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've developed chronic regional pain syndrome (CRPS) following a road accident in New South Wales, understanding your rights under the NSW Compulsory Third Party (CTP) scheme is critical. CRPS is a complex condition that may qualify for compensation under the Motor Accident Injuries Act 2017, but early action is essential. This article explains how to navigate the claims process, what evidence matters, and when to seek legal advice.
NSW CTP Rules for CRPS Claims
Under the NSW CTP scheme, injuries must meet specific criteria to qualify for benefits. CRPS is classified as a 'threshold injury' under the Motor Accident Guidelines, meaning it may entitle you to treatment and care benefits, weekly income payments, and compensation for ongoing pain. However, benefits for threshold injuries typically stop after 52 weeks unless the injury is severe enough to qualify for a damages claim. SIRA (State Insurance Regulatory Authority) assesses whether CRPS meets the threshold by evaluating clinical evidence, including neurological tests and specialist reports.
Practical Steps After a Road Accident
- Seek immediate medical attention: Document all treatment, as medical records are crucial to prove the link between your accident and CRPS. Delaying care may weaken your claim.
- Record symptoms and treatment: Keep a diary of pain levels, sleep disruption, and how CRPS affects daily activities. This helps demonstrate the condition's impact.
- Preserve accident details: Gather evidence like police reports, witness statements, and photos of the scene. This supports your account of the incident.
- Notify your insurer: Contact the at-fault driver’s CTP insurer within 52 weeks of the accident. Delays may jeopardize benefits for threshold injuries.
- Request a specialist assessment: A neurologist or pain specialist can confirm CRPS and explain its severity. SIRA may require this to determine if your injury exceeds the threshold.
Time Limits and Disputes
You have 52 weeks from the accident date to claim weekly benefits or treatment. After this period, benefits for threshold injuries generally stop unless your condition worsens or you meet the criteria for a damages claim. If SIRA disputes your claim, you may need to appeal through the NSW Civil and Administrative Tribunal (NCAT). However, disputes over CRPS are rare, as the condition is well-documented in medical literature.
When to Seek Advice
While some claims can be managed through SIRA, complex cases, such as those involving long-term pain, disability, or disputes over injury severity, often require a solicitor. A lawyer can help you understand whether your CRPS qualifies for a damages claim, which is only available if your injury meets the 'whole person impairment' threshold under the Motor Accident Injuries Act 2017.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.