CATASTROPHIC IMPAIRMENT ASSESSMENT

This is a multidisciplinary assessment designed to determine whether a claimant continues to suffer a partial or substantial inability to carry on with his or her normal daily activities.

The process is separated in four stages: referral, intake, assessment and reporting.

The CAT DAC assessment may be initiated in one of two ways:

1) A claimant applies to the insurer for catastrophic status, the insurer denies this request and the claimant responds by requesting a CAT DAC.

or

2) A claimant applies to the insurer for catastrophic status and the insurer requests a CAT DAC assessment, prior to providing a response to the claimant.

The application for catastrophic impairment determination will state the reasons, according to the treating practitioner completing the application, why his/her patient meets the definition. Factors such as an inadequately completed form or the referring practitioner’s apparent lack of understanding of the catastrophic criteria, should not prevent a DAC from conducting the assessment. As well, these factors should not limit the CAT DAC assessment to exploring only the impairment(s) identified in the application.

It is the CAT DAC’s responsibility to ensure that a comprehensive assessment of each claimant’s impairment(s) is conducted to determine if the impairment(s) qualifies as catastrophic.

RESIDUAL EARNING CAPACITY

This assessment is designed to determine an employment type that best reflects the victim’s earning capacity at the time of the assessment and the gross annual income that the claimant could earn from that assessment. The assessment process must include at least four practitioners including a physician, physiotherapist, psychologist and occupational therapist.

The first portion of the assessment is spent completing a series of assessments with the goal of developing a hypothetical suitable type or types of employment. The victim’s ability to perform the essential tasks of this employment is tested during the second part of the assessment process