How SIRA Funds Attendant Care Services for NSW CTP Claims
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 Illawarra or South Coast NSW and need help with daily living tasks, the State Insurance Regulatory Authority (SIRA) may fund attendant care services. This article explains how SIRA covers these costs under the NSW Compulsory Third Party (CTP) scheme and clarifies the legal boundaries of this funding.
SIRA's Role in Funding Attendant Care
SIRA administers the Motor Accident Injuries Act 2017 (MAIA) for NSW CTP claims. Under this scheme, injured road users may claim funding for attendant care services if their injuries prevent them from performing basic activities like dressing, eating, or bathing. This includes both personal care (e.g., assistance with hygiene) and supervision (e.g., monitoring medication). Funding is available through the SIRA Claims Portal for eligible injuries.
To qualify, your injury must meet the threshold injury criteria outlined in the Motor Accident Guidelines. This typically requires a whole person impairment (WPI) of 10% or more or a spinal nerve-root injury with neurological signs. SIRA assesses claims based on medical evidence, including reports from registered medical practitioners and treatment records.
How This Differs From Other Treatment Costs
Attendant care funding is distinct from other CTP-covered expenses like medical bills or rehabilitation. While SIRA funds treatment and care benefits for injuries, attendant care is a specific category under the 52-week statutory benefit period. After 52 weeks, weekly income payments and treatment benefits are generally limited unless the injury meets the threshold for long-term impairment.
For example, if you suffered a soft-tissue injury (like a whiplash) that doesn’t meet the threshold, SIRA may cover attendant care costs for up to 52 weeks. However, if your injury results in a whole person impairment of 10% or more, you may be eligible for ongoing support beyond this period.
Practical Steps to Claim Attendant Care Funding
To claim attendant care services, you must:
- Notify SIRA within 52 weeks of the accident (or 10 years if you were a child at the time)
- Provide medical evidence confirming your need for assistance
- Submit a claim form through the SIRA Claims Portal
Keep records of all medical appointments, care provider invoices, and correspondence with SIRA. If your claim is denied, you may request a review by an independent assessor or seek legal advice to challenge the decision.
Time Limits and When to Seek Advice
The 52-week statutory period for treatment benefits applies to all CTP claims. If your injury doesn’t meet the threshold, you may need to pursue compensation through the NSW Civil and Administrative Tribunal (NCAT) or a personal injury claim if fault is established. However, CTP claims are limited to no-fault compensation under the MAIA.
If you’re unsure whether your injury qualifies for attendant care funding, contact SIRA directly or consult a legal professional. The Illawarra and South Coast regions have specific SIRA offices that can assist with claims, but the legal standards apply uniformly across NSW.
Next Steps
CTP claims depend on the date of your accident, the nature of your injury, and the evidence you provide. To request contact about your circumstances, complete the quick, no obligation enquiry form.