Timelines are strict after an accident, so it’s important that you understand what you need to do to make sure you meet all of your deadlines. A large part of this application consists of forms you’ll need to quickly complete with your Accident Benefits Lawyer.
Below, you’ll learn which forms you’ll need to complete and the types of information required.
Employer’s Confirmation of Income (OCF-2)
The OCF-2 is necessary if you’ll claim Income Replacement Benefits. To be eligible for these benefits, you must have been employed for 26 of the 52 weeks before your accident occurred. Your accident must also prevent you from returning to work for more than one week after the accident date to qualify.
Permission to Disclose Health Information (OCF-5)
Do not complete the OCF-5 or Permission to Disclose Health Information, which permits an insurance company to see your medical records, unless your claim adjuster asks you to. It’s also essential to ask which medical records the adjuster is requesting and the reasons for the request. Finally, clearly print on the form the dates of the doctor visits you are agreeing to disclose records for.
Disability Certificate (OCF-3)
If your accident has resulted in a disability that has been diagnosed by a medical professional, you will need to complete the OCF-3 or Disability Certificate. Work with your doctor and other health professionals (such as chiropractors, optometrists, psychologists, nurse practitioners, etc.) to complete the form.
Election of Income Replacement, Non-Earner, or Caregiver Benefit (OCF-10)
Even though you may qualify for the Income Replacement Benefit, the Non-Earner Benefit, and the Caregiver Benefit, you can only apply for one of these. Ask your lawyer to help you understand which of these is best to apply for and make sure to submit the form within 30 days of receipt.
Pre-approved Framework Treatment Confirmation Form (OCF-23)
You do not need to complete the Pre-approved Framework Treatment Confirmation Form unless your insurance company directs you to. Only some categories of injuries require the form.
Application for Expenses (OCF-6)
Most people will need to complete the Application for Expenses because these benefits include medical or personal expenses your accident resulted in. Medications, physiotherapy, and any other treatments approved by your insurance company can be included. If you spend money on babysitters, housekeepers, transportation, or other services, this should also be included. You can also include personal items or clothing that were damaged because of your accident. You’ll need to submit receipts for these expenses when you submit the form, including those from babysitters or other non-professionals.
Declaration of Post-Accident Income and Benefits (OCF-13)
If you are able to work after your accident, but your injuries have prevented you from working at your regular job or for your usual number of hours, complete the Declaration of Post-Accident Income and Benefits. If you are eligible for disability benefits, you should still complete this form. It will help your insurer determine the amount of your Income Replacement Benefit.
Application for Determination of Catastrophic Impairment (OCF-19)
Not every accident benefits claim requires an OCF-19. This form is used when an injured person seeks a determination that an accident-related impairment meets one or more of Ontario’s legal criteria for catastrophic impairment.
CAT status can substantially increase the medical, rehabilitation and attendant care benefits available under the Statutory Accident Benefits Schedule (SABS). The OCF-19 identifies the CAT criterion or criteria being relied upon and includes a supporting medical assessment.
Because the applicable criterion, medical evidence and timing can affect the application, people with serious injuries should get legal advice as early as possible about whether and when an OCF-19 should be submitted.
For a detailed explanation of the form, insurer response requirements and a recent HIMPRO case involving an OCF-19 dispute, read our OCF-19 guide.
Disputing an Accident Benefits Decision at the Licence Appeal Tribunal (LAT-AABS)
If your insurer denies an accident benefit or disputes the amount payable, the disagreement may be brought to Ontario’s Licence Appeal Tribunal – Automobile Accident Benefits Service (LAT-AABS). The LAT-AABS resolves disputes about entitlement to, or the amount of, statutory motor vehicle accident benefits.
Do not wait until the dispute is well advanced to get legal advice. Limitation periods and filing requirements can apply, and an accident benefits lawyer can help assess the denial, preserve the evidence and prepare the claim before a LAT application or hearing becomes necessary.
Don’t forget to keep a copy of each form you submit, as well as copies of any materials you submit alongside it.
For more practical information about what to do after a serious accident, you can also download our free personal injury recovery kit.
If you have questions about your accident benefits, the forms you need to submit or how your insurer is handling your claim, request a Free Consultation with a HIMPRO accident benefits lawyer or call us at 1-855-446-7765.
