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).
In New South Wales, if you've suffered a serious motor accident resulting in injuries requiring ongoing care, you may be eligible for attendant care services under the Compulsory Third Party (CTP) scheme. This article explains how SIRA assesses claims for paid care and rehabilitation planning in Western Sydney, including the evidence needed and legal boundaries under NSW law.
How SIRA Assesses Attendant Care Services
SIRA evaluates whether your injury meets the threshold for attendant care by assessing the severity of your condition. Under the Motor Accident Injuries Act 2017, a 'threshold injury' includes injuries requiring treatment that results in a significant loss of function. For example, if you need assistance with daily tasks like dressing or cooking due to a spinal injury, SIRA may approve care services.
To qualify, your treatment plan must demonstrate that your injury requires ongoing supervision. This includes medical reports confirming your condition, evidence of how the injury impacts your daily life, and a rehabilitation plan from a registered medical practitioner. SIRA also considers whether your injury meets the spinal nerve-root qualification outlined in the Motor Accident Guidelines.
Evidence Needed for Rehabilitation Planning
Supporting your claim requires specific evidence. Key documents include:
- Medical records detailing your injury and treatment
- A rehabilitation plan outlining your care needs
- Evidence of how your injury affects your ability to perform daily tasks
- Income records if you're claiming weekly payments
- Correspondence with SIRA or your insurer
For instance, if you sustained a soft-tissue injury requiring a walking aid, your doctor's notes must show that your condition limits your mobility to a degree that necessitates assistance.
Time Limits and Dispute Options
You have 52 weeks from the accident date to claim weekly benefits for threshold injuries. After this period, benefits may be limited unless your injury meets the 'whole person impairment' threshold. If your claim is disputed, you can request a review by SIRA or seek independent medical assessment.
If your injury requires long-term care planning, such as assistance with personal hygiene or meal preparation, it's important to document how your condition affects your independence. This helps SIRA determine the appropriate level of support.
When to Seek Legal Advice
Consult a legal professional if you're unsure whether your injury meets the threshold, if SIRA denies your claim without explanation, or if you need help navigating the rehabilitation planning process. Legal advice can also help challenge a decision if you believe it's based on incorrect information.
Next Steps
CTP claims for attendant care depend on the specifics of your injury, treatment, and the date of the accident. To discuss your circumstances, complete the quick, no obligation enquiry form. Every claim depends on its own facts.