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).
Ankle fractures resulting from car accidents in NSW are now assessed under the revised Compulsory Third Party (CTP) scheme introduced in 2017. This article explains how the reforms have changed compensation rules for ankle injuries, with practical guidance for Ballina residents.
How the 2017 Reforms Changed CTP Claims for Ankle Fractures
The 2017 Motor Accident Injuries Act reforms redefined 'threshold injuries' under the CTP scheme. Ankle fractures are now classified as threshold injuries if they meet specific criteria in the Motor Accident Guidelines. This means claims for ankle fractures are subject to stricter rules regarding benefits and time limits.
Under the revised scheme, injuries are categorized as 'threshold' if they result in limited functional impairment, such as a sprained ankle or minor fracture without long-term complications. The key distinction is that threshold injuries are eligible for statutory benefits like weekly income payments and treatment costs, but these benefits are generally limited to 52 weeks after the accident.
If your ankle fracture is classified as a threshold injury, you may no longer be eligible for ongoing compensation after 52 weeks. However, if your injury results in long-term impairment (e.g., chronic pain, mobility issues), you may qualify for additional benefits under the 'whole person impairment' framework.
How SIRA Assesses Ankle Fractures Under the Revised Scheme
The State Insurance Regulatory Authority (SIRA) evaluates ankle fracture claims based on the Motor Accident Guidelines. Key factors include:
- Medical evidence confirming the injury's severity
- Evidence of functional limitation (e.g., difficulty walking, reduced range of motion)
- Documentation of treatment received
SIRA also considers whether the injury meets the 'spinal nerve-root qualification', a neurological injury affecting spinal nerves. While ankle fractures typically don't meet this threshold, severe cases with neurological signs may be reclassified.
Practical Steps for Ballina Residents
If you've suffered an ankle fracture in a car accident, take these steps:
- Seek immediate medical attention to document the injury
- Gather evidence of the accident (photos, witness statements, police reports)
- Contact your treating doctor to assess long-term impact
- Notify your insurer or SIRA within 52 weeks of the accident to claim statutory benefits
Keep detailed records of all medical treatments, income loss, and expenses. These will help determine whether your injury qualifies for ongoing benefits beyond the 52-week limit.
Time Limits and When to Seek Advice
Statutory benefits for threshold injuries are generally limited to 52 weeks. If your ankle fracture results in long-term impairment, you may need to pursue a 'whole person impairment' assessment. However, time limits apply to all claims:
- You must notify SIRA within 52 weeks of the accident to claim statutory benefits
- Claims for long-term impairment must be made within 52 weeks of the injury's onset
If your claim is denied or you're unsure about your eligibility, seek legal advice promptly. The 52-week deadline for statutory benefits means delays can result in lost entitlements.
Example: How an Ankle Fracture Claim Might Work
Imagine a Ballina resident who fractured their ankle in a low-speed car collision. Their doctor confirms the injury is a minor fracture with no long-term complications. Under the revised scheme, this would be classified as a threshold injury. The claimant would receive weekly income payments and treatment benefits for up to 52 weeks. If the injury later develops into chronic pain requiring ongoing treatment, they may need to reapply for benefits under the whole person impairment framework.
Next Steps
CTP claims for ankle fractures depend on the injury's classification and the date of the accident. To understand your options, complete the quick, no obligation enquiry form. A legal professional can help you navigate the 2017 reforms and ensure you meet all requirements for benefits.