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).
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).
Military personnel injured in motor accidents on NSW roads may face unique challenges when disputing CTP claims. The Personal Injury Commission (PIC) has specific expectations for disputes involving service members, particularly on the Central Coast. This article explains what evidence is required, how PIC handles military claims differently, and time limits for disputes.
NSW CTP Rules for Military Claims
CTP claims in NSW are governed by the Motor Accident Injuries Act 2017 and SIRA guidelines. For military personnel, additional documentation is required to establish injury severity and entitlements. The PIC assesses claims based on medical evidence, including service records and military-specific injury reports. Unlike civilian claims, military injuries may involve unique factors such as duty-related incidents or service-connected conditions.
Evidence and Documentation for Military Claims
To dispute a CTP claim, the PIC expects:
- Medical records confirming injury alignment with SIRA's threshold injury criteria (e.g., spinal nerve-root injuries with neurological signs).
- Service records showing the injury occurred during duty or training.
- Evidence of ongoing treatment, such as military medical reports or rehabilitation records.
- Proof of income loss, including military pay records or disability benefits.
A hypothetical example: A service member with a soft-tissue injury (confirmed by a military orthopaedic surgeon) disputes a PIC decision to limit benefits. The PIC requires detailed documentation linking the injury to the accident and demonstrating its impact on military duties.
PIC Dispute Process for Military Personnel
Disputes involving military claims are handled through the PIC's internal review pathway. The PIC may request a second medical opinion from a SIRA-approved specialist. Unlike civilian claims, military disputes often involve coordination with the Department of Veterans' Affairs to assess service-connected injuries. The PIC may also consider the impact of the injury on the individual's ability to perform military duties.
Time Limits and Dispute Resolution
CTP claims must be disputed within 52 weeks of the injury, unless the claimant provides evidence of a delay due to military medical review. For disputes involving the PIC's medical assessment, the internal review process typically takes 28 days. If the claimant disagrees with the review outcome, they may seek further review through the NSW Civil and Administrative Tribunal (NCAT).
When to Seek Legal Advice
Military personnel should consult a solicitor specialising in CTP claims if:
- The PIC disputes the injury's classification as a threshold injury.
- The claimant is unsure about the impact of the injury on their military career.
- The dispute involves the Department of Veterans' Affairs or service-related benefits.
The PIC's approach to military claims differs from civilian cases due to the unique nature of service-related injuries. Understanding these distinctions is critical to ensuring entitlements are properly assessed.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.