Ankle fractures following a car accident in NSW may now be treated differently under the 2017 reforms to the Compulsory Third Party (CTP) scheme. These changes, effective from 2017, have shifted the focus of claims from common law damages to statutory benefits under the Motor Accident Injuries Act 2017. For ankle fractures, the distinction between threshold injuries and more severe claims has become critical. This article explains how the reforms impact Central Coast claimants seeking compensation for ankle fractures, outlines the evidence required, and highlights practical steps to take.
How the 2017 Reforms Changed CTP Claims for Ankle Fractures
Before 2017, injured drivers, passengers, and pedestrians could pursue common law damages claims for ankle fractures, which often included compensation for pain, loss of income, and future care. Under the new statutory model, claims are now governed by the Motor Accident Injuries Act 2017, which prioritizes pre-determined benefits over individual damages assessments.
Ankle fractures are now classified under the threshold injury rules. Under the Motor Accident Guidelines, a threshold injury is defined as a soft tissue injury with a whole person impairment (WPI) of 5% or less. If an ankle fracture is determined to be a threshold injury, claimants are generally limited to 52 weeks of weekly benefits and treatment and care benefits. This means that after 52 weeks, ongoing payments for the same injury are typically not available unless the injury is more severe.
The reforms also introduced the spinal nerve-root qualification. For ankle fractures, if the injury involves a spinal nerve-root injury producing neurological signs (even without radiculopathy), it may still qualify as a threshold injury. This distinction is important because it affects whether a claimant can access ongoing benefits.
Evidence Required for Ankle Fracture Claims
To support a CTP claim for an ankle fracture, claimants must provide:
- Medical documentation confirming the fracture and its classification as a threshold injury or more severe.
- Accident reports from the police or insurance company.
- Witness statements or photographs of the incident.
- Income records to establish lost earnings.
- Medical records showing the impact of the injury on daily activities.
Claimants should ensure that their medical team documents the injury’s severity and any neurological signs, as this can influence whether the injury falls under the threshold injury category or requires a separate claim for more significant impairment.
Practical Steps for Central Coast Claimants
- Seek immediate medical attention to document the injury and its impact. Delaying treatment may affect the ability to claim benefits.
- Preserve accident details, including photos of the scene, vehicle damage, and any visible signs of injury.
- Notify the at-fault driver’s insurance company as soon as possible. Delays in reporting may lead to disputes over claim validity.
- Consult a legal professional if the injury is complex or if the claimant is unsure whether it qualifies for ongoing benefits.
Time Limits and Dispute Resolution
Under the CTP scheme, claimants have three years from the date of the accident to file a claim. However, the 52-week limit on benefits for threshold injuries applies regardless of this deadline. If a claimant’s ankle fracture is classified as a threshold injury, they may need to pursue a separate claim for more severe impairment after 52 weeks.
Disputes over claim validity or benefit amounts can be resolved through the NSW Civil and Administrative Tribunal (NCAT). Claimants should seek legal advice if their claim is rejected or if they believe the insurer is underpaying benefits.
When to Seek Legal Advice
The 2017 reforms have made it more complex to determine whether an ankle fracture qualifies for ongoing benefits. For example, a claimant with a fracture that causes limited mobility but falls within the threshold injury category may not be eligible for long-term payments. In such cases, an experienced solicitor can help assess the claim’s viability and explore options for additional compensation.
If the injury involves a spinal nerve-root injury or if the claimant is unsure about their eligibility for benefits, legal advice is strongly recommended. A solicitor can also help navigate disputes with insurers and ensure that the claimant’s rights under the CTP scheme are protected.
Conclusion
The 2017 reforms have significantly changed how ankle fractures are handled in NSW CTP claims. While threshold injuries are now limited to 52 weeks of benefits, more severe injuries may still qualify for ongoing payments. Central Coast claimants must carefully document their injuries and understand the distinction between threshold injuries and more serious impairments. Time limits and procedural requirements mean that prompt action is essential. For personalized advice, complete the quick, no obligation enquiry form to request contact about your circumstances.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.