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 a family member is injured in a distracted driving accident in Bega, NSW, caregivers may be eligible for financial support through the NSW Compulsory Third Party (CTP) scheme. This article explains what family-related claims are available, how the State Insurance Regulatory Authority (SIRA) assesses caregiver needs, and time limits for these claims.
What Support Is Available for Caregivers?
Under the Motor Accident Injuries Act 2017, injured people can claim support for family members who provide care. This includes:
- Weekly income payments for caregivers who reduce their work hours
- Care and treatment benefits for direct care costs like nursing or home modifications
- Out-of-pocket expenses for medical equipment or travel
SIRA evaluates these claims based on the injured person's medical condition and the caregiver's role. For example, if the injured person requires 20 hours of weekly care, the caregiver may qualify for income support.
How SIRA Assesses Caregiver Needs
SIRA uses the Motor Accident Guidelines to determine the level of care needed. Key factors include:
- The injured person's whole person impairment rating
- The type and frequency of care required (e.g., overnight stays, medication management)
- Whether the caregiver's role replaces the injured person's ability to self-care
A hypothetical example: After a distracted driving accident, a 62-year-old woman sustains a soft-tissue injury requiring 15 hours of weekly care. Her daughter, who works full-time, reduces her hours to provide care. SIRA would assess the daughter's lost income and the injured person's care needs to determine support.
Time Limits and Dispute Options
Family support claims must be submitted within 52 weeks of the accident if the injury is a threshold injury (per s 4.4 of the Motor Accident Injuries Act 2017). For non-threshold injuries, there is no strict time limit, but claims must be made within the statute of limitations for the injury itself.
If a claim is disputed, the injured person or caregiver can:
- Request a review by SIRA
- Seek independent medical assessment
- Lodge a complaint with the NSW Ombudsman
When to Seek Legal Advice
Caregivers should consult a solicitor if:
- The injured person's condition worsens after the 52-week mark
- SIRA denies a claim despite medical evidence
- There are disputes over the level of care required
Legal professionals can help navigate SIRA's assessment process and ensure all eligible support is claimed.
Next Steps
CTP claims involving family caregivers depend on the accident date, injury type, and claim history. To discuss your circumstances, complete the quick, no obligation enquiry form.