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 in NSW CTP claims require careful assessment of both the injury's impact and the practical needs of caregivers and families. Under the Motor Accident Injuries Act 2017 (MAIA), scarring injuries may qualify for statutory benefits or common law damages depending on their severity and long-term effects. This article explains how facial scarring is evaluated, the role of caregiver needs in claims, and steps to take in Greater Sydney.
How Facial Scarring Affects CTP Claims
Facial scarring is assessed under the MAIA as a 'threshold injury' if it meets specific medical criteria. SIRA (State Insurance Regulatory Authority) uses the Motor Accident Guidelines to determine whether scarring qualifies for statutory benefits. Key factors include the depth of the scar, its visibility, and its effect on the injured person's daily life. For example, a deep laceration requiring surgical repair with visible scarring may be classified as a threshold injury, entitling the claimant to weekly income payments and treatment benefits.
Caregiver considerations are separate but critical. If scarring leads to long-term functional limitations or psychological distress, the claim may include additional support for family members. SIRA evaluates whether the injury's impact extends beyond the individual, such as requiring ongoing assistance with personal care or household tasks.
Practical Steps and Evidence for Facial Scarring Claims
To support a claim, gather medical evidence showing the scarring's severity and its connection to the accident. This includes:
- Detailed medical records from a specialist (e.g., plastic surgeon or dermatologist)
- Before-and-after photographs of the injury
- Expert opinions on the scarring's permanence and psychological impact
- Evidence of caregiver involvement, such as witness statements or care records
SIRA also considers the injured person's ability to work and the long-term consequences of the scarring. For instance, if the injury affects self-esteem or requires cosmetic procedures, this may influence the compensation amount.
Time Limits and Dispute Resolution
CTP claims must be notified to the insurer within 52 weeks of the accident, but this deadline does not apply to claims involving long-term care needs. If scarring requires ongoing treatment or caregiver support, the claim may extend beyond this period. Disputes over scarring's severity or caregiver needs can be resolved through SIRA's review process or by seeking independent medical opinions.
Example: Scarring with Caregiver Impact
Consider a scenario where a pedestrian sustains a facial laceration in a car accident. The injury results in a visible scar requiring multiple cosmetic procedures. The claimant's family members take on caregiving roles, including assisting with skincare routines and emotional support. SIRA would assess both the scarring's medical impact and the family's practical needs to determine the appropriate compensation.
When to Seek Legal Advice
While SIRA handles most claims, complex cases involving long-term care, multiple injuries, or disputes over scarring severity may require legal assistance. A solicitor can help navigate the process, ensure all evidence is submitted, and challenge decisions that appear unfair.
Next Steps
CTP claims involving facial scarring require a balance between medical evidence and practical considerations. If your circumstances are unique, time limits are unclear, or disputes arise, seek guidance from a legal professional. Complete the quick, no obligation enquiry form to request contact about your situation.