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).
SIRA funds treatment costs for Australian Defence Force personnel injured in NSW motor accidents under the Motor Accident Injuries Act 2017. Service members must demonstrate a direct link between their injuries and the accident to access treatment funding. This article explains how SIRA evaluates claims, what evidence is required, and how military claims differ from civilian CTP claims.
How SIRA Funds Treatment Costs for Military Personnel
SIRA assesses treatment costs based on medical necessity and the accident's impact. For service members, claims must show the injury resulted from a motor accident and is unrelated to pre-existing conditions. Funding covers medical treatments, rehabilitation, and equipment if deemed clinically necessary. SIRA uses the Motor Accident Guidelines to evaluate whether treatment aligns with standard medical practices.
Documentation Required for Treatment Cost Claims
To support a claim, service members must provide: medical records detailing the injury and treatment, accident reports, witness statements, and invoices for all treatments. SIRA requires evidence that the injury meets the 'threshold injury' definition under the Motor Accident Injuries Act 2017. This includes showing the injury caused a measurable impact on daily activities or health.
Differences Between Military and Civilian CTP Claims
Military personnel claims are evaluated under the same CTP scheme as civilian claims but may involve additional considerations. For example, service-related injuries must be distinguished from pre-existing conditions. SIRA also considers the Defence Force's role in assessing whether the injury was aggravated by military duties. Claims involving combat or operational scenarios may require specialist medical opinions to establish a direct causal link to the accident.
Time Limits for Claiming Treatment Costs
Claims must be submitted within 52 weeks of the accident for treatment benefits to be available. After this period, SIRA generally stops paying weekly benefits for threshold injuries, though long-term care or severe impairments may qualify for extended support. Service members should act quickly to ensure all documentation is complete and submitted before deadlines.
Practical Steps for Service Members
- Seek immediate medical attention and document all treatments.
- Obtain a copy of the accident report and note details of the incident.
- Contact SIRA directly to confirm eligibility for treatment funding.
- Keep records of all correspondence with insurers or medical providers.
- Consult a legal professional if disputes arise over claim validity.
Example Scenario
A Defence Force member injured in a car accident in Ashfield NSW requires physiotherapy for a back injury. SIRA would assess whether the injury meets the threshold injury criteria and whether the treatment is medically necessary. If the claim is approved, funding covers the physiotherapy costs, but the member must submit invoices and medical reports to support the claim.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.