Attendant Care Services and CTP Scheme Eligibility
Where a person's only injuries resulting from the accident are threshold injuries, weekly benefits and treatment and care generally cease after 52 weeks (ss 3.11 and 3.28).
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 a serious motor vehicle accident in Newcastle or Hunter and need assistance with daily living, you may be eligible for attendant care services under the NSW Compulsory Third Party (CTP) scheme. This article explains how the scheme works, what injuries qualify, and the evidence needed to support your claim.
How the CTP Scheme Covers Attendant Care
The CTP scheme provides financial support for injuries caused by motor vehicle accidents. Attendant care services are available if your injury meets the 'threshold injury' criteria under the Motor Accident Injuries Act 2017. This means your injury must be serious enough to require assistance with basic activities like dressing, eating, or mobility.
SIRA (State Insurance Regulatory Authority) assesses claims using the Motor Accident Guidelines. For example, a spinal nerve-root injury causing neurological signs (even without radiculopathy) may qualify. The injury must be directly linked to the accident, and the care must be medically necessary.
What Evidence Is Needed for Your Claim
To support your claim, you'll need:
- Medical records confirming your injury meets threshold criteria
- A care plan from your treating medical practitioner
- Evidence of your need for assistance (e.g., a doctor's note detailing your daily challenges)
- Proof of the care services you've received (e.g., invoices, service records)
SIRA also requires you to notify them within 52 weeks of the accident date. If your injury is a 'threshold injury' and your only injuries, benefits may be limited after 52 weeks.
How SIRA Determines Eligibility in Newcastle and Hunter
SIRA applies the same national guidelines across all NSW regions, including Newcastle and Hunter. Claims are reviewed by SIRA's medical experts, who assess whether your injury meets the threshold and whether your care needs are genuine.
A hypothetical example: Sarah, a cyclist in Newcastle, suffered a spinal injury causing weakness in her legs. Her doctor confirmed she needed assistance with mobility. SIRA approved her claim for attendant care services under the CTP scheme.
Time Limits and Next Steps
You must notify SIRA within 52 weeks of the accident. If your claim is denied, you can request a review. If unresolved, you may need to escalate to the NSW Civil and Administrative Tribunal (NCAT) for a formal dispute.
When to Seek Legal Advice
If your claim is denied or you're unsure about your eligibility, consider consulting a legal professional. They can help you understand your options and ensure your claim meets all requirements.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.