What is Residual Disability left by a traffic accident?

Treatment of traffic accident injury will surely have an end even if pain and discomfort remain. Despite you don't completely recover, the insurance company might require you to stop treatment because they don't want to pay the treatment fees. Or, sometimes your doctor might tell you he/she has done all the available treatment and there is no way left. If your discomfort remains even after long term treatment and you cannot expect the recovery, consider applying for eligibility of special compensation for residual disability. In this article, we explain some advantages of getting eligibility and how to get it.   

Why you should apply for special compensation for residual disability

Let's say you have a residual disability and eligibility for its special compensation. In this case, the amount of compensation you legally deserve will drastically increase because of two additional compensations as follows:

  • Consolation money for residual disability
  • Lost wage due to residual disability.

The following are the precedents.

A 60-year-old housewife who was engaged in agriculture while taking care of her disabled husband and mother in law was qualified to have got residual disability in an automobile accident in court. She was admitted to have got residual disability of combination of dementia, urinary incontinence and visual impairment which is qualified as 1st grade. She is qualified to get compensation as follows:
JPY32,000,000 as compensation for residual disability
JPY5,800,000 as compensation for residual disability for her two family members
Total of compensation: JPY41,800,000
A 16-year-old female high school student was qualified to have got residual disability due to spinal cord injury in an automobile accident in court. She was qualified to get compensation as follows:
JPY26,000,000 as compensation for residual disability
JPY5,000,000 as compensation for residual disability for her father
Total of compensation: JPY31,000,000

The amount colored by red is the cost added as compensation for residual disability. You can see how much it increases when your residual disability is officially acknowledged.

CALI also has a particular compensation for victims with residual disability. That is for being ready for the drastic increase of compensation for which at-fault party is responsible. CALI offers a specific amount according to the grade of your residual disability. You can see the amount depending on the grade in the following table.

Grade of residual disabilityBenefit
1stJPY30,000,000
2ndJPY25,900,000
3rdJPY22,190,000
4thJPY18,890,000
5thJPY15,740,000
6thJPY12,960,000
7thJPY10,510,000
8thJPY8,190,000
9th JPY6,160,000
10th JPY4,610,000
11th JPY3,310,000
12th JPY2,240,000
13th JPY1,390,000
14th JPY750,000

Note that it's not based on the actual expenses you paid due to your disability. If your disability is admitted to falling into 3rd grade, you will get the full amount of JPY22,190,000. For further detail on the grade of residual disability, you can check the following article: Tables of CALI’s compensation for permanent disability

Once your disability is officially admitted as a residual disability, the amount of money to be compensated will drastically increase. The increase is sometimes so big that you should never forget the possibility your disability might be officially acknowledged as a residual disability. When you get injured in a traffic accident, always consider the possibility and have this practical advice in your mind while treatment.

Who determines the grade of residual disability?

The amount of CALI's compensation for residual disability depends on what grade your residual disability is. But who determines the grade?

GIROJ (General Insurance Rating Organization Japan) is an official organization in charge of the investigation before CALI's payout. It's also in charge of determining the grade of residual disability. They officially examine the victim's condition and determines the grade by checking every possible document victims submit to them.

The GIROJ's decision is a key factor to determine the whole amount of compensation which a victim legally deserves. The at-fault driver is responsible for compensation for all the victim's loss and damages. They usually compensate by using primary insurance CALI and voluntary automobile insurance. Voluntary insurance companies also refer to GIROJ's decision on the grade, when determining the whole amount of compensation. When a victim and at-fault party argue in arbitration or court, Judges also refer to GIROJ's decision.  

When to apply for eligibility of special compensation

Does your pain or disability still exist even after a certain amount of time you've spent for treatment? Does your doctor expect no further improvements for your symptoms?
If yes, consider applying compensation money for residual disability. You will find how to apply for it in the following article: How to apply for the entitlement of residual disability.

Definition of Residual Disability

Residual disability means a bodily impairment that is present after a person's recovery from an injury. In order to be qualified as a residual disability by GIROJ, your impairment should meet the following conditions:

  • The symptom is originated from injuries or diseases and left even after treatment
  • The symptom results in a mental or physical impairment which is not expected to recover even in future
  • The symptom is medically provable
  • The symptom results in loss of workability

So what we should do for applying for special compensation is to prove your bodily impairment meets all of four conditions. 

Treatment for car-accident-injury finishes even when pain, discomfort, or disability still exist. In some cases, your doctor might suggest ending treatment because he/she cannot expect any further recovery. In other cases, the insurance company paying for your medical bills might require to stop treatment partly because they don't want to pay further medical bills.  In any case, if you inevitably have to stop treatment even if your discomfort still exists, apply for GIROJ's qualification of residual disability.

To apply for special compensation for residual disability, you need to have your doctor judge your symptom is in the status of "stabilized." Stabilized symptom is a state where the symptoms of injuries and diseases are stabilized, and where no further medical effect can be expected even if further generally recognized medical treatment is provided. Ask the doctor to issue a Medical Certificate of Residual Disability including his opinion on your stabilized symptom. Submit the certificate and all the possible documents to GIROJ. Then GIROJ officially examines them. Usually, within 1-2 months, they decide on whether your disability can be recognized as Residual Disability by an automobile accident or not. If it is, they make a decision on what grade your disability comes under.

 
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