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 are generally covered under the NSW Compulsory Third Party (CTP) scheme, but eligibility depends on meeting specific criteria. If you've suffered an ankle fracture in a motor vehicle accident, you may be entitled to treatment costs, income support, or compensation for long-term impairment. This guide explains how ankle fractures qualify under the scheme, what evidence you need, and how the 10% impairment threshold applies.
How Ankle Fractures Qualify for CTP Benefits
Under the Motor Accident Injuries Act 2017, injuries that meet the 'threshold injury' definition are eligible for CTP benefits. Threshold injuries include fractures of the lower limbs, such as the ankle, provided they result in a whole person impairment of at least 10%. Ankle fractures are typically considered threshold injuries if they require medical treatment and cause functional limitation.
The New South Wales Motor Accident Guidelines (2023) state that fractures of the ankle or foot are included in the threshold injury category. However, the injury must be confirmed by a medical practitioner as meeting the clinical criteria. For example, a fracture that requires surgery or results in prolonged mobility issues would likely qualify.
Evidence Needed to Claim Treatment Costs
To claim treatment costs for an ankle fracture, you must provide:
- A medical report confirming the fracture and its severity
- Evidence of treatment received (e.g., hospital records, physiotherapy invoices)
- A statement from your treating medical practitioner linking the injury to the accident
The Scheme for the Injured Road User (SIRA) requires that treatment costs be 'reasonably necessary' and directly related to the injury. If your ankle fracture required surgery, rehabilitation, or ongoing care, this evidence supports your claim.
The 10% Impairment Threshold
Ankle fractures may also qualify for compensation if they result in a whole person impairment of 10% or more. The 10% threshold is calculated using the NSW Impairment Guides, which assess the long-term impact of injuries. For example:
- A fracture that causes chronic instability or arthritis may meet the 10% threshold
- A minor fracture with no lasting effects would not qualify
If your ankle injury results in a 10% or greater impairment, you may be eligible for additional compensation for pain, loss of income, and other impacts. The exact assessment depends on a medical practitioner's report.
Practical Steps After an Ankle Fracture
- Seek immediate medical attention to document the injury
- Keep all medical records, treatment invoices, and correspondence
- Report the accident to the at-fault driver's insurer within 52 weeks (the statutory deadline for CTP claims)
- Contact SIRA if you need help assessing your claim
When to Seek Legal Advice
If your ankle fracture results in long-term impairment, or if you're unsure about your eligibility, consult a legal professional. Claims involving complex injuries or disputes over impairment ratings often require expert review. The 52-week deadline for CTP claims means it's important to act promptly.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.