Attendant care services, what changed after 2017 reforms
The 2017 reforms to NSW Compulsory Third Party (CTP) motor accident compensation introduced significant changes to how attendant care services are assessed. Claimants in Illawarra and South Coast regions now face a more structured process to determine eligibility for ongoing care and supervision. This guide explains the key changes, how SIRA evaluates claims, and practical steps to support your case.
Key changes to attendant care claims under the 2017 reforms
- Before 2017, SIRA often treated attendant care as a separate category from whole-person impairment assessments. The reforms aligned care claims with the broader framework for long-term injuries, requiring claimants to demonstrate a
- threshold injury* and a
- whole-person impairment* of 10% or more. This shift means:
- Attendant care is no longer automatic for all serious injuries. It must be tied to a specific impairment rating.
- Medical evidence is critical. Claimants must provide detailed reports from medical practitioners confirming ongoing care needs.
- SIRA’s guidelines now explicitly link care entitlements to impairment assessments, reducing subjective discretion.
For example, a claimant with a 15% whole-person impairment due to a spinal injury may qualify for attendant care, but a 7% impairment would not. This change clarifies that care services are part of a broader compensation package, not a standalone benefit.
How SIRA assesses attendant care claims in Illawarra and South Coast
SIRA applies the same national standards to all NSW regions, including Illawarra and South Coast. Key factors include:
- 1. Medical evidence: A doctor must confirm that the injury requires ongoing care, such as assistance with bathing, dressing, or mobility. This is typically documented in a
- SIRA Form 1* or
- SIRA Form 2*.
- Impairment rating: The injury must result in a whole-person impairment of 10% or more under the Motor Accident Guidelines. This is determined by a registered medical practitioner.
- 3. Care necessity: SIRA evaluates whether the injury
- requires* care, not just
- benefits* from it. For example, a claimant who can walk independently but needs help with personal hygiene would qualify, while someone with partial mobility may not.
Claimants should ensure their medical records clearly link the injury to the care need. SIRA may request additional assessments if the connection is unclear.
Practical steps to support your attendant care claim
To strengthen your case, take these steps:
- Secure medical documentation: Obtain reports from a medical practitioner confirming the injury’s impact on daily living. This may include imaging, therapy notes, and a statement about care requirements.
- Complete SIRA forms accurately: Fill out
- SIRA Form 1* (for injury details) and
- SIRA Form 2* (for care needs) thoroughly. Incomplete forms may delay processing.
- Seek clarification on impairment ratings: If your doctor’s report doesn’t specify an impairment percentage, request a detailed explanation. SIRA requires this to assess eligibility.
- Submit evidence promptly: Delays in providing medical records or forms can lead to claim rejections or extended processing times.
Time limits and dispute resolution
- CTP claims must be submitted within five years of the accident. For attendant care claims, the 52-week statutory benefit period applies to
- threshold injuries* only. If your injury is classified as a
- threshold injury* (e.g., soft tissue damage), weekly payments may stop after 52 weeks, even if care needs persist. This distinction is crucial:
- threshold injuries* are limited to 52 weeks, while
- whole-person impairments* of 10% or more may qualify for longer-term care.
If SIRA denies your claim, you may request a review or escalate to the NSW Civil and Administrative Tribunal (NCAT). Independent legal advice is recommended to navigate disputes.
When to seek legal advice
The 2017 reforms introduced complex changes to how care needs are assessed. If your claim is denied, or if you’re unsure about your eligibility, consult a solicitor specialising in NSW CTP claims. Legal professionals can help you:
- Challenge SIRA’s impairment rating decisions
- Navigate the 52-week benefit limit for threshold injuries
- Ensure your care needs are properly documented
Summary of changes for Illawarra and South Coast claimants
The 2017 reforms require claimants to prove both a threshold injury and a whole-person impairment to qualify for attendant care. SIRA’s stricter guidelines mean medical evidence is more important than ever. While the process is uniform across NSW, claimants in Illawarra and South Coast should ensure their evidence clearly links the injury to the care need. Understanding these changes can help you secure the support you deserve.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.