Where a person's only injuries resulting from the accident are threshold injuries, weekly benefits and treatment and care generally cease after 52 weeks (ss 3.11 and 3.28).
When a child is injured in a motor accident in NSW, preparing for medical assessments is critical to securing compensation under the Compulsory Third Party (CTP) scheme. Medical evidence forms the foundation of claims, as it determines the nature of injuries, treatment needs, and eligibility for benefits. This guide explains how to prepare a child for assessments, what documentation matters, and how SIRA evaluates medical evidence in Albury and other NSW locations.
Legal Framework for Child Injury Claims
Under the Motor Accident Injuries Act 2017, CTP claims in NSW are governed by the Motor Accident Guidelines and SIRA’s operational standards. For children, the focus is on documenting injuries that meet the 'threshold injury' criteria, which includes soft tissue injuries with neurological signs or fractures. SIRA assesses whether the injury requires treatment, impacts daily activities, or results in long-term impairment. Parents must ensure medical records clearly link the injury to the accident, as this is essential for proving a claim.
Practical Steps for Preparing a Child for Assessments
- Secure Immediate Medical Attention: Transport the child to a registered medical practitioner as soon as possible. Emergency care should be documented with dates, times, and details of treatment. Delaying care may weaken the claim, as injuries must be assessed within a reasonable timeframe.
- Request Detailed Medical Records: Obtain records from all healthcare providers, including GP notes, imaging reports, and specialist consultations. These should specify the injury’s severity, treatment plan, and how it affects the child’s mobility, school attendance, or emotional well-being.
- Coordinate with SIRA Assessors: SIRA may require independent medical assessments to evaluate the injury’s impact. Parents should ensure the child attends all appointments and provides accurate information about symptoms and recovery progress.
Key Documentation for CTP Claims
- Accident Report: Police or witness statements confirming the incident, including vehicle details and fault.
- Medical Evidence: Reports from doctors, physiotherapists, or psychologists that detail the injury, treatment, and prognosis.
- School or Care Records: Evidence of how the injury affects the child’s education or care needs, such as missed school days or additional support required.
- Income and Expenses: For claims involving lost income or out-of-pocket costs, provide payslips, receipts, and proof of financial impact.
SIRA’s Approach to Child Injury Claims
SIRA evaluates medical evidence using the Motor Accident Guidelines, which define threshold injuries and outline how to assess long-term impairment. For children, the focus is on whether the injury requires ongoing treatment, impacts development, or results in permanent disability. SIRA may also consider the child’s age, developmental stage, and the likelihood of recovery. Parents should work closely with medical professionals to ensure assessments align with SIRA’s criteria.
Time Limits and Dispute Resolution
CTP claims must be submitted within 52 weeks of the accident if the injury is classified as a 'threshold injury.' For non-threshold injuries, the 52-week limit does not apply, but delays in reporting may still affect the claim. If SIRA disputes the injury’s severity, parents can request a review or seek independent medical opinions. It is crucial to act promptly and maintain clear records to support the child’s case.
Example Scenario
A 7-year-old child sustains a fractured arm in a car accident. Parents take the child to a hospital, where X-rays confirm the break. Medical records note the injury limits the child’s ability to play sports and attend school. SIRA assesses the injury as a threshold injury, approving treatment benefits and income support for the family. This example highlights how thorough documentation and timely medical assessments are essential to securing compensation.
When to Seek Legal Advice
While SIRA handles most CTP claims, complex cases, such as disputes over injury severity, long-term care needs, or overlapping workers’ compensation claims, may require legal assistance. A solicitor can help navigate SIRA’s processes, challenge incorrect assessments, or negotiate for additional benefits. Always seek advice before submitting a claim if the injury involves multiple injuries, chronic pain, or psychological trauma.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.