Where a person's only injuries resulting from the accident are threshold injuries, weekly benefits and treatment and care generally cease after 52 weeks (ss 3.11 and 3.28).
A threshold injury under the Motor Accident Injuries Act 2017 (NSW) includes a soft tissue injury and a psychological or psychiatric injury that is not a recognised psychiatric illness (adjustment disorder and acute stress disorder are the usual examples; s 1.6 and Motor Accident Guidelines Part 5).
Amputation injuries in NSW CTP claims require careful handling to avoid errors that could jeopardize compensation. This guide explains key mistakes to avoid, how SIRA assesses claims, and evidence critical to success.
Key Mistakes in Amputation Claims
A common error is failing to document the full impact of the injury. SIRA requires detailed records of how the amputation affects daily life, including mobility, work capacity, and prosthetic needs. For example, not recording the need for a specialist prosthetist could reduce compensation.
Another mistake is delaying medical treatment. Prompt medical attention is essential to establish the injury's permanence and link it to the accident. Delays may lead to disputes over the injury's severity.
Some claimants overlook the importance of reporting the injury to their insurer within the 52-week statutory period. While amputation injuries typically exceed threshold injury criteria, failure to notify insurers on time can result in lost benefits.
SIRA's Assessment of Amputation Claims
SIRA evaluates amputation claims using the Motor Accident Guidelines. A complete amputation of a limb (e.g., below the knee) is classified as a severe injury under the permanent impairment threshold. Claims must demonstrate how the injury impacts the claimant's ability to work, perform daily tasks, or maintain independence.
SIRA also considers the need for ongoing medical treatment, such as prosthetic fittings, physiotherapy, and psychological support. Documentation of these needs strengthens the claim.
Critical Evidence for Amputation Claims
Medical records are essential. These should include:
- Detailed injury reports from emergency services
- Specialist opinions on the injury's permanence
- Prosthetic assessment reports
- Records of any complications (e.g., infections, nerve damage)
Witness statements and accident reports can also support the claim. For example, a witness confirming the severity of the collision may help establish the injury's cause.
Time Limits and Dispute Resolution
Claims must be submitted within 52 weeks of the accident, unless an extension is granted. While amputation injuries typically qualify for long-term benefits, disputes may arise over the injury's classification. If SIRA rejects a claim, claimants can request a review or seek independent medical opinions.
When to Seek Legal Advice
Complex cases, such as those involving multiple injuries or disputes over impairment ratings, may require legal assistance. A solicitor can help navigate SIRA's assessment process and ensure all evidence is properly submitted.
Next Steps
Amputation injuries in NSW CTP claims require careful documentation and timely action. To request contact about your circumstances, complete the quick, no obligation enquiry form.