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).
Families supporting injured road users in Western Sydney need to understand how the NSW Compulsory Third Party (CTP) scheme covers care and support needs. The CTP scheme, administered by SIRA, provides financial assistance for unpaid care, medical treatment, and income replacement after a motor accident. Early action is critical to secure support, as time limits apply. This guide explains how families can access care services, document needs, and navigate the claims process.
What Support is Available for Families?
Under the Motor Accident Injuries Act 2017, the CTP scheme covers care and family support costs for injured road users. This includes payments for unpaid caregiving, such as helping with daily tasks, medical appointments, or transport. Families can also claim for additional expenses like travel costs or lost income if a caregiver needs to take time off work.
SIRA provides a dedicated claims portal (https://www.sira.nsw.gov.au/claims/motor-accidents) to apply for care benefits. Families should contact SIRA directly to request a care and support needs assessment, which may involve a medical professional confirming the injury’s severity. For example, a family caring for a child with a soft-tissue injury may need to provide medical records showing the need for ongoing support.
How to Document Family Care Needs?
To claim care benefits, families must prove the injured person’s care requirements. Key evidence includes:
- Medical reports detailing the injury’s impact on daily living
- Care logs showing hours of assistance provided
- Witness statements from family members or friends
- Proof of income loss if a caregiver has to reduce work hours
Families should also keep records of all communication with SIRA, including dates and details of correspondence. If a claim is denied, families can request a review by submitting additional evidence or seeking legal advice.
Time Limits and Dispute Options
CTP claims must be submitted within 52 weeks of the accident for certain benefits, such as weekly income payments. If the injury is classified as a 'threshold injury' (e.g., a soft-tissue injury without long-term impairment), benefits may stop after 52 weeks. Families should act quickly to ensure they meet deadlines.
Disputes over claim eligibility or benefit amounts can be resolved through SIRA’s internal review process. If necessary, families may seek independent legal advice to challenge a decision. For instance, if a family believes their care needs exceed the threshold injury definition, they can request a reassessment by a medical expert.
When to Seek Legal Advice
While SIRA provides support, families may need legal assistance to navigate complex claims. A solicitor can help with:
- Negotiating fair compensation for long-term care needs
- Contesting decisions to stop benefits after 52 weeks
- Ensuring all evidence is properly submitted
Families should consult a lawyer if they face disputes, delays, or uncertainty about their claim’s viability. Legal professionals can also help with applications for additional support, such as access to respite care or home modifications.
Example Scenario
A family in Western Sydney caring for a relative injured in a car accident needs to document the injured person’s care requirements. They submit medical records showing the injury’s impact, complete a SIRA care needs form, and request a review if benefits are denied. Acting within 52 weeks ensures they meet deadlines for income support payments.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.