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Catastrophic Designation in Ontario: Transtibial or Higher Amputation of a Leg: What Does This Mean?

By Matt Lalande in Catastrophic Injuries, Hamilton Personal Injury Lawyer on January 23, 2021

Catastrophic Designation in Ontario: Transtibial or Higher Amputation of a Leg: What Does This Mean?


Most people who have a missing limb were not born that way. Many amputees areforced into this unfortunate change to their body by a traumatic or chronic medical event.  Amputation poses challenges on many levels; physical, emotional, psychologial social, spiritual ect. Challenges may vary from individual to individual, however in most cases – research shows that unexpected traumatic amputation leads to physical chronic pain, PTSD, anxiety, depression, self image and body image issues.

As with any severe loss, there are overlapping psychological consequences and emotional stages of recovery. There are differing opinions in medical journals on the process – but most agree that there are common emotional phases a person may encounter may include shock, denial, bargaining, anger, grief, anxiety, and acceptance/adjustment. Not everyone goes through each stage, nor do people always follow a rigid sequence. Experiencing some of the emotional phases seems to allow our whole being the opportunity to recover and regroup and start to deal with the way they see body alteration perceive their bodies—or changes of function in the activities and roles that they are able to carry out. Some amputees experience vengeful anger or disabling sadness. Some amputees experience tremendous grief – and many will experience life-altering axiety.

The long and short is that many amputees, if not most, will not only require life long future care costs to assist with rehabilitation, adaptation and coping, but most will require life-long emotional and psychological support, particularly if the amputee suffered from prior mental health disturbances.

We understand that traumatic amputations are one of the most emotionally disturbing wounds one could experience.  Unfortunately they do remain very common injuries, often caused in serious pedestrian accidents, car accidents, motorcycle and  trucking accidents. If you’ve been rendered an amputee because someone else was careless, please call our Hamilton personal injury lawyers today at 905-333-8888. We would be happy to talk to you about how we can help recover the compensation you deserve.

What is Catastrophic Designation?

When you pay your motor vehicle insurance premiums in exchange for a policy of insurance, you not only pay for third-party insurance in case you hurt somebody, but you also pay for first party insurance in case you, yourself are hurt. This first party insurance stems from the statutory accident benefits schedule (SABS) which is the no-fault accident insurance benefits regime that is available to anyone injured in a car accident in Ontario. The Insurance Act deems every motor vehicle liability policy in Ontario must include all benefits set out in the statutory accident benefits schedule.  The SABS sets out what benefits are available to injured pesons, and the criteria and procedures for claiming and approving or rejecting benefits. 

The type of benefits, and the monetary limit of benefits depend how injured the accident victim is. There are three tiers to the accident benefits schedule. The first tier provides victims up to $3500 in medical rehabilitation benefits. If an accident victim’s injuries do not fall into this category, call the Minor Injury Guideline, they typically fall into the next tier which provides a monetary limit of $65,000 for medical, rehabilitation and attendant care funding, for up to five years.

For the more serious injuries, he or she might qualify to be deemed catastrophically impaired according to the SABS. Typically, catastrophic designation is reserved for the most impaired accident victims. If one is deemed catastrophically impaired, the amount then depends on whether or not that person purchased “optional benefits” –  however –  the standard medical, rehabilitation and attendant care limits are $1 million, available over the victim’s lifetime. There are also other additional benefits available to catastrophically impaired victims, such as the ability to hire a case manager and housekeeping benefits.

How does one qualify? They must be deemed catastrophically impaired in one of eight categories, which can be located at section 3.1(1) of the SABS.

One of the categories is the severe impairment of ambulatory mobility or use of an arm, or amputation. Amputation, in the context of catastrophic designation, is defined as a transtibial or higher amputation of the leg OR and an amputation of the arm or other impairment causing the total and permanent loss for use of an arm.

What is the a transtibial or higher amputation of the leg?

Trans-tibial is the term used to designate the area of the leg below the knee, and a trans-tibial amputation occurs when the foot, ankle joint, and distal tibia (the shin bone) and fibula (the calf) are removed.  A trans-tibial or higher amputation of a leg refers to the removal of the leg at any point below or above the knee. 

Generally, a trans-tibial or higher amputation of a leg will be performed only in urgent emergency situations. This occurs when the victim’s life is at risk, if there is a severe risk of sepsis or infection (such as an ulcer that does not heal), or if there is an extremity below the area of amputation that cannot be recovered. 

In traumatic personal injury cases, a trans-tibial amputation may occur when the leg or foot are crushed or severed in an accident to the point where they cannot be repaired surgically. Typically, this occurs from major accidents such as car accidents, pedestrian accidents, bicycle accidents, or motorcycle accidents.

Prognosis and Recovery

After a trans-tibial amputation, or other leg amputation, is performed, the surgeon will shape the limb in order to allow the individual to be fitted for a prosthetic leg or foot. Once this process is complete, the individual will normally begin physical therapy and rehabilitation.  During rehabilitation and recovery, an amputation victim will undergo a variety of treatments designed to assist them in learning to walk with a prosthetic limb, caring for their prosthetic equipment, regaining muscle strength, controlling pain and swelling, and prevention of contractures (stiff joints). 

Life After a Trans-Tibial Amputation 

life after an amputation is not always easy. As mentioned above, many amputees go through an initial emotional phases such as shock, denial, bargaining, anger, grief, anxiety and hopefully, acceptance. It is not uncommon for some amputees to suffer complex emotional problems or depressive conditions. In these situations, it’s very important for the amputee to obtain psychological support, which, for most can be life long, especially for those who suffer pre-existing mental health conditions.

Depending on the individual’s job, this might mean they are unable to return to work or must attempt to search for alternative work that can accommodate their injury. This can lead to a variety of psychological ramifications, including social anxiety, self-consciousness, loss of self worth, job loss, missed wages and financial distress, and depression.

Physical pain may occur as well. As many as 80% of individuals who have had a limb amputated suffer from phantom limb pain. This occurs when an individual feels sharp, chronic residual pain in the area where the limb has been amputated. Phantom limb pain can last for many years after an amputation, and can begin at any point in time after the injury. There is no specific cause, and it is a complex phenomenon that has puzzled medical researchers for years. As a result, it can be difficult to treat effectively.

I was Injured in an Accident and my Leg Was Amputated. Do I Have a Case?

Our Hamilton Personal Injury Lawyers understand the physical, mental, psychological and physical challenges that amputations present. If you have suffered an amputation injury in Ontario because somebody else’s careless or negligent and your injury could have been avoided, then yes, you will more likely than not have a case. We understand that the loss of limbs and amputations have permanent life long lasting effects for a victim and his or her family.  An experienced Hamilton personal injury lawyer can properly assist you in determining whether your injuries qualify you for catastrophic designation in Ontario. It is of the utmost importance that you work with a lawyer who has experience in amputation injuries who understands every facet of the law and can ensure that you will not be settling for less than you deserve. 

If You Have Suffered a Catastrophic Injury, our Hamilton Personal Injury Lawyers can help

Amputations are a very serious catastrophic injury that can permanently derail your life. When someone else’s negligence leads to your pain and suffering, you have the right to seek fair compensation. Matt Lalande has been representing amputee victims across Ontario since 2003 – and is known for diligently securing high-value outcomes for amputee victims whether through settlement or trial verdict.  Schedule a call back online or call us local in the Hamilton / GTA at 905-333-8888 or nationwide at 1-844-LALANDE (525-2633) to book your consultation and speak to a lawyer today.

1 King Street East, Suite 1705
Hamilton, On L8P 1A4

*The above information was approved by Matt Lalande or another lawyer at Lalande Personal Injury Lawyers. The information comes from legal experience, trial experience, extensive medical research and discussion with medical professionals, medical journal review and updates and/or consultations with fellow friends and colleagues in the legal and medical field.



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