SIRA determines whether you can claim care and family support costs after a NSW motor accident. This article explains how SIRA assesses these claims, what evidence is needed, and how they differ from other CTP benefits.
What types of care and family support are covered under NSW CTP claims?
Under the Motor Accident Injuries Act 2017, care and family support claims cover costs incurred to provide unpaid care to someone injured in a motor accident. This includes:
- Paid care costs (e.g., nursing, home help)
- Lost income from family members who must leave work to care for the injured person
- Expenses for adapting the home to accommodate the injury
SIRA considers these claims as part of the 'care and family support' category under the Motor Accident Guidelines. However, claims must meet specific criteria to be eligible.
How does SIRA assess the value of care and family support claims?
SIRA evaluates claims based on:
- The nature and severity of the injury
- The level of care required (e.g., full-time, part-time)
- The duration of care needed
- The relationship between the injured person and the caregiver
For example, if a family member must take time off work to care for an injured relative, SIRA will assess the lost income based on the caregiver's earnings and the time required. Claims must demonstrate a direct link between the injury and the care needs.
What documentation is required to support a care and family support claim?
To substantiate a claim, you must provide:
- Medical records confirming the injury and care requirements
- Proof of the caregiver's income (e.g., payslips, tax returns)
- Evidence of the care costs (e.g., invoices, receipts)
- A statement from the caregiver detailing the time and effort required
SIRA may also request a report from a medical practitioner confirming the care needs. Without proper documentation, claims may be denied or reduced.
How do SIRA's rules on care and family support differ from other CTP claim types?
Care and family support claims are distinct from other CTP benefits like weekly income payments or treatment benefits. They are specifically for:
- Costs directly related to providing care
- Lost income from caregivers
- Home modifications
Unlike other claims, care and family support claims are not limited to 'threshold injuries' under the Motor Accident Injuries Act 2017. However, they must still meet the scheme's eligibility criteria for compensation.
Example: How SIRA evaluates a family care claim
Consider a scenario where a parent is injured in a motor accident and requires full-time care. The parent's spouse must leave their job to provide 24/7 care. SIRA will:
- Assess the spouse's income to calculate lost wages
- Evaluate the care requirements based on medical reports
- Determine the duration of care needed
- Calculate the total claim value based on these factors
This example illustrates how SIRA balances the injured person's needs with the caregiver's circumstances.
Time limits, disputes and when to seek advice
You have 52 weeks from the accident date to claim care and family support benefits under the Motor Accident Injuries Act 2017. After this period, claims for 'only injuries' are generally limited. If your claim is denied or disputed, you may:
- Request a review from SIRA
- Seek independent medical assessment
- Consult a legal professional
It is important to act promptly and gather all necessary evidence to support your claim.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.