What the PIC Expects in Disputes Over Domestic Duties Care Costs
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).
In New South Wales, the Personal Injury Commission (PIC) determines whether domestic duties care costs are payable under a Compulsory Third Party (CTP) motor accident claim. These costs cover household tasks like cooking, cleaning, and shopping when injuries prevent a claimant from performing them. However, disputes often arise over what is considered reasonable or necessary. The PIC evaluates these claims based on specific criteria outlined in the Motor Accident Injuries Act 2017 and SIRA guidelines.
Types of Domestic Duties Covered Under NSW CTP Claims
Domestic duties care costs are limited to tasks that are essential for maintaining a household when a claimant is injured. Examples include:
- Preparing meals and grocery shopping
- Cleaning and laundry
- Managing household bills and correspondence
- Child or pet care where the claimant is unable to perform these tasks
The PIC does not cover discretionary tasks like gardening or social activities. Costs must be directly related to the claimant’s inability to perform daily living activities due to their injury.
How the PIC Assesses Reasonableness of Care Costs
The PIC uses a structured approach to evaluate domestic duties claims:
- Medical evidence: A doctor must confirm the claimant’s injury limits their ability to perform household tasks. This includes a statement about the impact on daily functioning.
- Necessity of the task: The PIC considers whether the task is essential for the claimant’s well-being. For example, cooking for a family of four is more critical than preparing meals for one person.
- Reasonable cost: The PIC assesses whether the care costs are proportionate to the injury. This includes checking if the provider’s rates are within the local market range.
- Timeframe: Care costs are typically limited to 52 weeks unless the injury results in long-term or permanent limitations.
A 2023 SIRA case example shows how the PIC rejected a claim for weekly house cleaning when the claimant’s injury only limited their ability to cook, not perform all household tasks.
Practical Steps to Resolve PIC Disputes
If the PIC disputes your domestic duties care costs, take these steps:
- Request a detailed review: Ask the PIC to explain why they rejected specific costs. This helps identify gaps in your evidence.
- Submit additional evidence: Provide updated medical reports, receipts for care services, and witness statements from family members or carers.
- Seek internal review: Under the Motor Accident Injuries Act 2017, you can request a review by a different PIC officer within 28 days of the initial decision.
- Consult a legal expert: If the PIC refuses to reconsider, a solicitor can help challenge the decision through the NSW Civil and Administrative Tribunal (NCAT).
Time Limits and When to Seek Advice
You must submit a claim for domestic duties care costs within 52 weeks of the accident date. If the PIC rejects your claim, you have 28 days to request a review. For disputes beyond this timeframe, you may need to apply to NCAT for an extension.
Final Considerations
Domestic duties care costs are a critical part of CTP claims for injured people unable to manage household tasks. However, the PIC’s assessment focuses on necessity, medical evidence, and proportionality. If your claim is disputed, acting quickly with thorough documentation is essential. For personalized advice tailored to your circumstances, complete the quick, no obligation enquiry form.