Child Injury Claims and Medical Assessments 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 your child was injured in a motor accident in New South Wales, preparing for medical assessments is a critical step in claiming compensation under the Compulsory Third Party (CTP) scheme. The NSW Motor Accident Injuries Act 2017 and SIRA guidelines outline specific requirements for child injury claims, including documentation of medical evidence, assessment timelines, and the role of independent medical experts. This guide explains what parents and guardians need to know to support their child’s claim.
Key Medical Evidence for Child Injury Claims
To establish the nature and extent of your child’s injuries, you’ll need comprehensive medical records. Essential documents include:
- Medical reports from doctors, specialists, and allied health professionals detailing the child’s injuries, treatment, and recovery progress.
- Imaging results (e.g., X-rays, MRIs) showing physical damage.
- Specialist opinions from paediatricians, physiotherapists, or psychologists assessing long-term impacts.
- Notes on daily activities showing how the injury affects the child’s mobility, sleep, or school attendance.
- Accident reports from emergency services or the police, if applicable.
SIRA (State Insurance Regulatory Authority) oversees CTP claims and may require independent medical assessments to evaluate the child’s injuries. These assessments are typically conducted by SIRA-approved medical practitioners who follow the Motor Accident Guidelines.
SIRA’s Role in Child Injury Assessments
SIRA plays a central role in determining the type and amount of compensation available for child injuries. When a claim involves a child, SIRA considers:
- Developmental factors - how the injury may affect the child’s growth or development.
- Long-term prognosis - whether the injury is likely to have lasting effects.
- Threshold injury criteria - injuries meeting the soft-tissue or whole-person impairment thresholds under the Motor Accident Injuries Act 2017.
For example, a child with a minor head injury may require a neurological assessment to determine if it meets the spinal nerve-root qualification for a threshold injury. SIRA will also evaluate whether the child’s injuries qualify for weekly income payments or treatment benefits.
Common Pitfalls to Avoid
Parents should avoid these mistakes when preparing for medical assessments:
- Delaying medical attention - Early documentation is crucial to establish the injury’s timeline.
- Missing appointments - SIRA may require multiple assessments to evaluate the child’s condition.
- Failing to document daily impacts - Keeping a journal of symptoms, sleep patterns, and school absences can support claims for long-term effects.
- Not preserving accident details - Witness statements, photographs of the scene, and vehicle damage records are essential evidence.
Time Limits and Dispute Resolution
CTP claims must be submitted within specific timeframes. For injuries resulting from an accident on or after 1 December 2017, claims must be made within 52 weeks of the accident date. If the child’s injuries are limited to threshold injuries, benefits may be restricted after 52 weeks under s 4.4 of the Motor Accident Injuries Act 2017.
If SIRA disputes the claim, you may need to:
- Request a review - SIRA allows for independent medical reviews to reassess the child’s condition.
- Seek legal advice - A solicitor can help challenge decisions or negotiate a fair outcome.
When to Seek Legal Advice
Parents should consult a legal professional if:
- The child’s injuries are complex or require specialist care.
- SIRA denies the claim or limits benefits.
- The child’s condition worsens, requiring additional assessments.
- There are disputes over fault or contributory negligence.
Final Steps for Parents
Preparing for medical assessments involves gathering detailed records, understanding SIRA’s requirements, and acting promptly. While CTP claims are designed to support injured children, the process can be complex. By following the guidelines outlined in this article and seeking legal advice when needed, parents can better navigate the claims process.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.