Facial Scarring Claims Under NSW CTP After 2017 Reforms
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).
Facial scarring injuries now fall under the Motor Accident Injuries Act 2017 (MAIA) in New South Wales, replacing the previous Motor Accidents Compensation Act 1999 (MACA). The 2017 reforms changed how scarring claims are assessed, particularly for injuries not meeting the 'threshold injury' criteria. This article explains the key changes, how the New South Wales Motor Accident Claims Authority (SIRA) evaluates scarring, and practical steps for claimants.
Key Changes to Facial Scarring Claims After 2017
Before 2017, facial scarring injuries under MACA were often treated as 'minor injuries' with limited compensation. The 2017 reforms introduced the MAIA, which shifted focus to the impact of scarring rather than just its presence. Under the new framework:
- Scarring is assessed for functional and cosmetic impact. SIRA considers whether the scar affects daily activities, self-esteem, or appearance. For example, a deep scar causing chronic pain or limiting facial movement may qualify for additional benefits.
- Threshold injuries now have stricter rules. Under MAIA s 4.4, injuries below the 'threshold' (such as superficial cuts) are generally limited to 52 weeks of weekly benefits. However, scarring that results in long-term disfigurement may still qualify for extended support if it meets the 'whole person impairment' standard.
- Cosmetic injury claims are now more nuanced. SIRA uses the Motor Accident Guidelines to evaluate whether scarring constitutes a 'cosmetic injury' requiring specialist treatment. This includes assessing the scar's visibility, psychological impact, and whether it affects the claimant's quality of life.
How SIRA Assesses Facial Scarring Under MAIA
SIRA evaluates scarring claims based on medical evidence and the Motor Accident Guidelines. Key factors include:
- Medical Documentation: A specialist report from a dermatologist or plastic surgeon is critical. The report must detail the scar's location, depth, and impact on the claimant's physical or emotional well-being.
- Cosmetic Impact: SIRA considers whether the scar is visible to others and whether it affects the claimant's ability to work, socialise, or engage in daily activities. For example, a scar on the face that causes chronic anxiety may qualify for additional support.
- Long-Term Effects: If the scar leads to ongoing pain, restricted movement, or psychological distress, it may be classified as a 'threshold injury' under MAIA s 3.11. This allows for extended benefits beyond the 52-week limit.
- Comparative Assessment: SIRA compares the scarring to other injuries under the same claim. For instance, a claimant with both a facial scar and a broken arm may receive combined benefits based on the overall impact.
Practical Steps for Facial Scarring Claims
To strengthen a scarring claim, injured persons should:
- Seek Immediate Medical Attention: Document the injury with a specialist report. This is crucial for proving the scar's existence and impact.
- Preserve Evidence: Keep records of all medical treatments, photographs of the scar, and any correspondence with insurers. SIRA may request these to assess the claim.
- Understand Time Limits: Claims must be submitted within 52 weeks of the accident for weekly benefits. However, scarring claims may extend beyond this if they meet the 'threshold injury' criteria under MAIA s 4.4.
- Consider Specialist Advice: A solicitor experienced in CTP claims can help navigate SIRA's assessment process and ensure all evidence is properly submitted.
Example: How a Facial Scar Might Be Assessed
Consider a claimant who sustained a deep facial laceration in a car accident. Under the 2017 reforms, SIRA would:
- Review the medical report to confirm the scar's depth and visibility.
- Assess whether the scar causes chronic pain or restricts facial movement.
- Determine if the scar leads to psychological distress, such as social withdrawal or anxiety.
- Compare the scar to other injuries to calculate the total claim value.
If the scar meets the 'whole person impairment' standard, the claimant may receive extended benefits beyond the 52-week limit.
When to Seek Legal Advice
The 2017 reforms introduced significant changes to how scarring claims are assessed. If your facial injury involves scarring, it's important to:
- Understand whether your scar qualifies as a 'threshold injury' under MAIA.
- Know the time limits for submitting a claim.
- Ensure all medical evidence is properly documented.
Legal advice can help clarify these points and ensure your claim is assessed fairly under the new framework.
Next Steps
CTP claims involving facial scarring require careful documentation and understanding of the 2017 reforms. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.