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're seeking compensation for attendant care services after a motor accident in NSW, understanding what evidence to gather is critical. Under the NSW Compulsory Third Party (CTP) scheme, claimants must provide documentation to prove the need for care and supervision. This includes medical records, care provider details, and evidence of how the injury impacts daily living. Proper record-keeping ensures your claim aligns with SIRA guidelines and maximizes your chances of securing support.
Types of Evidence Required for Attendant Care Claims
To support an attendant care claim under the CTP scheme, you must provide evidence that demonstrates the necessity of care and supervision. Key documents include:
- Medical reports from a registered medical practitioner confirming the injury’s impact on your ability to perform daily tasks.
- Care provider records such as invoices, receipts, or statements from a registered care agency or family member providing the service.
- Evidence of care needs like a care plan, therapist notes, or a doctor’s opinion explaining how the injury affects your independence.
- Accident details such as police reports, witness statements, or photographs to establish the incident’s circumstances.
SIRA guidelines emphasize that the care must be 'reasonably necessary' and directly related to the injury. For example, if you require assistance with dressing, eating, or mobility due to a spinal injury, this must be clearly documented.
How to Organize Documentation for Attendant Care Claims
Claimants should systematically organize records to meet CTP requirements. Start by compiling all medical evidence, including:
- A copy of your medical records showing the injury’s severity and recovery timeline.
- A letter from your treating doctor confirming the need for attendant care.
- Any reports from physiotherapists or occupational therapists assessing your functional limitations.
For care services, retain:
- Invoices from the care provider, including dates of service and the nature of care provided.
- A care plan outlining how the service addresses your specific needs.
- Any correspondence with the care provider confirming the service’s necessity.
It’s also important to document how the injury affects your daily life. For instance, if you need assistance with personal hygiene due to a head injury, this should be clearly stated in medical records.
SIRA Resources for Attendant Care Claims
SIRA provides authoritative guidance on what can be claimed under the CTP scheme. According to SIRA’s What you can claim page, attendant care is available for injuries that result in a 'threshold injury' or higher. This includes injuries such as spinal cord damage, brain trauma, or fractures requiring prolonged recovery.
The Making a motor accident claim guide from SIRA outlines that claimants must submit evidence of care needs within 52 weeks of the accident. After this period, weekly benefits for threshold injuries are generally limited, though long-term care may still be available depending on the injury’s severity.
Example: Documenting Attendant Care Needs
Consider a claimant who suffered a spinal injury in a car accident. Their doctor documents radiculopathy (nerve-related pain) and recommends 24/7 care. The claimant retains invoices from a registered care agency, a care plan outlining tasks like dressing and mobility support, and a medical report confirming the injury’s impact. This evidence supports a claim for attendant care under the CTP scheme.
Time Limits and When to Seek Advice
Under the CTP scheme, claimants must submit evidence of care needs within 52 weeks of the accident. Delays can result in reduced benefits or claim rejection. If you’re unsure whether your records meet CTP requirements, seek advice from a legal professional or SIRA’s support services.
Next Steps
CTP entitlements depend on the accident date, injury type, and evidence provided. To request contact about your circumstances, complete the quick, no obligation enquiry form.