Ankle Fractures and NSW CTP Claims
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).
If you've suffered an ankle fracture in a car accident in Ballina, you may be wondering what compensation you're entitled to under NSW's Compulsory Third Party (CTP) scheme. Ankle fractures are considered 'threshold injuries' under the Motor Accident Injuries Act 2017, which means they fall under the statutory benefits framework managed by the State Insurance Regulatory Authority (SIRA). This article explains what claims are available, how to document your injury, and key deadlines to be aware of.
What CTP Claims Are Available for Ankle Fractures?
Under NSW CTP rules, ankle fractures qualify as threshold injuries. This means you may be eligible for:
- Weekly income payments if your injury prevents you from working.
- Treatment and care benefits to cover medical expenses.
- Rehabilitation benefits for physiotherapy or other recovery support.
These benefits are paid by the at-fault driver's insurer through SIRA. However, claims for 'threshold injuries' are limited to 52 weeks after the accident, unless the injury results in a whole person impairment (WPI) of 10% or more. This distinction is crucial, if your ankle fracture does not meet the WPI threshold, you will not be eligible for ongoing compensation beyond 52 weeks.
How to Document an Ankle Fracture for a CTP Claim
To support your claim, you must provide:
- Medical records confirming the fracture, including X-rays and treatment plans.
- Accident details such as the date, time, location, and circumstances of the crash.
- Witness statements or photographs of the scene if available.
- Income records to demonstrate lost wages or reduced earning capacity.
SIRA requires these documents to assess whether your injury meets the 'threshold injury' definition. For example, a fracture of the tibia or fibula with neurological signs may qualify, while a minor sprain may not. Always seek medical attention promptly to ensure your injury is properly documented.
SIRA's Role in Ankle Fracture Compensation
SIRA administers the CTP scheme in NSW. When you make a claim, SIRA will:
- Review your medical evidence to confirm the injury.
- Calculate weekly income payments based on your pre-accident earnings.
- Approve treatment benefits for necessary medical care.
- Determine whether your injury meets the 52-week limit or requires further assessment for WPI.
SIRA aims to resolve claims within 60 days of receiving all required documentation. If your claim is denied, you may request a review or seek independent legal advice.
Time Limits for Ankle Fracture Claims
You have 52 weeks from the date of your accident to claim statutory benefits for a threshold injury. If your ankle fracture does not meet the WPI threshold, you will not be eligible for ongoing compensation beyond this period. However, if your injury results in a WPI of 10% or more, you may be entitled to long-term damages under common law. This distinction is important, a WPI assessment requires a specialist report from a medical practitioner.
When to Seek Legal Advice
If your ankle fracture has not healed within 52 weeks, or if you believe your injury meets the WPI threshold, it is essential to consult a legal professional. A solicitor can help you:
- Challenge a SIRA decision to deny benefits.
- Pursue a common law damages claim if your injury is severe enough.
- Navigate the complex process of claiming for long-term impairments.
Example: A Ballina Resident's CTP Claim
Consider a scenario where a Ballina resident is involved in a car accident and sustains a fractured tibia. They submit medical records confirming the injury and claim weekly payments. SIRA approves the claim for 52 weeks but denies further benefits. The injured person then seeks a second opinion from a specialist, who finds a 12% WPI. This allows them to pursue additional compensation through a solicitor.
Next Steps for Injured People in Ballina
If you've suffered an ankle fracture in a car accident in Ballina, take the following actions:
- Visit a medical practitioner to document your injury.
- Gather evidence of the accident, including witness statements.
- Notify the at-fault driver's insurer through SIRA.
- Complete the quick, no obligation enquiry form to discuss your options.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.