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 caring for a loved one injured in a motor accident in New South Wales, understanding how to prepare for medical assessments is critical. The NSW Compulsory Third Party (CTP) scheme covers care and family support claims, but success depends on meeting SIRA's evaluation criteria. This guide explains what evidence matters, how SIRA assesses care needs, and practical steps to take in Bathurst and beyond.
What Evidence Matters for Care and Family Support Claims
To claim care and family support under the CTP scheme, you must demonstrate the injured person's need for assistance with daily living. Key evidence includes:
- Medical records showing the injury's impact on mobility, cognition or daily activities
- Care logs documenting the type, frequency and duration of assistance provided
- Witness statements from family members or carers
- Income records showing the injured person's pre-accident earning capacity
- Medical reports from specialists confirming the need for care
SIRA requires these documents to assess whether the injury meets the 'threshold injury' definition under the Motor Accident Injuries Act 2017. For example, a spinal nerve-root injury causing neurological signs may qualify as a threshold injury even without radiculopathy.
How SIRA Assesses Care and Family Support Needs
SIRA evaluates care needs using the Motor Accident Guidelines. Assessors consider:
- The injured person's ability to perform basic activities like dressing, cooking or personal hygiene
- The impact of the injury on their ability to work or study
- The level of assistance required for 24-hour care, including emotional support
- Whether the injury is likely to result in long-term or permanent care needs
A hypothetical example: If a carer documents that the injured person requires assistance with toileting, eating and mobility for 12 hours daily, this demonstrates a clear need for care. SIRA may then consider the claim for weekly income payments or treatment benefits.
Practical Steps for Families in Bathurst
- Organise medical evidence by compiling all relevant reports, specialist opinions and care records
- Keep detailed care logs noting the type of assistance provided, duration and any changes in the injured person's condition
- Document all interactions with SIRA, healthcare providers and insurers
- Seek medical opinions about the long-term impact of the injury on daily living
- Consult a legal professional if you believe your claim may be undervalued or disputed
Time Limits and Dispute Options
You have 52 weeks from the accident date to claim weekly income benefits if your injuries are limited to threshold injuries. After this period, benefits are generally limited unless the injury results in a whole person impairment of 10% or more. If you disagree with SIRA's assessment, you may:
- Request a review of the decision
- Apply for a medical assessment through the NSW Civil and Administrative Tribunal (NCAT)
- Seek legal advice about disputing the assessment
When to Seek Legal Advice
Families should consider legal assistance if:
- You're unsure whether your care needs meet SIRA's criteria
- You believe the injured person's needs have worsened since the initial assessment
- You need help challenging a decision to reduce or terminate benefits
- You want to understand your options for long-term care planning
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.