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).
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 you've suffered a facial scarring injury in a motor accident in NSW, you need to document your injuries thoroughly to support a CTP claim. Facial scarring is a visible injury that may affect your claim's outcome, and the New South Wales Motor Accident Injuries Act 2017 (MAIA) sets specific rules for assessing such injuries. This article explains what evidence is required, how SIRA evaluates facial scarring, and practical steps to prepare your claim in the Illawarra and South Coast regions.
What Documentation is Required for Facial Scarring Claims
To prove a facial scarring injury under NSW CTP rules, you must provide clear evidence of the injury and its impact. Key documentation includes:
- Medical records: A doctor's report confirming the scarring injury, its cause, and any treatment. This should include details of the accident, such as the date, location, and vehicle involved.
- Photographs: Before-and-after photos of the scarring, taken by a medical professional or documented in a clinical setting. These help demonstrate the injury's severity and progression.
- Witness statements: Accounts from witnesses who saw the accident or the scarring, especially if the injury was not immediately visible.
- Accident report: A police report or statement from the scene, which can establish the incident's circumstances.
- Medical imaging: X-rays, MRIs, or CT scans showing any underlying damage, even if the scarring appears superficial.
SIRA (State Insurance Regulatory Authority) uses these records to assess whether the scarring meets the threshold for a CTP claim. Facial scarring is considered a 'threshold injury' under the MAIA, meaning it qualifies for statutory benefits regardless of fault.
How SIRA Evaluates Facial Scarring Injuries
SIRA evaluates facial scarring injuries based on the Motor Accident Guidelines, which define 'threshold injuries' as those that require medical treatment. For scarring injuries, this typically includes:
- Visible scarring that affects appearance or function.
- Neurological signs if the scarring is caused by a spinal nerve-root injury, as outlined in the MAIA.
- Clinical documentation showing the scarring's impact on daily life, such as difficulty speaking, eating, or socializing.
In Illawarra and South Coast regions, claimants should ensure their medical records are reviewed by a specialist in facial trauma or plastic surgery, as these injuries may require expert assessment. SIRA may also request a second opinion if the injury's severity is disputed.
Key Evidence Requirements for Facial Scarring Claims
Under NSW CTP rules, you must establish that the scarring injury resulted from the motor accident. This involves:
- Proving causation: Medical evidence linking the scarring to the accident, not a pre-existing condition.
- Documenting treatment: Records of all treatments, including cosmetic procedures, to show ongoing care needs.
- Financial impact: Evidence of lost income or additional expenses due to the scarring, such as medical bills or travel costs.
- Psychological effects: If the scarring causes distress, a psychologist's report may be required to support a claim for non-physical harm.
For example, a claimant who suffered a facial laceration in a car accident on the South Coast would need to provide a doctor's note confirming the injury, photos of the scarring, and proof of any treatment. SIRA may also assess the scarring's impact on the claimant's quality of life.
Time Limits and When to Seek Advice
You have 52 weeks from the accident date to claim statutory benefits for threshold injuries under the MAIA. After this period, benefits are generally limited unless the injury is classified as a 'whole person impairment' (WPI) of 10% or more. If your scarring injury does not meet this threshold, you may need to pursue a common law damages claim separately.
Disputes over facial scarring claims are resolved through SIRA's dispute resolution process, which may involve an independent medical expert. It's crucial to seek legal advice if your claim is denied or if you're unsure about the evidence required.
Next Steps
If you're in the Illawarra or South Coast regions and need help documenting your facial scarring injury, contact a solicitor specialising in NSW CTP claims. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.