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 preparation for medical assessments. SIRA assesses these injuries based on clinical guidelines, and claimants must provide detailed documentation to support their case. This article explains how to prepare for assessments, what evidence matters, and how to challenge unfair outcomes under NSW law.
NSW CTP Rules for Facial Scarring Claims
Under the Motor Accident Injuries Act 2017, facial scarring injuries are evaluated using the Motor Accident Guidelines. SIRA considers factors such as the depth of scarring, visible impact on appearance, and functional limitations. A 'threshold injury' may apply if the scarring meets specific clinical criteria, such as visible deformity or psychological distress. Claimants must demonstrate that the injury resulted from a motor accident and is not due to pre-existing conditions.
Key Documentation for Facial Scarring Claims
Claimants should gather: medical records detailing the injury and treatment, photographs of the scarring taken at the time of the accident and during recovery, witness statements, and any correspondence with insurers. A specialist report from a registered medical practitioner is critical, as SIRA requires assessments to be conducted by approved clinicians. Keep all records organized to show the injury's progression and impact on daily life.
Preparing for CTP Medical Assessments in Balmain
Before an assessment, claimants should: review their medical history with their doctor, prepare a list of questions for the assessor, and ensure they have all required documents. SIRA may request a 'treatment and care' assessment to determine ongoing needs, such as skincare or reconstructive surgery. If the assessor's findings seem unfair, claimants can request a review or seek independent medical opinion under the CTP scheme.
Challenging Unfair Medical Assessments
If a claimant believes their facial scarring injury is misclassified or under-recognized, they can challenge the assessment. SIRA allows for disputes under the Motor Accident Injuries Act 2017, including appeals to the NSW Civil and Administrative Tribunal (NCAT). Claimants should seek legal advice if the assessment impacts their eligibility for weekly payments or long-term benefits.
Time Limits and Next Steps
Claimants must notify their insurer within 52 weeks of the accident if they seek treatment and care benefits. For disputes over injury classification, time limits depend on the specific claim type. If the injury is classified as a 'threshold injury' after 52 weeks, weekly benefits may be reduced. Always seek guidance from a solicitor if the assessment affects long-term compensation.
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