UPDATE – The Expert Panel’s Report to the Superintendent on Catastrophic Impairment
Author(s): Darcy R. Merkur
September 29, 2011
From a legal perspective, the most fundamental problem with the CAT Expert Report appears to be a misconception by some of the Panel members about the impact of a CAT designation. A declaration of CAT does not mean automatic entitlement to benefits! The SABS process, whether CAT or non-CAT, is a needs based system, wherein accident victims are eligible to make claims for reasonable and necessary expenses, up to certain limits.
This fundamental misunderstanding of the implications of a CAT designation seems to form the basis of many of the Panel’s recommendations, including what many consider a positive suggestion of an interim CAT designation.
The idea of labeling someone interim CAT, expressly with the hope that the claimant can get early treatment and avoid being CAT, is fundamentally flawed—the accident victims should be designated CAT, receive early reasonable and necessary treatment and hopefully their condition improves such that they do not require long term access to their CAT accident benefits. A catastrophic designation is a permanent, not an interim designation, and by being permanent it protects against any unforeseen medical setbacks.
The CAT Expert Panel’s Report is a bold attempt to modernize the definition of CAT with the goal of trying to design a definition that will provide a CAT designation only to those with the most severe injuries and that are likely to have long term medical needs. However, that goal is a policy goal that is outside the Panel’s mandate and there is no justifiable reason for the Panel to narrow the CAT definition given that the system is a needs based system and given that the Panel was not considering economic implications.
For more information, read my full paper.