Last reviewed: September 2026
A letter from your insurer says your injury falls under the “Minor Injury Guideline.” That label decides how much treatment and care your accident benefits will pay for, and for how long. It does not limit a claim against the driver who caused the collision. For medical, rehabilitation and attendant care benefits, Ontario claims can be understood through three practical classifications: injuries treated under the Minor Injury Guideline, with a $3,500 cap, non-catastrophic impairments, with a standard limit of $65,000, and catastrophic impairments, with a standard limit of $1,000,000. A classification follows the medical evidence, and it can be reviewed as that evidence develops.
Key Takeaways
- The Minor Injury Guideline in Ontario caps medical and rehabilitation benefits at $3,500, with no attendant care, but only for injuries that are predominantly minor.
- $65,000 is the standard combined limit for medical, rehabilitation and attendant care when an injury is outside the Guideline but not catastrophic.
- $1,000,000 is the standard combined limit for a catastrophic impairment. Attendant care can be up to $6,000 per month, and the usual 260-week duration limit does not apply.
- July 1, 2026 made most other accident benefits optional for new policies, so the level you are placed in now carries more weight.
- 2 years from the insurer’s written decision is generally the window to dispute it at the Licence Appeal Tribunal, and that period can sometimes be extended.
What are the three injury levels in Ontario’s accident benefits system?
Ontario’s no-fault accident benefits come from a regulation called the Statutory Accident Benefits Schedule. Medical, rehabilitation and attendant care is included in every Ontario auto policy, and for policies entered into on or after July 1, 2026, it is the only benefit that remains mandatory. How much it pays depends on how your injury is classified.
The Statutory Accident Benefits Schedule sets a standard combined limit of $65,000 for non-catastrophic impairments and $1,000,000 for catastrophic impairments. It also limits medical and rehabilitation benefits to $3,500 where the insured person’s impairment is predominantly a minor injury. The Minor Injury Guideline governs the treatment framework for those minor injuries. That is how one claim comes to be worth $3,500, $65,000 or $1,000,000.
Ontario’s three injury levels for medical, rehabilitation and attendant care
| Feature | Minor Injury Guideline | Non-catastrophic | Catastrophic impairment |
| Standard limit | $3,500 for medical and rehabilitation | $65,000 combined | $1,000,000 combined |
| Attendant care | Not available | Up to $3,000 per month, within the combined limit | Up to $6,000 per month, within the combined limit |
| Time limit, standard coverage | Pre-approved treatment blocks over 12 weeks; further treatment within the cap by treatment plan | Medical, rehabilitation and attendant care generally up to 260 weeks (5 years), or to age 28 for a person under 18 at the time of the accident | The 260-week duration limit does not apply |
| Optional higher limit | None. The cap applies regardless of coverage purchased | $130,000 or $1,000,000 | Up to $2,000,000 with the $1,000,000 optional medical, rehabilitation and attendant care coverage, and up to $3,000,000 where the optional catastrophic benefit was also purchased |
| How the level is set | The insurer’s initial assessment, which can be challenged with medical evidence | The injury is not predominantly a minor injury | A physician (or a neuropsychologist, for a brain impairment only) completes the OCF-19, and the insurer decides, subject to dispute at the Licence Appeal Tribunal |
Sources: FSRA, Customize your liability and accident benefits coverage; FSRA, Superintendent’s Guideline No. 01/14, Minor Injury Guideline; FSRA, Standard Benefit Statement; FSRA, Statutory Accident Benefits Schedule Guidelines Review consultation paper, September 2024, Appendix C; FSRA, Application for Determination of Catastrophic Impairment (OCF-19). Applicable HST may be payable in addition to these limits, and every benefit is subject to the eligibility and reasonableness rules in the Statutory Accident Benefits Schedule, O. Reg. 34/10. Optional coverage varies by policy, so the limits and durations available in a particular claim depend on the policy in force.
What counts as a minor injury under the Minor Injury Guideline?
The Guideline defines a minor injury as “a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and any clinically associated sequelae.” In plainer terms: soft tissue injuries, bruises, scrapes, cuts and partial dislocations, along with the symptoms that usually come with them.
Two details in the Guideline matter more than the list itself. First, an injury comes within it only if the impairment is “predominantly a minor injury.” An injury with a significant component that is not on that list does not become minor because it also involves a sprain. A concussion, for example, is not one of the injuries named in the definition. Second, whiplash counts only where it shows no objective, clinically relevant neurological signs and no fracture or dislocation of the spine. Numbness, weakness or reflex changes that a clinician can document are the kind of findings that can take whiplash outside the Guideline. Symptoms that continue well past the expected recovery, such as persistent pain, headaches, poor sleep or anxiety after the collision, are also worth raising with your treating practitioner, because they bear on whether the injury is predominantly minor at all.
What the $3,500 buys is modest. Treatment is organized in three blocks across 12 weeks, and FSRA summarizes it this way: the Guideline provides “12 weeks of treatment and $2,200 in benefits, without requiring prior approval from an insurer,” with the balance of the $3,500 plus HST available through a treatment plan. Attendant care is not part of it. FSRA states that attendant care benefits “are not available if the injuries sustained are classified under the Minor Injury Guideline.” Symptoms that persist beyond the 12-week treatment blocks do not automatically take an injury outside the Guideline. Persistent or evolving symptoms may, however, justify reassessment where the medical evidence suggests the impairment is not predominantly minor.
The pre-existing condition exception
The Guideline has one written exception. An injury can be treated outside it where “compelling evidence provided by a health practitioner satisfactorily demonstrates that a pre-existing condition that was documented by a health practitioner before the accident” will prevent the person from achieving maximal recovery within the Guideline’s limits. That evidence is submitted on a Treatment and Assessment Plan (OCF-18), with the medical documentation attached.
The Guideline also says a pre-existing condition “will not automatically exclude” an injury from it, so a prior back problem will not take an injury outside it on its own, and having one does not, by itself, weaken a claim. Records from before the accident can become some of the most useful evidence on the file, and if the collision made an old condition worse, that worsening can form part of both the benefits claim and any claim against the at-fault driver.
What benefits are available for a non-catastrophic injury?
An injury that is not predominantly a minor injury, and does not meet the catastrophic test, falls into the non-catastrophic level. The standard combined limit for medical, rehabilitation and attendant care rises to $65,000. Under standard coverage, medical, rehabilitation and attendant care benefits are generally available for up to 260 weeks (5 years), or to age 28 for a person who was under 18 at the time of the accident. Attendant care can be paid at up to $3,000 per month, within the combined limit.
Injuries that fall outside the Guideline’s list, such as a broken bone, or whiplash with documented neurological findings, generally belong at this level, and more serious injuries may qualify as catastrophic, as the next section explains. The move from $3,500 to $65,000 is an increase of more than eighteen times, and it covers the kinds of support that serious but non-catastrophic injuries tend to need: longer physiotherapy, occupational therapy, psychological treatment, assistive devices, and help at home.
Some people carry more. FSRA confirms that the non-catastrophic limit can be increased to $130,000 or $1,000,000 as optional coverage. Whether a policy includes one of those options is worth checking early, because it changes what this level is worth in your case.
What makes an injury catastrophic in Ontario?
For a catastrophic impairment, the standard combined medical, rehabilitation and attendant care limit is $1,000,000. Attendant care can reach $6,000 per month, and the usual 260-week duration limit does not apply, subject to the applicable combined limit. Optional coverage can raise it further. Buying the $1,000,000 optional medical, rehabilitation and attendant care coverage raises the catastrophic limit to $2,000,000, and buying the optional catastrophic benefit adds a further $1,000,000, bringing the limit to $3,000,000 where both were purchased.
“Catastrophic” has a specific legal meaning. It depends on medical criteria, set out in the regulation and reproduced on FSRA’s Application for Determination of Catastrophic Impairment (OCF-19), rather than on how severe an injury feels. A physician completes the application, and where the impairment is a brain impairment only, a neuropsychologist may complete it instead. On the basis of that application, the insurer may designate the person as catastrophically impaired, which opens up the higher catastrophic limits. If the insurer refuses, that decision can be disputed at the Licence Appeal Tribunal.
The routes to a catastrophic designation
| Route | What it generally requires |
| Paraplegia or tetraplegia | A spinal cord injury meeting set severity criteria on standard spinal cord injury scales, once neurological recovery allows the permanent level to be determined |
| Amputation or severe loss of mobility or use of an arm | A leg amputation at or above the lower leg, loss of an arm or total and permanent loss of its use, or severe permanent impairment of one or both legs affecting indoor mobility |
| Loss of vision in both eyes | Visual acuity of 20/200 (6/60) or less, or a field of vision of 20 degrees or less, in both eyes |
| Traumatic brain injury, adult | Positive brain imaging plus a qualifying rating on the Glasgow Outcome Scale, Extended, at set points after the accident |
| Traumatic brain injury, child | Several alternative criteria designed for children, which can be met in different ways |
| Physical impairment | Physical impairments rated at 55% or more of the whole person |
| Physical and mental or behavioural combined | Mental or behavioural impairment, excluding traumatic brain injury, combined with physical impairment, rated at 55% or more of the whole person |
| Mental or behavioural impairment | A marked impairment in three or more areas of function that precludes useful functioning, or an extreme impairment in one or more areas |
Source: FSRA, Application for Determination of Catastrophic Impairment (OCF-19), AF-144E (2026), which reproduces the criteria in the Statutory Accident Benefits Schedule, O. Reg. 34/10. Impairment ratings follow the editions of the American Medical Association Guides named in the regulation.
This table is a simplified overview, not a self-assessment checklist. Catastrophic impairment can depend on timing, combined impairments and detailed medical evidence, and more than one route may need to be considered. A designation does not require a single devastating injury: several physical impairments can add up to the 55% threshold, and a qualifying mental or behavioural impairment, excluding traumatic brain injury, can combine with physical impairment to reach that threshold. Normal brain imaging does not, by itself, rule out every route to catastrophic impairment. Other criteria may apply depending on the documented impairments and the medical evidence. If you or a family member may be in this category, our catastrophic injury lawyers can explain how the criteria apply to the medical picture.
When a catastrophic impairment can be decided
Timing is built into the definition. For an adult with a traumatic brain injury, the qualifying outcome ratings can be assessed one month, six months or one year after the accident, depending on the level of disability. The whole person and mental or behavioural routes generally apply once two years have passed since the accident, or earlier if a physician concludes the impairment is unlikely to improve below the threshold. For the 55% whole person routes, that earlier physician assessment must take place at least three months after the accident.
A catastrophic application can come months or years after a collision, so someone first placed lower may qualify later. A family should not assume that because nobody raised the word “catastrophic” in the first weeks, it will never apply. The medical record that supports these routes is built long before an application is filed, which is why advice early on matters.
What changed on July 1, 2026, and what stayed the same?
The July 1, 2026 changes did not alter the dollar limits for the three levels. FSRA’s current coverage page still sets out the same $65,000 and $1,000,000 standard limits, the Minor Injury Guideline remains listed as active, and FSRA’s July 2026 edition of the minor injury treatment form (OCF-23) is still issued for services “in accordance with the Minor Injury Guideline.” The catastrophic impairment criteria on FSRA’s current OCF-19 are the same routes described above.
The changes were to the benefits and rules around those levels:
- Most benefits became optional for new policies. FSRA’s wording: “For policies entered into on or after July 1, 2026, only standard medical, rehabilitation and attendant care benefits will remain a mandatory part of your auto insurance policy.” Income replacement, non-earner, caregiver, housekeeping and home maintenance, death and funeral benefits, among others, are now optional.
- Optional benefits cover fewer people. They apply to the named insured, their spouse, their dependants and people listed as drivers on the policy, and FSRA says that change applies regardless of when the policy renews.
- Existing coverage does not disappear silently. Existing policies renew with the same coverage and limits unless the customer agrees in writing to a change.
- Auto insurance generally pays first. For medical and rehabilitation benefits, auto insurers became first payors effective July 1, 2026, ahead of extended health care plans, a change the province set out in its 2025 Budget. Medication expenses are an exception, and should still be submitted to supplementary health insurance plans first.
Together, these changes make the injury level matter more. For someone on a policy with only the mandatory coverage, the medical, rehabilitation and attendant care benefit may be most of what the no-fault side of their claim offers, so whether it is $3,500, $65,000 or $1,000,000 now makes a bigger difference to what they can recover. The claim against the at-fault driver does not depend on which optional benefits were purchased.
When a Minor Injury Guideline classification may need review
Where the medical evidence shows that an impairment is not predominantly a minor injury, remaining in the Guideline can materially limit the medical and rehabilitation benefits available, and it excludes attendant care. That is why the classification is worth reviewing against the medical evidence as recovery progresses.
Labels are usually applied early. In the first weeks after a collision, the file may contain little more than an emergency room note and a family doctor’s first visit. Some injuries take longer to show themselves: nerve symptoms, the effects of a concussion, pain that does not settle, or the psychological impact of the collision itself. A label based on that early record may not match how you are doing a few months later, and it stays in place unless someone asks the insurer to look again.
The insurer also has its own medical input. The accident benefits schedule allows the insurer to require examinations, which are sometimes carried out as a file review without the claimant attending, and those opinions often carry weight in the insurer’s decision. Treating-practitioner records and the documented course of recovery may also be relevant to the classification.
Disputes over accident benefits are common. Ontario’s tribunal for them received over 16,000 appeals in 2023 to 2024, the highest number since it took over these cases from the province’s former insurance regulator in 2016.
How to dispute your classification
Here is how a dispute usually unfolds.
- Written decision. The Licence Appeal Tribunal’s clock runs from the insurer’s written notice, which includes the reasons for the decision. Keep it, and ask for it if you only heard the decision by phone.
- Medical evidence. Your treating practitioner can submit a Treatment and Assessment Plan (OCF-18) explaining why the injury is not predominantly minor, or why a documented pre-existing condition takes it outside the Guideline. For a catastrophic impairment, a physician completes the OCF-19. Consistent care helps document your recovery. Gaps in treatment are common, and the reasons for them, whether cost, access or something else, can often be explained.
- Licence Appeal Tribunal. If the insurer does not change its position, the Tribunal’s Automobile Accident Benefits Service resolves disputes about “entitlement to, or amount of, statutory motor vehicle accident benefits.” An application generally has to be made within two years of the insurer’s written notice, and the filing fee is $106.
- Case conference. This usually takes place about 3 to 5 months after a completed application and includes a discussion of settlement.
- Hearing and decision. If the matter does not resolve, a hearing typically follows 4 to 8 months after the case conference. Decisions are legally binding on both the injured person and the insurance company.
The Tribunal has confirmed that the July 2026 changes do not affect your right to appeal. If more than two years have passed, ask anyway: the Tribunal can sometimes extend the time limit, and whether the clock has started can depend on the notice you received.
Accident benefits deadlines, from claim to appeal
| Deadline | Time limit | What it applies to |
| Tell the insurer, your own or the one that responds to your claim, that you plan to apply for benefits | 7 days after the accident, or as soon as possible after that | Starting an accident benefits claim |
| Return the Application for Accident Benefits (OCF-1) | 30 days after receiving it. If late, send it with an explanation | Starting an accident benefits claim |
| Apply to the Licence Appeal Tribunal | Generally 2 years after the insurer’s written notice of its decision. The Tribunal can sometimes extend this | Disputing a classification or a denied benefit |
| Ask the Tribunal to reconsider its decision | 21 days after the decision | Limited grounds set out in the Tribunal’s rules |
| Appeal to the Divisional Court | 30 days after the decision, on a legal error only | Challenging a Tribunal decision in court |
| If one of these has already passed | Relief may still be available | Some deadlines can be extended. Ask before assuming you are too late. |
Sources: FSRA, After an Accident: Understanding the Claims Process; FSRA, Application for Accident Benefits (OCF-1), AF-145E (2026); Tribunals Ontario, LAT-AABS application and hearing process; Tribunals Ontario, Licence Appeal Tribunal Rules.
The label does not cap your claim against the at-fault driver
The Minor Injury Guideline, and every level above it, governs accident benefits only. If someone else caused the collision, a separate claim against that driver can seek compensation for pain and suffering, lost income, future care and other losses, and the $3,500 cap does not limit it. The Licence Appeal Tribunal does not hear those claims; they are outside its jurisdiction and proceed in court.
That claim has its own rules. For pain and suffering, Ontario’s statutory threshold generally requires that the injury result in death, permanent serious disfigurement, or permanent serious impairment of an important physical, mental or psychological function, under the Insurance Act. Whether an injury meets that test is highly fact-specific. It is judged on the medical evidence as it develops, not on an early benefits label, and chronic pain and psychological injuries can meet it where the evidence supports that. For 2026, a deductible of $47,913.01 is subtracted from a pain and suffering award, and it stops applying once the award exceeds $159,708.71. That deductible applies to pain and suffering, not to compensation for lost income.
Written notice of an intended claim generally has to be given within 120 days under the Insurance Act, though a court can allow a longer period. A lawsuit generally has to be started within two years under the Limitations Act, 2002, usually counted from when the claim was discovered, which can be later than the accident date.
How we help when the classification does not fit the injury
At our firm, it’s personal. Many people call us after a letter placing them in the Minor Injury Guideline, or after being told a catastrophic application is premature, and want to know whether that decision is final. Often it can be revisited.
We review the classification against the medical record and the policy that was in force on the day of the accident, including what the July 2026 changes mean for that policy. Where the evidence supports a higher level, we work with treating practitioners to put it in front of the insurer, pursue catastrophic designation where the criteria may be met, and take disputes to the Licence Appeal Tribunal when that is the right step. Alongside the accident benefits claim, we assess the claim against the at-fault driver, which the classification does not limit.
We act on injuries at every level, from soft tissue injuries and chronic pain to catastrophic impairment. We offer a free consultation and work on a contingency fee basis, No Win, No Fee, with the written retainer agreement explaining how fees and disbursements are handled. Where getting to an office is not realistic, we can often meet at home or in hospital, and our team can work with clients in a number of languages. We are based in Ottawa, with a second office in Hawkesbury, and we act for people across Ontario.
If an insurer has called your injury minor but you are not recovering the way that label suggests, tell us what happened and we can talk you through your options.
Legal information, not legal advice
This article explains general rules that apply in Ontario and figures that were current when it was written. It is legal information, not legal advice. Benefit limits, forms and deadlines change, and how any of them applies depends on the facts of a particular situation and the policy involved. Speak with a lawyer about your own circumstances before acting on anything here.
About the author
Miryam Gorelashvili, LL.B. is the founder of MG Law Personal Injury Lawyers in Ottawa, where she has acted for injured people and their families since 2009. Her practice has a particular focus on serious and catastrophic, life-changing injuries and wrongful death, alongside the firm’s broader personal injury and accident benefits work. Read the full profile of Miryam Gorelashvili, LL.B.
References
Frequently asked questions
Can an injury be moved out of the Minor Injury Guideline after it has been placed there?
Yes. The classification follows the medical evidence, and a treatment plan supported by that evidence can ask the insurer to treat the injury outside the Guideline at any stage of recovery. If the insurer refuses, that refusal is a decision you can take to the Licence Appeal Tribunal. Moving up to the catastrophic level follows its own timing rules, set out above.
I had a concussion. Is that a minor injury?
A concussion is not one of the injuries named in the Guideline, so whether a minor injury classification fits depends on the full medical picture. In more serious cases, the catastrophic impairment criteria may need to be assessed. Some catastrophic routes require positive brain imaging, while other routes turn on different documented impairments and functional consequences. Our brain injury lawyers can review how the classification was reached.
What happens when the $3,500 is used up?
It is often the right moment to ask whether the injury was ever predominantly minor. Your practitioner can submit a treatment plan with medical evidence asking the insurer to treat it outside the Guideline, where the $65,000 limit applies, and a refusal can be disputed. A claim against the at-fault driver may also include the cost of future treatment. Within the Guideline itself, $3,500 is the limit for medical and rehabilitation benefits, whatever coverage you bought.
I was walking and I do not have car insurance. Do these levels apply to me?
Yes. FSRA confirms that people who do “not have your own automobile insurance policy and are not listed on someone else’s policy” may still claim medical, rehabilitation and attendant care benefits, and the same three levels decide how much those benefits are worth. Which insurer responds is decided under Ontario’s priority rules, and where no insurance is available, the Motor Vehicle Accident Claims Fund may.
Does it cost anything to talk to a personal injury lawyer?
The initial consultation is free. If MG Law accepts the case on a contingency fee basis, legal fees are payable from a successful recovery in accordance with the written retainer agreement. We can explain how fees, HST and disbursements would apply to your case.
