When a catastrophic determination matters

Under SABS, a catastrophic designation moves the claimant from a $65,000 Non-MIG benefit pool to a $1,000,000 benefit pool for life, plus attendant care up to $6,000 per month. The determination is binary — either the criteria are met or they are not — but the file behind it is rarely simple. We provide the multidisciplinary work-up that supports a defensible determination either way.

SABS criteria we assess against

• Criterion 1 — Paraplegia or tetraplegia. ASIA-based.
• Criterion 2 — Severe impairment of ambulatory mobility / use of upper limb. Distance, time and assistive-device thresholds.
• Criterion 3 — Amputation or other loss of use. Defined functional thresholds.
• Criterion 4 — Loss of vision. Best corrected, both eyes.
• Criterion 5 — Traumatic brain injury (adult and paediatric pathways). GCS, GOS-E, neuroimaging.
• Criterion 6 — Mental or behavioural impairment with Class 4 marked impairment in one area or Class 5 extreme impairment. Standardised psychological assessment.
• Criterion 7 — 55% whole-person impairment combining physical and mental. AMA Guides 4th edition.
• Criterion 8 — Combined Criterion 6 + 7.

Our multidisciplinary CAT panel

A defensible CAT report typically requires three to seven assessors. We assemble the panel from our roster and a network of consulting specialists:

• Physiatrist (lead assessor on most files)
• Neuropsychologist (Criteria 5, 6, 7, 8)
• Psychiatrist or Psychologist (Criterion 6)
• Orthopaedic / Neurological consultants where indicated
• Occupational Therapist (functional impact, attendant care)
• Physiotherapist (mobility, ambulation, ASIA)

Process and turnaround

Step 1 — referral and file review (2–3 business days). Step 2 — examinations scheduled with each panel member; typically 3–6 weeks depending on availability and claimant scheduling. Step 3 — integrated report from the lead assessor within 10 business days of the final examination.

What you receive

• Individual discipline reports per AMA Guides 4th ed. / SABS criteria
• Integrated CAT report with combined whole-person impairment calculation
• Defensible methodology section with traceable scoring
• Functional impact narrative supporting the determination
• Attendant-care Form 1 recommendation where applicable