What if my injuries interfere with my domestic duties?

Reimbursement for where injured persons need to hire services for care or housework

1- The Caregiver Benefit (CGB)

The caregiver benefit (or CGB) can be available if the injured person was a stay-at-home parent or caregiver at the time of the MVA, and now requires third-party services to take over their caregiving tasks. The benefit can help reimburse the injured person for the reasonable and necessary costs of these services. The housekeeping and home maintenance benefits (HKBs and HMBs) can be available to help reimburse an injured person for reasonable and necessary expenses of hiring a third party to do their pre-accident household chores if they are unable to do them because of their accident injuries. Changes within the past decade to the Statutory Accident Benefits Schedule (“SABS”), a regulation made under the Insurance Act, RSO 1990, c. I.8, have made CGBs, HKBs and HMBs more difficult to obtain. They are now only available to be claimed if the injury from the MVA was catastrophic or if the insured had purchased optional benefits.[1]

To qualify for the CGB, the injured person must:

1. at the time of the accident, been residing with someone in need of care – someone below the age of 16 years or who requires care because of physical or mental incapacity;
2. at the time of the accident, been the primary caregiver of the person in need of care;
3. at the time of the accident, not been receiving remuneration for the caregiving role; and
4. as a result of the accident, suffered an impairment that makes them “substantially unable” engage in the caregiving activities in which he/she was engaged at the time of the accident.[2]

The duration of the CGB lasts up to 104 weeks from the date of the accident. After that point, the injured person may qualify to continue to receive the CGB if he/she is “completely unable” to carry on a normal life.[3]

The maximums for the CGB are up to $250 per week for the first person in need of care and $50 for each additional person.[4]

2- Housekeeping and Home Maintenance Benefits (HKBs and HMBs)

The qualify for the HKB or HMB, the injured person must have suffered an impairment as a consequence of the MVA that results in their being “substantially unable” to perform the housekeeping and home maintenance services he/she normally performed.[5]

The duration of the HKB or HMB lasts up to 104 weeks from the date of the accident.

The maximum for the HKB and HMB is up to $100 per week.[6]

In determining the quantum of a CGB, HKB or HMB, the following factors are considered:

1. what (caregiving, housekeeping, home maintenance) tasks the injured person performed at the time of the accident;
2. the nature of the impairment sustained as a result of the accident; and
3. how the impairment affects the injured person’s ability to perform the aforesaid tasks.

[1] SABS, ss. 13 and 23 and para. 28(1)2.

[2] SABS, s. 13(1).

[3] SABS, s. 13(4).

[4] SABS, s. 13(2).

[5] SABS, s. 23.

[6] SABS, s. 23.