Compensation for bodily injury

If you have suffered bodily injury as a result of a road accident (for example, a cervical sprain, a herniated disc, a head injury, etc.), the law provides that the SAAQ must compensate you for your damage.

To do this, however, the SAAQ will first conduct an analysis of your file in order to establish the extent and seriousness of your damage. More specifically, the SAAQ will seek to determine whether you have suffered a permanent impairment of one or more of their 25 recognized functional units , including:

• Balance;
• The movement and maintenance of the head, trunk, and upper or lower limbs;
• Manual dexterity;
• Skin sensitivity of the skull, face, neck, trunk, genitals, and upper or lower limbs;
• And vision, hearing, taste and smell;

To this end, it should also be noted that scars, cardio-respiratory difficulties and sexual difficulties following the accident, among others, can also be considered as a compensable physical injury.

It is therefore important to challenge a decision that incorrectly establishes your permanent sequelae, since these will have a major impact on your file. Indeed, your permanent sequelae will serve as a reference point for the SAAQ to establish not only your ability to hold a job, but also the nature of that job. In addition, only a recognized sequelae may be the subject of a relapse, recurrence or aggravation in the future for the purposes of the SAAQ.

However, to challenge the SAAQ’s assessment of sequelae, the production of one or more forensic expertise is essential. Indeed, the testimony of the victim of the accident, however credible it may be, will never be sufficient to satisfy his or her burden of proof on a balance of probabilities. Thus, it is held that, with respect to the establishment of compensation for loss of quality of life, the Tribunal usually renders its decision only on the basis of the medical evidence presented, and not on the basis of the victim’s allegations.

Assessment of permanent sequelae

For the assessment of bodily injury and the corresponding compensation in saAQ matters, the relevant legal provisions can be found in
the Regulation respecting lump-sum compensation for non-pecuniary damage
(“Regulation”).

Reading these, we learn from the outset that the permanent sequelae are evaluated only when the customer is consolidated. However, there is consolidation of “any sequelae of a functional or aesthetic [lorsque] nature the examinations carried out and the recognized medical knowledge do not make it possible to predict, in the short or medium term, a significant improvement in the condition of the victim”. It is therefore understood that it is not necessary that your wounds be healed to assess them for the purposes of the SAAQ, but that they be stabilized.

It is then noted that the Regulations also provide for various classes of severity to which a permanent sequelae resulting from an automobile accident may correspond. However, these severity classes essentially represent the different degrees of harm that can be attributed by the SAAQ to each of the functional units negatively affected by your accident. The severity class is established by identifying the limitation or harm suffered that has the most severe impact on the victim among the options provided for in the Regulation for each functional or aesthetic unit affected. Thus, the fact of no longer being able to run following an accident corresponds to a lower severity class, at the level of locomotion, to the fact of no longer being able to walk for more than 30 minutes, for example.

In addition, similar to the extent of the permanent sequelae recognized in your file, the severity class identified will also be used, in a timely manner, to assess your ability to hold the job determined by the SAAQ. However, a higher severity class generally represents more severe limitations for the victim in terms of his or her ability to return to work.

Finally, it is important to note that the victim who was already affected by a pre-existing medical condition may also be compensated for his accident, by invoking the fragile skull theory. However, this victim must demonstrate that his accident caused a worsening of his previous condition, and can only be compensated to the extent of this aggravation. To prove this aggravation, the victim will also have to demonstrate objectively, thanks to the medical evidence in his file, the increase in his damage.

Challenging a SAAQ decision

If you do not agree with a decision of the SAAQ, whether concerning the assessment of your permanent sequelae or your ability to return to work, it is important to consult a lawyer to contest it as soon as possible.

Indeed, it is important not to do a job search or try to exercise a job so you are not completely consolidated, since it could harm your cause. Instead, contact a lawyer to preserve your rights and establish the appropriate strategy in your case.

Similarly, do not hesitate, if you believe that your condition is not yet consolidated, to continue your medical treatments, even if the SAAQ refuses to reimburse you for these expenses, since this is a decision that can be challenged. We invite you to consult our page on the reimbursement of medical treatment expenses for more information on this subject.

Finally, please note that it is essential to contact us as soon as you receive an unsatisfactory decision. Indeed, a SAAQ file takes a long time to prepare and requires a lot of legal analysis, especially since you only have one chance to successfully challenge your decision. Thus, it is important to put all the chances on your side from the beginning of the process, that is to say upon receipt of your initial decision. We offer you a free initial consultation if you have a decision to challenge.

* The 25 functional units, some of which are separated into subsections, are as follows: psychic function, state of consciousness, cognitive aspect of language, functions of the visual apparatus, functions of the hearing aid, taste and smell, skin sensitivity, clinical pictures of balance disorders, phonation, mimicry, movement and maintenance of the head, displacement and maintenance of the trunk, the function of moving and maintaining the upper limb, manual dexterity, locomotion, protection provided by the skull, protection provided by the rib cage and abdominal wall, nasopharyngeal respiration, digestive functions, cardio-respiratory function, urinary functions, genitosexual functions, endocrine functions, hematological, immune and metabolic, clinical pictures of paraplegia and tetraplegia, and aesthetic unity.

The SAAQ file

• SAAQ lawyer in Montreal
• Consolidation and road accidents (SAAQ)
• Compensation for psychological damage
• Income Replacement Indemnity Claim
• Return to work after a road accident

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