What qualifies as attendant care under NSW CTP law?
Under the Motor Accident Injuries Act 2017, attendant care services are paid for when a person needs help with daily personal care tasks because of injuries sustained in a motor accident. These services are not limited to medical treatment but include practical assistance with activities such as bathing, dressing, toileting, preparing meals, and managing household tasks. The care must be provided by a qualified person, not a family member, unless the family member is formally engaged and paid under a care plan. The service must be necessary and reasonable, and it must be directly linked to the motor accident injury.
Practical examples of attendant care claims in Greater Sydney
In a case in Sydney’s Inner West, a 42-year-old woman sustained a spinal cord injury in a collision on the M4 motorway in 2024. She required daily assistance with transferring from bed to wheelchair, using the toilet, and preparing simple meals. A care provider was engaged through a registered home care agency, and the claim for attendant care services was approved by the insurer under SIRA’s guidelines. The care was provided in her apartment in Leichhardt, and the claim was supported by a medical report confirming her functional limitations.
Another example occurred in 2025 in the Northern Beaches. A 68-year-old man, a passenger in a car that was struck by a distracted driver near Manly, sustained a traumatic brain injury. He developed cognitive and physical impairments that made him unable to manage his medication, cook, or leave his home safely. His family arranged for a registered care worker to visit three times a week for two hours each session. The claim was supported by a neuropsychological assessment, a care plan from a registered provider, and a record of payments made via a bank transfer. SIRA accepted the claim as valid because the care was not provided by a family member, was regularly scheduled, and was medically justified.
How to prove the need for attendant care services
To claim attendant care services under NSW CTP, you must provide evidence that the care is necessary and directly related to your motor accident injury. Key documents include:
- A medical report from a treating practitioner or specialist that details your functional limitations and the need for assistance with daily tasks.
- A formal care plan from a registered home care provider, specifying the frequency, duration, and nature of the care.
- Receipts or invoices for paid care services, including the provider’s ABN and contact details.
- A record of payments made via bank transfer, credit card, or direct debit.
Photographs of the care provider at your residence, witness statements from neighbours or family members who observed your daily challenges, and a diary of your daily functioning (e.g., notes on difficulty with meals or hygiene) may also support your claim.
What happens if the claim for attendant care is disputed?
SIRA may dispute a claim for attendant care services if it considers the care is not necessary, not reasonable, or not directly linked to the accident. Common grounds for dispute include:
- The care is provided by a family member without formal payment or registration.
- The care plan lacks detail on the tasks performed or the frequency of visits.
- The medical evidence does not clearly link the injury to the need for assistance.
- The cost of care exceeds the SIRA-approved rate for similar services in the region.
If a dispute arises, you may request a review by SIRA. You can also seek independent advice from a legal practitioner or a community legal centre. SIRA may refer the matter to a dispute resolution process, but this is not automatic. You must submit your evidence within the timeframe specified in the dispute notice.
Regional differences in Greater Sydney
There is no formal regional variation in how SIRA assesses attendant care claims across Greater Sydney. All claims are assessed under the same national standards, including the Motor Accident Injuries Regulation 2017 and the Motor Accident Guidelines. However, local factors may influence the approval process, such as:
- The availability of registered care providers in the area.
- The cost of care services in different suburbs (e.g., higher rates in the Eastern Suburbs compared to Western Sydney).
- The type of accommodation (e.g., apartment vs. house) and whether it affects access to care.
SIRA uses a national benchmark for care rates, but local cost of living and provider availability may affect how quickly a claim is processed. For example, a claim in the City of Sydney may be processed faster due to higher provider density, but the eligibility criteria remain identical.
Time limits and procedural steps
There is no fixed deadline for submitting a claim for attendant care services, but it is best to notify your insurer as soon as possible after the accident. The claim must be made within the general time limits for motor accident claims, which are generally three years from the date of the accident. However, if you are claiming for care services that began more than three years ago, you may not be able to recover past payments.
You must keep all records related to your claim, including:
- Copies of all invoices and payment records.
- Medical reports and care plans.
- Correspondence with your insurer or SIRA.
If you are receiving weekly income payments or treatment and care benefits, you must inform the insurer if your care needs change, as this may affect your entitlements.
When to seek independent advice
If your claim for attendant care services is denied, or if you are unsure whether your care qualifies, it is advisable to seek advice from a legal practitioner or a community legal centre. SIRA does not provide legal advice, and independent review may help identify gaps in your evidence or clarify whether a care provider is registered.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.