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 a motor vehicle accident may qualify for compensation under NSW's Compulsory Third Party (CTP) scheme, but eligibility depends on specific legal criteria. The Motor Accident Injuries Act 2017 (MAIA) governs claims, and the New South Wales Motor Accident Claims Authority (SIRA) provides guidance on what injuries qualify. This article explains how ankle fractures are assessed under the scheme, the evidence required to support a claim, and practical steps to take after an accident.
How Ankle Fractures Qualify for CTP Compensation
Under the MAIA, injuries must be caused by a motor vehicle accident to be eligible for compensation. Ankle fractures resulting from a car crash, pedestrian collision, or motorcycle accident may qualify, provided they meet the scheme's injury thresholds. SIRA guidelines classify fractures of the ankle bones (tibia or fibula) as 'threshold injuries' under the scheme. However, the severity of the fracture matters: minor fractures with minimal long-term impact may fall under the 52-week statutory benefit period, while more severe fractures could qualify for long-term payments.
The key distinction is whether the ankle fracture meets the 'threshold injury' definition in the Motor Accident Guidelines. For example, a fracture that causes limited mobility but does not result in chronic pain or functional loss may still be considered a threshold injury. SIRA clarifies that injuries must be 'caused by the accident' and documented by a medical practitioner to be eligible.
Evidence Needed for an Ankle Fracture Claim
To claim compensation for an ankle fracture, you must provide evidence that the injury was caused by a motor vehicle accident and meets the scheme's criteria. Essential documentation includes:
- Medical records: A doctor's report confirming the fracture, its location, and its relation to the accident.
- Accident details: Police reports, witness statements, and photographs of the scene.
- Medical treatment records: Evidence of treatment, such as X-rays, scans, or physiotherapy sessions.
- Income records: Proof of lost wages or reduced earning capacity if the fracture affects work.
SIRA requires these documents to assess whether the injury qualifies for benefits under the CTP scheme. For example, a fracture that results in a 10% whole person impairment (WPI) rating may be eligible for long-term weekly payments, while a minor fracture with no lasting impact may only qualify for short-term benefits.
Practical Steps After an Ankle Fracture Accident
If you've suffered an ankle fracture in a motor vehicle accident, take these steps immediately:
- Seek medical attention: Visit a hospital or GP to confirm the injury and document it. A medical report is critical for a CTP claim.
- Preserve evidence: Collect details of the accident, including dates, times, vehicle information, and witness contact details.
- Notify the insurer: Contact the at-fault driver's CTP insurer to report the claim. SIRA provides a claims form for this purpose.
- Consult SIRA: Use the SIRA website to understand your options and submit your claim within the required timeframe.
Time Limits and Dispute Resolution
The MAIA imposes strict time limits for CTP claims. Generally, you must notify the insurer within 30 days of the accident and submit your claim within 6 months. If the injury is a threshold injury, benefits may be limited after 52 weeks unless it meets the 'whole person impairment' threshold. Disputes over eligibility or benefit amounts can be escalated to the NSW Civil and Administrative Tribunal (NCAT) for review.
When to Seek Legal Advice
While the CTP scheme provides a pathway for many injuries, each case is unique. Ankle fractures can vary in severity, and the legal rules for eligibility depend on the accident date, injury type, and claim history. For example, a fracture that results in a 20% WPI rating may qualify for long-term payments, while a minor fracture may only be eligible for short-term benefits. To ensure your claim is properly assessed, contact a solicitor who specializes in NSW CTP claims.
Next Steps
CTP entitlements depend on the specifics of your accident, injury, and claim. If you're unsure whether your ankle fracture qualifies for compensation, complete the quick, no obligation enquiry form to request contact about your circumstances. Every claim depends on its own facts, and the right legal guidance can help you understand your options.