Attendant Care Services and CTP Claims in NSW
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 or a family member has suffered a serious motor vehicle accident in Ballina and requires ongoing care, the NSW Compulsory Third Party (CTP) scheme may cover attendant care services. This article explains how the scheme supports caregivers, what evidence is needed, and practical steps for families managing care responsibilities.
How the CTP Scheme Covers Attendant Care
Under the Motor Accident Injuries Act 2017, the NSW CTP scheme provides financial support for care-related expenses after a motor accident. Attendant care services include assistance with daily living tasks such as eating, dressing, mobility, and personal hygiene. These services are available to claimants who meet the scheme’s eligibility criteria, including a threshold injury or whole person impairment rating.
SIRA (State Insurance Regulatory Authority) assesses claims for attendant care based on medical evidence. A registered medical practitioner must confirm the need for care, and the care must be provided by a registered nurse, carer, or other approved professional. Families should retain records of medical reports, care plans, and invoices to support claims.
Practical Considerations for Caregivers and Families
When managing care for an injured person, families must balance practical and legal responsibilities. Key considerations include:
- Medical documentation: Ensure all care-related medical records are preserved, including assessments of the injured person’s capacity and care requirements.
- Care provider records: Keep invoices, receipts, and service logs from caregivers or home-help agencies.
- Time limits: The CTP scheme provides weekly income benefits and treatment benefits for up to 52 weeks after an accident. After this period, benefits may reduce unless the claimant has a whole person impairment rating of 10% or more.
- SIRA’s role: SIRA evaluates claims based on the Motor Accident Guidelines. Families should submit claims promptly and respond to SIRA’s requests for additional information.
Navigating the Claims Process
Families should notify their insurer of care needs as soon as possible. Delays in reporting can affect eligibility for benefits. If a claim is disputed, families may need to seek independent medical opinions or challenge SIRA’s decision through the NSW Civil and Administrative Tribunal (NCAT).
A hypothetical example: After a serious collision, a family in Ballina may need to arrange 24-hour care for a non-verbal child. Medical records confirming the child’s need for assistance with mobility and communication would be essential to claim attendant care benefits.
When to Seek Legal Advice
While the CTP scheme provides support for care-related expenses, claims can be complex. Families should consult a legal professional if:
- The injured person’s care needs are unclear or disputed.
- The claimant’s condition worsens, requiring additional services.
- SIRA denies a claim or proposes a reduced benefit.
Next Steps
CTP claims involving attendant care depend on accurate documentation, timely submissions, and understanding of SIRA’s assessment criteria. Families in Ballina should act quickly to preserve their rights and seek assistance if needed.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.