Criteria for regarding an injury as serious
The Road Accident Fund (RAF) considers an injury “serious” based on guidelines provided in the American Medical Association’s Guides to the Evaluation of Permanent Impairment, Sixth Edition.
These guidelines, called the AMA Guides for short, provide criteria for determining an injured person’s so-called “Whole Person Impairment” (WPI). WPI is expressed as a percentage of the body.
The Minister of Transport set the threshold percentage for determining serious injury at 30%.
This means that a road accident victim must be assessed as being 30% WPI to qualify for an award of general damages.
Who’s responsible for making a serious injury assessment?
The assessment of serious injury can be made only by an appropriate medical specialist.
The specialist is required to base the assessment on the AMA Guides.
If an injury isn’t rated as 30% WPI in terms of the AMA Guides, the medical practitioner may apply a “narrative test” to determine whether the claimant may still be entitled to compensation for general damages.
In this case, an injury can be classified as serious if it has resulted in:
- long-term impairment or the loss of a body function
- permanent, severe disfigurement
- a serious long-term mental or behavioural disturbance or disorder
- the loss of an unborn child.
When the assessment can be made
The assessment can be made only after the victim has reached maximum medical recovery.
In other words, the person’s injuries must have stabilised. They shouldn’t have notably improved or deteriorated for a period of several months prior to the assessment.
Examples of road accident injuries that are and aren’t considered “serious”
Some examples of injuries that may meet the 30% threshold are amputations, permanent brain damage and paraplegia.
Certain common road accident injuries have, by regulation, been classified as not serious, unless there are complications.
These include whiplash, sprains, torn ligaments, the loss of fingers or toes and superficial wounds.
Claiming for serious injury
If you’ve suffered a serious injury in a road accident that wasn’t solely your fault, it’s likely you’re entitled to claim damages from the RAF.
These could cover your past and future medical expenses, loss of income associated with the injury and compensation for pain and suffering.
To support your claim, you’ll need to be examined by a medical professional.
The medical practitioner will then need to compile a Serious Injury Assessment Report (a RAF 4 report). This must confirm that your injury is serious enough to warrant compensation.
In many cases, substantiating reports and annexures must also be submitted with the report.
Getting expert legal representation
For the best chance of a successful claim, it’s strongly recommended that you consult an attorney with direct experience in handling road accident claims.
At DSC Attorneys, all our attorneys are highly experienced in personal injury law and offer many years of combined experience in handling Road Accident Fund claims.