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).
Attendant care services are a critical support for injured people recovering from serious motor accidents in NSW. Under the NSW Compulsory Third Party (CTP) scheme, claimants may be eligible for assistance with daily living tasks if their injuries prevent them from managing independently. This guide explains what types of care are covered, how to request them, and what evidence is needed to support your claim.
What Types of Attendant Care Services Are Covered Under NSW CTP?
Attendant care services under the NSW CTP scheme include assistance with activities such as eating, dressing, bathing, mobility, and personal hygiene. These services are available to claimants who have sustained injuries that significantly impair their ability to perform daily tasks. The New South Wales Motor Accident Injuries Act 2017 and SIRA guidelines define 'attendant care' as support required to maintain basic living standards.
SIRA assesses eligibility based on medical evidence showing that the injury has caused a functional limitation. For example, a claimant with a spinal injury requiring regular assistance to prevent pressure sores may qualify. Services may include home help, nursing care, or assistance with medication management. The scope of care is determined by a medical practitioner's assessment, not the claimant's subjective needs.
How to Request Attendant Care Services Through Your CTP Claim
To request attendant care services, you must notify SIRA of your need through your CTP claim process. This involves submitting a completed 'Request for Additional Services' form, which is available on the SIRA website. You must also provide supporting medical documentation from a registered medical practitioner detailing the nature of your injury and how it impacts your ability to perform daily tasks.
Your claim must demonstrate a clear link between your injury and the need for assistance. For instance, a claimant with a traumatic brain injury that impairs cognitive function may require supervision to manage personal care. The medical report must specify that the injury has caused a functional limitation that necessitates ongoing support.
Evidence Required to Support a Claim for Attendant Care Services
SIRA requires specific evidence to assess the need for attendant care. This includes:
- A detailed medical report from a registered medical practitioner
- Evidence of how the injury affects your ability to perform daily tasks
- Documentation of any previous attempts to manage independently
- Proof of the type and frequency of care required
Medical records should include clinical findings, treatment plans, and recommendations. For example, a physiotherapist's report noting that a claimant cannot safely perform dressing without assistance would be critical. SIRA may also request input from a rehabilitation specialist to determine long-term care needs.
How SIRA Assesses the Need for Attendant Care Services
SIRA evaluates claims using the Motor Accident Guidelines, which outline criteria for determining functional limitations. A medical practitioner must confirm that the injury has caused a significant impairment that cannot be managed through other means. For instance, a claimant with a severe leg injury requiring a walking aid may need assistance with mobility.
The assessment process considers both the nature of the injury and the claimant's ability to perform tasks independently. SIRA may also review the claimant's history of care needs and any previous medical advice. If the evidence is insufficient, SIRA may request additional information or a second medical opinion.
Practical Steps for Claimants
- Seek medical attention immediately after the accident to document your injuries.
- Notify SIRA of your need for attendant care services as part of your CTP claim.
- Provide detailed medical records showing the impact of your injury.
- Coordinate with healthcare providers to ensure your care needs are clearly documented.
- Monitor your condition and update SIRA if your care requirements change.
Time Limits and Dispute Options
You have 52 weeks from the date of the accident to request attendant care services under the CTP scheme. After this period, SIRA may limit benefits unless the claimant can demonstrate ongoing care needs. If your claim is denied, you may request a review or seek independent medical advice to challenge the decision.
When to Seek Legal Advice
While SIRA provides a framework for assessing care needs, the process can be complex. Legal professionals can help ensure that your claim is submitted correctly and that all evidence is properly documented. If you are unsure about your eligibility or need assistance with the application process, consider consulting a solicitor specialising in NSW CTP claims.
Conclusion
Attendant care services are an essential support for injured claimants in NSW, but the process of securing them requires careful documentation and adherence to SIRA guidelines. Understanding the legal framework, gathering the right evidence, and following the correct procedures are crucial to ensuring your claim is evaluated fairly. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.