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 are commonly claimed under the Compulsory Third Party (CTP) scheme, but claimants in Ballina often make errors that delay or block compensation. This article explains how to avoid these mistakes based on the Motor Accident Injuries Act 2017 and SIRA guidelines.
Key Legal Framework for Ankle Fractures
Under the Motor Accident Injuries Act 2017, ankle fractures are classified as 'threshold injuries' if they meet specific medical criteria. SIRA assesses claims using the Motor Accident Guidelines, which require a spinal nerve-root injury producing neurological signs (excluding radiculopathy) to qualify as a soft-tissue injury. For ankle fractures, medical evidence must confirm the injury meets the 'threshold injury' definition in Schedule 1 of the Motor Accident Injuries Regulation 2017.
Common Mistakes in CTP Claims
- Delaying Medical Attention: Failing to seek immediate medical care after the accident can lead to claim denials. SIRA requires documentation of the injury's date and severity to establish a causal link to the accident.
- Incomplete Evidence: Claimants often omit critical records like accident reports, witness statements, or photographs of the scene. These are essential to prove the injury occurred during a motor accident.
- Confusing Statutory Benefits with Damages: Statutory benefits (e.g., weekly payments) are limited to 52 weeks for 'only injuries' under s 4.4 of the Motor Accident Injuries Act 2017. Claimants may mistakenly assume they qualify for ongoing common law damages.
- Ignoring Location-Specific Rules: While Ballina is a NSW local government area, the legal character of the accident (e.g., whether it occurred on a public road) affects CTP coverage.
Critical Evidence for Ankle Fractures
To avoid claim denials, gather:
- Medical records confirming the ankle fracture and its date
- Accident reports from the NSW Police or Transport for NSW
- Witness statements or photos of the accident scene
- Income records to support weekly benefit claims
- SIRA's 'What You Can Claim' checklist to ensure all eligible benefits are pursued
Time Limits and Dispute Resolution
CTP claims must be submitted within 52 weeks of the accident for statutory benefits, though this period may extend for complex cases. If your injury is classified as a 'threshold injury', benefits may stop after 52 weeks, but you may still pursue common law damages if your injury meets the 'whole person impairment' threshold.
When to Seek Legal Advice
If your ankle fracture claim is denied, or if you're unsure about your entitlements, contact a solicitor specialising in NSW CTP claims. Legal professionals can help navigate SIRA's assessment process and ensure all evidence meets the legal standard.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.