# Test the file against the catastrophic criteria, page by page

> Ontario CAT files turn on specific SABS tests. Thickness of the record set is not one of them.

Source: https://imecore.com/use-cases/catastrophic-impairment

## The file is thick. Nobody has tested it against the criteria.

A CAT referral asks whether the person meets the SABS catastrophic definition. The brief is a hospital dump plus rehab notes with no Glasgow score pulled forward. The examiner hunts for the criteria in hundreds of pages, and the report discusses disability in general instead of the test that pays.

- Acute-care scores are buried and never listed on the case.
- Physiatry, neurology, and psychiatry opinions are not sequenced.
- The report talks about impairment and never applies the SABS test.
- Plaintiff and insurer CAT files use different question lists on the same desk.
- The specialist wait blows the date the benefits decision needed.

## What IMECore does about it

### The SABS CAT questions are the case

Intake captures which catastrophic criteria the referrer wants tested. Those tests stay visible through review.

### Acute care, rehab, and neuropsych in order

Hospital, Glasgow documentation, rehab, and neuropsychological testing attach by source and date. Gaps show before you book.

### The right specialties, in the right order

CAT files often need physiatry, neurology, or psychiatry. Book them against the criteria, not against whoever had a slot.

### The report has to apply the test

The template asks for a finding on each criterion you named. A general disability narrative will not pass review.

### A date the benefits decision can use

Psychiatric and neurological diaries run long. The case shows the committed report date from the day it opens.

### A trail for the dispute that follows

CAT files are fought. Export the records index, the criteria list, and the audit log with the report.

## How it runs

1. **Name the criteria on the referral.** Record the accident date, the SABS CAT questions, and which tests the referrer wants applied.
2. **Pull acute care before you book.** Request hospital records, Glasgow documentation, rehab notes, and neuropsychological testing.
3. **Book the specialties the tests need.** Match physiatry, neurology, or psychiatry to the criteria, then set the report date.
4. **Review against the criteria, not the narrative.** Confirm each named SABS test has a finding, then release the report and the index.

## Numbers worth knowing

| Figure | What it measures | Source |
|---|---|---|
| $4,000–$8,000+ | Typical BC psychiatric or neurological IME cost | lawyerinfo.ca, BC WCAT guide |
| 2–6 months | Typical wait to book a BC specialist IME | lawyerinfo.ca, BC WCAT guide |
| 4–8 weeks | Typical wait for the report after the exam in BC | lawyerinfo.ca, BC WCAT guide |

## Questions people ask

### Is catastrophic impairment only an Ontario SABS issue?

The CAT designation in this page means the Ontario SABS catastrophic definition, overseen by FSRA. Other provinces have serious-impairment questions, but they are not the same test.

### Which records decide a CAT file?

Acute-care notes, Glasgow documentation, rehab, imaging, and neuropsychological testing. A family-doctor chart alone will not meet the criteria questions.

### Who refers CAT assessments?

Accident-benefits insurers and plaintiff counsel. Defence counsel refer them when the CAT designation is in dispute.

### Do we need more than one specialty?

Often yes. Physiatry, neurology, and psychiatry answer different criteria. Put each on the same case so the record set is shared.

### Can we start with a file review?

Yes, to see whether the paper supports a CAT examination. A paper review cannot complete every SABS catastrophic test on its own.