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).
Ankle fractures from car accidents in NSW may require family support, and the CTP scheme offers specific provisions for caregivers. Families caring for injured loved ones should understand how to claim support expenses, how injuries affect daily responsibilities, and what evidence is needed. This guide explains SIRA's approach to claims involving family care needs and outlines practical steps for Ballina residents.
NSW CTP Rules for Family and Caregiver Support
Under the Motor Accident Injuries Act 2017, the NSW CTP scheme covers treatment, income loss, and care expenses for injured claimants. Families providing ongoing support may claim for:
- Additional household expenses incurred due to the injury
- Loss of income if a family member reduces work hours or leaves employment to care for the injured person
- Reasonable out-of-pocket costs for caregiving, such as transport or home modifications
SIRA assesses these claims based on documented evidence showing a direct link between the injury and the family's additional needs. For example, if a parent's ankle fracture prevents them from working, the family may claim lost income during the recovery period.
Practical Steps and Evidence for Caregiver Claims
To support a family-related CTP claim, gather:
- Medical records confirming the ankle fracture and its impact on mobility
- Proof of income changes, such as payslips or employer statements
- Documentation of additional household costs, like bills for home modifications or increased groceries
- Witness statements or family records showing the injured person's reliance on caregiver support
Families should also keep records of how the injury affects daily tasks, such as difficulty walking or standing, which may limit the caregiver's ability to work. SIRA requires these details to assess whether the injury meets the 'threshold injury' criteria for compensation.
Time Limits and Dispute Resolution
Claims must be submitted within 52 weeks of the accident, unless the injured person is under 18 or has a severe injury. Families should notify SIRA of their intent to claim caregiver expenses within this timeframe. If a claim is disputed, families can request a review or seek mediation through SIRA's dispute resolution process. It's important to note that SIRA may require independent medical assessments to verify the connection between the injury and the family's additional needs.
When to Seek Legal Advice
While the CTP scheme covers many caregiver-related expenses, each claim depends on its own facts. Families should consult a solicitor if:
- The injury results in long-term mobility issues requiring ongoing care
- There are disputes over the value of care expenses
- The claim exceeds the 52-week deadline
Legal professionals can help families navigate SIRA's requirements, ensure all evidence is properly documented, and challenge decisions that may unfairly limit compensation.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.