If you have been injured in an accident you may qualify for a number of Part 7 benefits. These benefits are generally meant to help you pay for medical costs associated with your recovery, as well as deal with the financial consequences of an accident. Some of the benefits you may be entitled to include:
Medical and Rehabilitation Benefits
ICBC is liable to provide up to $150,000 for “reasonable” and “necessary” medical and rehabilitation benefits in the case of most motor vehicle accidents. The objective of these benefits is to put an insured to their former level of self-sufficiency as quickly as practically possible. This includes being able to manage a household and the achievement of gainful employment. Examples of such benefits include physiotherapy, ambulance and professional nursing services, chiropractic treatment, occupational therapy and similar treatments.
Payment for some of the benefits is mandatory, while payment for others is available at the discretion of ICBC. Usually, benefits include medical and rehabilitative coverage such as travel expenses to and from medical appointments, medication costs, chiropractic treatments, massage therapy, and physiotherapy. However, ICBC has developed a set of internal guidelines aimed at limiting payment of certain medical and rehabilitation expenses. In some cases, ICBC will refuse to pay the fees commonly associated with therapies, and limit coverage to a brief period following your accident, even if this goes against the recommendations of your doctor.
Disability (Wage Loss) Benefits
If you have been injured in an accident and rendered totally disabled from performing doing your job you may be entitled to weekly total disability benefits (“TTD Benefits”). In order to receive these benefits, ICBC will require proof of your employment status previous to the accident as well as medical evidence showing you are disabled. To qualify these benefits you must have either been employed at the time of the accident, or have worked at least 26 of the 52 weeks immediately prior to the accident. The amount of benefits will be the lesser of $300 per week or 75% of your average weekly gross earnings during the 12 months preceding your accident.
ICBC may also take into account compensation from other sources, including the Employment Insurance (“EI”) sick benefits you are entitled to receive in determining the amount of disability benefits you are entitled to. The amount of the EI benefits you are entitled to receive will generally be deducted from your TTD benefits regardless of whether you have applied for or are actually receiving the EI benefits. After the accident, you should apply for the EI Benefits as quickly as possible to ensure your best chances at obtaining maximum compensation for your injuries. Keep in mind that there is a seven-day waiting period before your TTD Benefits are payable.
If you are unable to perform your usual duties at work due to your injuries, you are permitted to receive TTD Benefits for the length of time that it takes you to recover from your disability, or up to two years after your accident. After that two year grace period, you will only be entitled to receive TTD Benefits if it is determined that you cannot hold a suitable job. Suitability is based on your age, education, and experience. At this time, ICBC will require that you also apply for CPP Disability Benefits. If you do qualify for TTD Benefits beyond the first two years, they extend only to age 65. CPP Benefit applications take a long time to process. In order to speed up the process and ensure that you retain your coverage, you should submit your claim for CPP Benefits in advance of that two-year mark. A delayed response on your part means that ICBC could suspend your TTD Benefits pending a decision from Service Canada on your CPP benefits. If it is determined that you are eligible for CPP Disability Benefits, your TTD Benefits will be reduced in accordance with the amount of CPP Benefits you receive.
If you are a stay-at-home mother or homemaker whose abilities have been compromised so that you are unable to perform household tasks on a regular basis, you are eligible to receive benefits of up to $145 per week. This benefit is intended to cover the cost of hiring household help during your period of disability. As with all other claims, ICBC will ask that you provide medical evidence to support your case.
If the head of a household or their spouse is killed, their family will be entitled to a benefit of $2,500 for funeral expenses. Additionally, the family members of a person killed in an accident may be entitled to lump-sum death benefits of up to $5000, as well as weekly benefits of up to $145 per week for 2 years.