadriplegia claim often involves greater need for upper-limb assistance, nursing, positioning, skin protection, feeding, transfers, and round-the-clock support. An incomplete SCI claim often contains a debate about why some level of retained function does not mean recovered function.

​

ASIA Classification in Spinal Cord Injury Claims

 

The ASIA Impairment Scale provides doctors, rehabilitation teams, insurers, and lawyers a common language for classifying spinal cord injuries. The grade can help identify whether the injury is complete or incomplete and how much motor or sensory function remains below the neurological level of injury.

​

In Ontario accident benefits claims, ASIA grading is central because section 3.1(1), paragraph 1 of the SABS uses the permanent ASIA grade as the starting point for the paraplegia and tetraplegia catastrophic impairment test.

​

An ASIA A, B, or C classification can satisfy the SCI criterion if the other wording of the regulation is met. ASIA D requires closer analysis because the injured person has more preserved motor function. That does not end the claim. It moves the analysis to SCIM item 12, catheterization, neuro-urological impairment, and bowel function.

​

For more detail on the grading system, see our article on the ASIA Impairment Scale in Ontario spinal cord injury claims.

​

ASIA D and Incomplete SCI Disputes

​

ASIA D cases are frequently disputed more heavily be insurance companies since the injured person has some preserved motor function below the neurological level of injury. Insurers often focus on walking, transfers, a clinic observation, or a short surveillance clip.

​

However, section 3.1(1), paragraph 1 expressly includes ASIA D injuries where the additional SCIM, bladder, or bowel criteria are met. A person who walks short distances indoors can still qualify if the statutory evidence supports catastrophic impairment.

​

The strongest ASIA D file is organized around the wording of the SABS. It should address the ASIA assessment, neurological level, SCIM item 12 score, assistive devices, falls, transfers, spasticity, fatigue, catheterization, urinary tract infections, bowel routine, toileting urgency, attendant care, rehabilitation progress, home barriers, and the difference between a controlled assessment and ordinary life.

​

Central Cord Syndrome and Hand Function

 

Some incomplete cervical spinal cord injuries are diagnosed as central cord syndrome. These cases can sometimes be underestimated since walking can be better preserved than hand function. Clients can walk short distances but still struggle with grip strength, fine motor control, buttons, zippers, meal preparation, bathing, toileting, transfers, driving, writing, phone use, or work tasks requiring hand function.

​

That distinction can be important in both the accident benefits claim and the lawsuit. The insurer can focus on the legs while the more disabling problem is in the hands, arms, balance, endurance, bowel or bladder symptoms, and loss of independence.

​

For a focused discussion of this injury pattern, see our article on central cord syndrome in Ontario injury claims.

​

SCIM Item 12 and the 10-Metre Indoor Mobility Test

 

SCIM item 12 is part of the Spinal Cord Independence Measure, Version III. In the SABS spinal cord injury criterion, it is applied to indoor mobility over a distance of up to 10 metres on an even indoor surface.

​

This does not measure winter conditions, curbs, slopes, parking lots, stairs, crowded spaces, uneven ground, fatigue, spasms, pain, toileting urgency, or endurance across a full day. It does not answer if someone is capable of having a safe shower, carry groceries, get from a car into a building, work a full day, or live alone without support.

​

For accident benefits, SCIM item 12 can decide whether an ASIA D injury satisfies the catastrophic impairment test. For the lawsuit, however, the score should not become the whole mobility story. The tort claim still needs evidence about real-life mobility, safety, assistive devices, falls, endurance, care needs, home accessibility, and the barriers the person faces outside a controlled assessment.

​

Spinal Cord Compression, MRI Findings and Legal Proof

​

Some cases involve spinal cord compression, cervical myelopathy, traumatic disc injury, fracture, stenosis worsened by trauma, or surgical decompression. These cases need careful medical proof because imaging alone does not answer every legal question.

​

Cord compression does not prove catastrophic impairment. The legal and medical evidence still has to connect the imaging to neurological symptoms, gait change, hand dysfunction, weakness, spasticity, bowel or bladder changes, ASIA classification, treatment needs, and functional loss.

​

In a lawsuit, the defence can argue that imaging findings are degenerative, pre-existing, or unrelated to the accident. The record should address the client’s pre-accident function, the mechanism of injury, the onset of neurological symptoms, MRI findings, surgical records, rehabilitation evidence, and whether the accident caused or materially worsened the condition.

​

For more on this issue, see our article on spinal cord compression after an accident in Ontario.

​

Bowel and Bladder Dysfunction in Paralysis and SCI Claims

​

Bowel and bladder evidence is often central in incomplete SCI claims. The ASIA D criterion in section 3.1(1), paragraph 1 directly refers to residual neuro-urological impairment requiring surgical diversion, an implanted device, or intermittent or constant catheterization. It also refers to impaired voluntary control over anorectal function requiring a bowel routine, surgical diversion, or implanted device.

​

Urology records, catheterization records, bowel-routine records, rehabilitation notes, occupational therapy records, prescription and supply records, infection history, attendant care assessments, and family or support-worker evidence can all become important. The same evidence can also affect future care, income loss, travel restrictions, sleep, intimacy, dignity, work interruptions, attendant care, and the person’s ability to leave home with confidence.

​

Patel v. RSA Insurance and the Timing of SCI Catastrophic Impairment

​

In Patel v. RSA Insurance, Tribunal File Number 19-000560/AABS, the Licence Appeal Tribunal considered the post-2016 spinal cord injury catastrophic impairment test under section 3.1(1), paragraph 1 of the SABS.

​

Aiysha Patel suffered a spinal cord injury in a motor vehicle accident. Her classification changed from T7 ASIA C to T7 ASIA D. The evidence brought forth in the hearing also addressed SCIM item 12. The insurer argued that catastrophic impairment should not yet be determined because spinal cord injury recovery could continue and reassessment should occur later.

​

The Tribunal rejected the insurance company's position. It found that there is no fixed 24-month waiting period in paragraph 1 of section 3.1(1).  Patel is a very supportive case for AISA D spinal cord injury victims since it deals with the precise issues that often arise: ASIA classification, SCIM evidence, permanence, and an insurer’s attempt to delay catastrophic impairment by relying on the general possibility of improvement.

​

Attendant Care After Paraplegia: Henry v. Gore Mutual

 

Spinal cord injury and paralysis claims often create immediate attendant care needs. A person with paraplegia or tetraplegia can require help with transfers, bathing, dressing, toileting, catheterization, bowel routines, skin checks, positioning, medication, meals, transportation, and safety.

​

In Henry v. Gore Mutual Insurance Company, Tyrone Henry was rendered a paraplegic after a motor vehicle accident. His mother took an unpaid leave from work to provide the full-time care he required. The insurer disputed whether attendant care benefits were payable for the full 24-hour care need or only for the 40 hours per week of employment his mother gave up.

​

Henry is useful because it arose from a very common care problem that occurs following paraplegia: family members become the first care system, and the insurer disputes how the care should be valued. The Form 1, the task-by-task care record, the family evidence, and any economic loss evidence all become important.

​

The SABS wording and accident date still have to be checked in each case. But the proof issue remains familiar in serious SCI claims: the legal file needs to show what care is required, who provides it, why it is required, and how the care connects to the spinal cord injury.

​

Home-Based Care After Quadriplegia: Andrews v. Grand & Toy

​

Andrews v. Grand & Toy Alberta Ltd. involved a young plaintiff who was rendered a quadriplegic after a motor vehicle accident. The case remains important in spinal cord injury litigation because it addressed the cost of future care for a person with catastrophic paralysis.

​

A common future care dispute in an SCI lawsuit is with respect to the model of life after the injury. A defendant can point to a cheaper care model. The plaintiff’s evidence has to explain the care, equipment, accessibility, transportation, attendant care, pressure sore prevention, bowel and bladder management, nursing, safety, and dignity required for life outside an institution.

​

For someone suffering paraplegia or tetraplegia, future care evidence should not be reduced to a list of treatment appointments. The case has to address how the person will live, where they will live, who will assist, what equipment will be replaced over time, what home changes are required, and what supports are needed to preserve health and independence.

​

The 55% Whole Person Impairment Route

 

Section 3.1(1), paragraph 1 is the main spinal cord injury catastrophic impairment criterion. The 55% whole person impairment routes in paragraphs 6 and 7 are not the primary SCI test, but they can still be important.

​

Paragraph 6 applies to a physical impairment or combination of physical impairments resulting in 55% or more physical impairment of the whole person. Paragraph 7 deals with a combination of physical impairment and mental or behavioural impairment reaching 55% whole person impairment.

​

Those routes are relevant if the spinal cord injury does not fit cleanly into the paraplegia or tetraplegia criterion, or where the client has several accident-related impairments in addition to the SCI. That can include fractures, chronic pain, traumatic brain injury, psychological injury, sexual dysfunction, sleep disruption, medication effects, or permanent orthopedic impairment.

​

The 55% WPI analysis requires medical opinion evidence and proper use of the AMA Guides. It should be prepared deliberately rather than added late as a fallback after the SCI classification evidence has already been missed.

​

Common Insurance Companies in Spinal Cord Injury and Paralysis Claims

 

Spinal cord injury cases often attract close insurance companies because they carry such significant financial consequences.

​

Defence lawyers and insurers like to try to focus on isolated function in these cases. Someone who walks a short distance indoors might still need catheterization, a bowel routine, mobility aids, attendant care, accessible housing, or help with bathing and transfers. A client who attends a medical appointment, drives briefly, carries a light item, or completes a short household task might still be unable to work, live safely without support, manage stairs, or leave home confidently.

​

Strong SCI claim are built around ASIA classification, SCIM scoring, urology evidence, bowel and bladder records, attendant care evidence, equipment evidence, occupational therapy records, physiotherapy records, income evidence, and witnesses who see the client outside a clinic or insurer examination.

​

Spinal Cord Injury Claims Often Overlap With Catastrophic Injury Cases

 

Many spinal cord injury and paralysis claims are also catastrophic injury claims. Where the central dispute is catastrophic impairment, our Ontario catastrophic injury lawyers page explains how serious injury claims are built around future care, attendant care, income loss, and long-term disability.

​

For collision claims, the legal route depends on how the injury happened. A spinal cord injury from a car crash can involve the insurance and liability issues discussed on our Ontario car accident lawyers page. Motorcycle, bicycle, and pedestrian spinal cord injury claims often require separate attention to vulnerable-road-user evidence, sightlines, road conditions, speed, turning movements, and insurance coverage, which are discussed on our Ontario motorcycle accident lawyers, Ontario bicycle accident lawyers, and Ontario pedestrian accident lawyers pages.

​

Speak With an Ontario Spinal Cord Injury Lawyer

​

If you or a family member have suffered a spinal cord injury or paralysis in Ontario, Foster Injury Law can help you understand the accident benefits claim, the catastrophic impairment issues, and the lawsuit against the at-fault party.

​

We can represent people with complete and incomplete spinal cord injuries, including paraplegia, tetraplegia, ASIA D injuries, catheterization, bowel routines, neuro-urological impairment, chronic neuropathic pain, mobility impairment, attendant care needs, home modification claims, future care claims, and income-loss claims.

​

Contact Foster Injury Law for a free consultation. There are no legal fees unless we recover compensation for you.

​

Frequently Asked Questions About Spinal Cord Injury and Paralysis Claims in Ontario

​

What is the spinal cord injury catastrophic impairment test in Ontario?

​

For accidents on or after June 1, 2016, the SCI catastrophic impairment test is in section 3.1(1), paragraph 1 of the SABS. It applies to paraplegia or tetraplegia and uses the ASIA Impairment Scale. ASIA A, B, or C can qualify. ASIA D can qualify where the paraplegia or tetraplegia criterion is otherwise engaged and the additional SCIM, bladder, or bowel criteria are met.

​

Can ASIA D qualify as catastrophic impairment?

​

Yes, ASIA D is not excluded, although it is not automatic. If paraplegia or tetraplegia criterion is otherwise engaged, an ASIA D spinal cord injury can qualify if the injured person also meets one of the listed criteria involving SCIM item 12 indoor mobility, catheterization or other neuro-urological impairment, or impaired anorectal control requiring a bowel routine, surgical diversion, or implanted device.

​

Is a paralysis injury claim different from a spinal cord injury claim?

​

Although the terms overlap, they are not identical. Paralysis describes loss of movement or function. A spinal cord injury is one cause of paralysis. In legal claims, the evidence should identify the injury, the neurological classification, the resulting paralysis or impairment, the care needs, and whether the SABS catastrophic impairment criteria are met.

​

What is SCIM item 12?

​

SCIM item 12 is the Mobility Indoors item of the Spinal Cord Independence Measure, Version III. Under the SABS SCI criterion, it is measured over up to 10 metres on an even indoor surface. It can be central in ASIA D catastrophic impairment disputes.

​

Why are bowel and bladder records important in an SCI claim?

​

Bowel and bladder records are frequently key in these cases since the SABS ASIA D criterion directly refers to catheterization, residual neuro-urological impairment, impaired anorectal control, and bowel routines. These records can also affect attendant care, future care, income loss, dignity, travel, sleep, and work capacity.

​

Can family members be paid for attendant care after paralysis?

​

Family care is a common major issue after paraplegia or tetraplegia. Whether attendant care is payable, and how much is payable, depends on the SABS wording, the accident date, the Form 1, the care provided, economic loss evidence, and the applicable limits. Legal advice should be obtained before assuming the insurer’s position is correct.