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).
Elderly pedestrians involved in motor vehicle accidents in New South Wales must prepare thorough medical documentation to support their Compulsory Third Party (CTP) claims. This guide explains how to prepare for medical assessments, how the NSW government evaluates claims for older claimants, and practical steps for the Newcastle and Hunter regions. Time limits and dispute resolution options are also outlined.
Key CTP Rules for Elderly Pedestrians
Under the Motor Accident Injuries Act 2017, CTP claims cover injuries caused by motor vehicles, including pedestrian accidents. For elderly claimants, medical evidence must clearly link the accident to injuries, accounting for pre-existing conditions. SIRA (State Insurance Regulatory Authority) evaluates claims based on medical reports, not just the accident itself. If an elderly pedestrian has chronic conditions like arthritis or mobility issues, doctors must specify whether the accident caused new or worsened injuries.
Critical Medical Evidence for Elderly Claims
Medical assessments must include:
- Detailed records of pre-accident health, including mobility limitations or chronic pain
- Post-accident diagnosis confirming new injuries or exacerbations
- Specialist reports from physiotherapists, orthopaedic surgeons or geriatricians
- Evidence of functional decline, such as difficulty walking or balance issues
- Documentation of treatment plans and recovery progress
In the Newcastle and Hunter regions, claimants should seek assessments from SIRA-approved medical practitioners. Doctors must avoid vague terms like 'minor injury' and instead use specific terminology like 'soft tissue injury' or 'spinal nerve-root damage' as defined in the Motor Accident Guidelines.
SIRA's Approach to Age-Related Claims
SIRA evaluates elderly claims by comparing pre-accident function with post-accident capacity. For example, if an elderly pedestrian had limited mobility before the accident but now requires a walking aid, this demonstrates a worsening condition. Claims involving pre-existing conditions must show the accident caused a 'threshold injury', a term defined in the Motor Accident Injuries Act 2017. This includes injuries like whiplash, fractures, or soft tissue damage requiring medical treatment.
A hypothetical example: An 80-year-old woman with osteoarthritis is struck by a car. Her doctor notes she was previously able to walk 500 metres unaided but now requires a walking stick. This demonstrates a functional decline linked to the accident, supporting a CTP claim.
Regional CTP Claim Preparation Tips
In the Hunter region, claimants should:
- Coordinate with local SIRA offices to ensure medical reports meet requirements
- Request copies of all accident-related medical records
- Seek independent medical opinions if there's a dispute over pre-existing conditions
- Document daily functional limitations, such as difficulty climbing stairs or standing for prolonged periods
Time limits apply. Most CTP claims must be submitted within 52 weeks of the accident, though extensions may be granted for complex cases. If a claimant's injuries worsen after this period, they may need to pursue a separate damages claim under common law.
When to Seek Legal Advice
Consult a solicitor if:
- The claimant's injuries are disputed as 'threshold injuries'
- There are conflicts over pre-existing conditions
- The claimant needs to challenge a SIRA decision
- The accident occurred before 2016 (when CTP rules changed)
Legal professionals can help navigate SIRA's assessment process and ensure all evidence supports the claimant's recovery needs.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.