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 complex regional pain syndrome (CRPS) following a road trauma in New South Wales, understanding your rights under the Compulsory Third Party (CTP) scheme is critical. This article explains the early steps to take, how SIRA guidelines apply to CRPS claims, and what evidence is needed to support your claim. The focus is on injured road users in the Illawarra and South Coast regions, where prompt action can help secure benefits under the Motor Accident Injuries Act 2017.
NSW CTP Rules for CRPS Claims
Under NSW law, CRPS following a motor accident may qualify as a 'threshold injury' under the Motor Accident Guidelines. This means it could entitle you to treatment and care benefits, weekly income payments, or compensation for ongoing pain and disability. However, the type of benefits available depends on the severity of your condition and whether it meets the medical criteria outlined in the guidelines.
SIRA (State Insurance Regulatory Authority) administers CTP claims in NSW. Their guidelines state that CRPS must be diagnosed by a medical practitioner and linked to the accident. If your CRPS is classified as a threshold injury, weekly benefits are generally limited to 52 weeks after the accident date. This applies only if your injuries are the sole consequence of the accident and do not involve whole-person impairment.
Practical Steps for Early CTP Claims
- Seek Immediate Medical Attention: Document your CRPS diagnosis with detailed medical records. A GP or specialist report confirming the link between your accident and CRPS is essential. Delaying treatment may weaken your claim.
- Preserve Accident Evidence: Collect details of the incident, including police reports, witness statements, and photographs of the scene. If you were a cyclist or pedestrian, note how the accident occurred and any pre-existing conditions.
- Notify SIRA: Contact SIRA within 52 weeks of the accident to report your claim. While there is no strict deadline, delays may reduce your ability to claim weekly benefits after the 52-week period.
- Keep Financial Records: Track all medical expenses, lost income, and out-of-pocket costs. These records help establish the financial impact of your CRPS.
SIRA Guidance on CRPS Claims
SIRA’s Motor Accident Claims page explains that CRPS claims must demonstrate a direct connection to the accident. For example, if you developed CRPS after a car collision, your claim must show that the injury would not have occurred without the accident. SIRA also emphasizes that weekly benefits are not available if your CRPS is classified as a 'threshold injury' and your only injuries are those.
A hypothetical example: A cyclist in Wollongong suffered CRPS after a collision with a car. Their GP documented the condition as a direct result of the accident, and they notified SIRA within 12 weeks. This helped secure treatment benefits and income support during the 52-week period.
Time Limits and Dispute Resolution
If your CRPS is not classified as a threshold injury, you may still be eligible for compensation under common law. However, NSW CTP claims must be submitted within 52 weeks of the accident to access weekly benefits. If your claim is denied, you can request a review through SIRA or seek legal advice to challenge the decision.
When to Seek Legal Advice
CRPS claims can be complex, especially if your condition worsens or overlaps with other injuries. A solicitor can help you understand whether your CRPS qualifies for additional compensation beyond the 52-week benefits. Early legal input is particularly important if your claim involves disputes over diagnosis or causation.
Next Steps
CTP entitlements depend on the date of your accident, the nature of your CRPS, and whether it meets the threshold injury criteria. To request contact about your circumstances, complete the quick, no obligation enquiry form.