What Changed for Care and Family Support Claims After the 2017 Reforms
The 2017 reforms to NSW Compulsory Third Party (CTP) motor accident compensation introduced significant changes to how care and family support claims are assessed. These reforms, under the Motor Accident Injuries Act 2017 and Motor Accident Injuries Regulation 2017, shifted the focus from broad entitlements to a more structured evaluation of care needs. For claimants in Bankstown and across NSW, this means clearer rules on what qualifies as a 'care need' and how evidence must be presented.
Under the revised scheme, care and family support payments are now tied to specific, measurable requirements. For example, claimants must demonstrate that their injury has caused a 'loss of capacity' to perform daily activities, such as personal hygiene or mobility. This replaces the previous system where care needs were assessed more subjectively.
Practical Steps and Evidence for Family Support Claims
To support a family care claim, claimants must provide detailed documentation. Key evidence includes:
- Medical reports confirming the injury’s impact on daily living
- Evidence of unpaid care provided by family members (e.g., time records, witness statements)
- Financial records showing the cost of care (if applicable)
- A completed 'Care Needs Assessment' form from a registered medical practitioner
SIRA’s updated guidelines emphasize that claims must show a direct link between the injury and the care need. For instance, a claimant who requires assistance with dressing due to a spinal injury would qualify, while a claim based on general inconvenience (e.g., needing a lift to a car) may not.
Time Limits and Dispute Resolution
Claimants must notify their insurer within 52 weeks of the accident, as per the Motor Accident Injuries Act 2017 s 4.4. If the injury is classified as a 'threshold injury' (e.g., soft tissue damage without long-term impairment), weekly benefits and care payments are generally limited to 52 weeks. However, serious injuries with lasting care needs may qualify for extended support.
Disputes over care claims are resolved through SIRA’s dispute resolution process. Claimants should seek legal advice if their insurer rejects a claim, as the 2017 reforms introduced stricter criteria for 'loss of capacity' that may require expert medical opinion.
A Hypothetical Example
Consider a Bankstown resident who suffered a serious spinal injury in a car accident. Their spouse now provides full-time care, including assistance with mobility and personal hygiene. Under the revised CTP scheme, the claimant must:
- Submit medical evidence showing the injury caused a 'loss of capacity' to perform daily tasks
- Provide records of the spouse’s unpaid care hours
- Demonstrate that the injury directly led to the care need
If these criteria are met, the claimant may receive weekly care payments and support for family members’ lost income.
When to Seek Legal Advice
The 2017 reforms introduced complex rules about what qualifies as a care need. For example, the 'spinal nerve-root qualification' in the Motor Accident Guidelines now requires specific clinical signs (e.g., neurological deficits) to classify an injury as a 'threshold injury.' Claimants in Bankstown should consult a solicitor if:
- Their claim is denied due to lack of 'loss of capacity' evidence
- They need help navigating SIRA’s updated assessment forms
- They face disputes over the duration of care payments
Next Steps
The 2017 reforms have made family care claims more demanding but also more transparent. Claimants must now meet strict evidentiary standards, particularly around 'loss of capacity.' If you’re in Bankstown and need help understanding your care entitlements, contact LegalAdvice.com.au for a free, no-obligation assessment of your circumstances.