Care and Family Support in 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're injured in a motor vehicle accident in Balmain and need help with daily living or family support, the NSW Compulsory Third Party (CTP) scheme may cover these costs. This article explains what care and family support claims involve, how SIRA assesses them, and what evidence you’ll need.
What Types of Care and Family Support Are Covered?
Under the NSW CTP scheme, you may claim for:
- Home help (e.g., assistance with meals, cleaning, or personal hygiene)
- Personal care (e.g., help with dressing, bathing, or mobility)
- Family support (e.g., unpaid care from a family member or friend)
- Specialised equipment (e.g., mobility aids or home modifications)
These claims are governed by the Motor Accident Injuries Act 2017 and SIRA’s guidelines. SIRA assesses whether your care needs are directly related to the accident and meet the 'threshold injury' criteria.
How SIRA Assesses Eligibility
SIRA evaluates claims based on:
- Medical evidence (e.g., reports from doctors or physiotherapists confirming your injury and care needs)
- Documentation of care arrangements (e.g., evidence that a family member is providing unpaid support)
- Financial impact (e.g., records showing how the injury has affected your ability to work or manage daily tasks)
You must provide evidence that your care needs are a direct result of the accident. SIRA may also consider whether your injury meets the 'threshold injury' definition under the Motor Accident Guidelines.
What Documentation Is Required?
To support your claim, you’ll need:
- Medical records detailing your injury and treatment
- Accident reports from police or witnesses
- Proof of income (e.g., payslips or tax returns) to show how the injury has affected your finances
- Care provider details (e.g., invoices from a carer or a letter from a family member confirming unpaid support)
Keep all documents organised. SIRA may request additional information during the claims process.
Time Limits and Dispute Options
You have five years from the date of the accident to make a CTP claim under the Motor Accident Injuries Act 2017. However, some benefits (like weekly payments) may stop after 52 weeks if your injuries are classified as 'threshold injuries.'
If your claim is disputed, you can:
- Request a review from SIRA
- Seek mediation through the NSW Civil and Administrative Tribunal (NCAT)
- Consult a solicitor for further options
When to Seek Advice
CTP claims can be complex, especially when care and family support are involved. Ensure you:
- Understand the difference between statutory benefits and common law damages
- Know how SIRA’s assessment process works
- Seek legal advice if your claim is denied or delayed
Final Steps
If you’re in Balmain and need help with care or family support after a motor accident, start by gathering all relevant documents and contacting your insurer. Remember, every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.