What is a ‘Form 1’ and why do I need it to get accident benefits?

If you are seriously injured in a car accident there are many benefits available that a personal injury lawyer can help you apply for. One of these benefits is called ‘attendant care’ and it relates to services provided around the home.

Examples of attendant care include: dressing, undressing, grooming, preparing food, eating food, taking medication, bathing and exercising.

Many seriously injured people have difficulty with these attendant care needs and require help that accident benefits were designed to provide. However, the Statutory Accident Benefits Schedule places a number of hurdles in the way of injured persons who wish to claim these benefits.

Limits

In a recent decision of the License Appeal Tribunal, Adjudicator Grant considered whether attendant care should be paid to someone who did not submit a Form 1. (A.A. v. Primmum Insurance, 2019 ONLAT 18-000727/AABS)

In this case, the Applicant was a chemotherapy patient who suffered a crush injury to the lower leg when he was pinned between two cars. This serious injury resulted in attendant care needs that were provided by the Applicant’s son.

Unfortunately the Applicant died before he could complete a Form 1.

Adjudicator Grant made it very clear – if the Form 1 is not completed – there is no attendant care payable pursuant to section 42(5) which states: “an insurer is not required to pay an expense for attendant care needs which is incurred prior to a Form 1 being submitted”.

Another barrier to claiming these benefits is that a Form 1 cannot be completed by an injured person. Only an Occupational Therapist or Registered Nurse can fill out the form and sign it. Although a person may be entitled to these benefits – if they cannot afford to arrange for someone to fill out this form, they cannot claim these benefits.

Lastly, there is a hard limit on the amount of money provided to persons requiring attendant care. For a non-catastrophically injured person that cap is $3,000 per month. No matter how much attendant care is needed – the insurer is only responsible for $3,000 worth of care. They will never provide more than this limit for a non-catastrophically injured person.

Conclusion

Therefore, it is clear there are many barriers to claiming attendant care benefits. Even in a situation where attendant care was provided – not completing a Form 1 is a total roadblock stopping an Applicant from receiving those benefits. A lawyer can help you navigate these many hurdles and claim the benefits in the proper way.

Brendan Sullivan
Written by

Brendan is a lawyer working in Hamilton Ontario at Harvey Katz law office. He has had the privilege of working closely with Harvey Katz and assists seriously injured people with claims arising from motor vehicle accidents, slip and falls, dog bites, life insurance denials and long-term disability. Brendan completed his articles in 2016 with a large insurance defence firm where he assisted with a seven week jury trial in Toronto. Brendan is a member of the Hamilton Law Association and the Ontario Trial Lawyers Association.