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Accident Benefit Assessments
Independent Medical Accident Benefits Assessments are objective evaluations requested by insurers or legal representatives to determine an injured individual’s entitlement to various benefits. These assessments provide impartial opinions on the nature and extent of injuries, the necessity and appropriateness of medical or rehabilitative treatment, and the claimant’s functional abilities or impairments. This process supports decision-making aligned with provincial auto insurance regulations and legal frameworks.
Insurer Assessments
These assessments focus on validating claims related to:
Medical and Rehabilitation Benefits: Includes review and evaluation of Treatment and Assessment Plans (e.g., OCF-18 forms) to ensure treatment is reasonable, necessary, and appropriately documented.
Minor Injury Guideline (MIG): Application of guideline limits for minor injuries such as sprains or whiplash, helping define benefit eligibility and scope.
Income Replacement Benefits: Assessment of claims before and after 104 weeks post-accident, determining the injured person's ability to return to work or need for ongoing income support.
Non-Earner Benefits: Evaluation of eligibility for individuals unable to perform essential activities or employment due to injury, both short and long term.
Attendant Care Benefits: Determination of the requirement and scope of attendant care services to support daily living activities following injury.
Catastrophic Determination Assessments
These comprehensive evaluations are conducted for claimants with severe and permanent impairments, including:
Whole Person Impairment (WPI) Ratings: Application of the American Medical Association (AMA) Guides, 4th and 6th editions, to quantify impairment severity in a standardized and legally recognized manner.
Executive Summaries: Concise, high-level overviews crafted for legal counsel and insurance professionals to facilitate case understanding and strategy.
Comprehensive Documentation: Detailed, evidence-based reports suitable for submission in court or mediation, clarifying catastrophic impairment status and related care needs.
Medical Cannabis Assessments
Evaluations provide an expert opinion on the appropriateness of medical cannabis use for pain management within WSIB/WCB and accident benefit claims.
Medical File Paper Reviews
Thorough, documentation-only reviews of medical files serve to provide expert opinions on accident benefit or legal claims without in-person assessment. Opinions are based solely on the medical records and information provided, assessing the completeness, consistency, and adequacy of documentation to support claims. This service is designed for situations where an in-person evaluation is not required or feasible.
Death Reviews
In-depth examination of fatality cases linked to motor vehicle accidents incorporates coroner reports and medical evidence to determine cause and contributing factors. These reviews support litigation or insurance proceedings by providing expert testimony when needed.
WHY CHOOSE US?
Delivering credible, impartial independent medical examinations to support your legal needs.
Expert-Led Assessments
Assessments are completed by a chronic pain physician, offering consistent and informed perspectives throughout the evaluation process.
Diverse Case Experience
We handle a wide range of cases including plaintiff and defence medical legal reports, accident benefit reports, and death reviews, providing thorough assessments for diverse legal needs.
Nationwide Service
Expert independent medical examinations are accessible nationwide remotely, and in person within Ontario, Alberta, and Saskatchewan.
Client-Focused Efficiency
Our streamlined assessment process delivers clear, expedited reports, and proactive communication, vital for your legal and insurance decisions.