The purpose of this article is to inform the public of their right to ask the Société de l’assurance automobile du Québec (SAAQ) to pay for personal home help and possibility of contesting the refusal, assessment or amount of such aid granted by the latter.
Clients are often unaware of their right to personal assistance following a road accident. Following an accident, even if it is a member of your family who helps you with your activities of daily living, the latter is entitled to compensation by the SAAQ.
Apply for personal help at home
To apply for personal assistance at home, you must ask your agent to send you a needs assessment form. The agent may then decide to send an occupational therapist to assess your needs.
The assessment is done with a scorecard determined in three categories to examine the degree of need for personal assistance at home:
- No need for help;
- Need partial help;
- Need help
Examples of activities of daily living
The following is a list of activities of daily living that constitute personal assistance needs at home that can be found in the assessment grid (detailed assessment scale):
Personal activities : personal hygiene, dressing and undressing, taking meals.
Bladder removals : Use of the toilet, menstrual hygiene, use of hygienic panties, emptying of the bladder in a bag stuck to the skin, emptying of the bladder by intermittent sounding (catheterizations), emptying of the bladder by permanent probe, emptying of the bladder by condom, emptying of the bladder by condom and help by tapping, emptying of the intestine in a bag stuck to the skin, emptying of the intestine by enema, suppositories or stimulation, bladder irrigation.
Health care: Medication, tracheostomy and aspiration care, chest clapping or pressure, postural drainage, preventive skin care (pressure ulcers), specialized home program, other health care (according to the method provided in the description of activities), installation of orthotics or prostheses, maintenance of specialized equipment.
Travel: Getting up and going to bed, using the amenities of the house, getting on and off a means of transport, using a lift or needing 2 people to carry out transfers.
Domestic activities: Preparation of simple meals, preparation of a complex meal, daily maintenance, weekly cleaning, maintenance of linen and clothing, consumption of goods and services, budget management.
Other activities: Free occupation, sleep
Weekly cleaning includes, among other things, washing floors, vacuuming and taking out garbage. As for the preparation of a complex meal, it is described by the Regulations as the planning and preparation of one meal a day, which requires several stages of realization (usually dinner).
It is important to note that to be reimbursed for personal assistance at home, you must keep receipts.
Challenging the SAAQ’s assessment
As explained above, personal help at home is evaluated according to a scorecard and the amount can vary greatly depending on the scale.
It is certainly possible to challenge the assessment and score made by the SAAQ. To consult the SAAQ’s evaluation grid, click here.
Home help is too often minimized by customers. However, it can make a huge difference in the long run. For example, an amount granted of $80 per week by the SAAQ will correspond to more than $40,000 over 10 years.
Dispute procedure with a SAAQ lawyer
The SAAQ may issue a decision that refuses your application for personal assistance at home or grants you an amount lower than the amount to which you believe you are entitled. Our firm will help you analyze and challenge the decision in question.
We will conduct an assessment to identify whether you are able to carry out your activities of daily living, as well as your disabilities that remain despite the facilitating factors, the obstacles you encounter in your environment, as well as the constraints experienced by those around you. To view the evaluation grid we use with our clients, click here.
Facilitating factors include devices, such as corrective lenses, hearing aids, orthotics or medications taken naturally.
Please note, however, that it will probably be necessary to obtain medical expertise. Good independent expertise by a specialist is often essential in these types of cases. For more information, we refer you to our page on the
importance of expertise
.
For any dispute of the SAAQ’s decision, do not hesitate to
contact our firm
, which works to defend victims of automobile accidents.