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 resulting from a motor accident in New South Wales may be compensable under the Compulsory Third Party (CTP) insurance scheme. To support a claim, you must demonstrate that the scarring arose from the accident and that it has caused a measurable impact on your life. The assessment of facial scarring is not based solely on appearance but on medical evidence of the injury’s nature, permanence, and effect on function or well-being. This article explains how the CTP system in NSW evaluates facial scarring, what evidence is typically required, and how to prepare for medical assessments, particularly in the Greater Sydney area.
How CTP Evaluates Facial Scarring Injuries in NSW
Under the Motor Accident Injuries Act 2017 (MAIA), compensation for facial scarring is assessed based on the extent of the injury and its effect on your life, not just its visual appearance. The assessment is conducted by an independent medical assessor, often under the guidance of the Motor Accident Injuries (MAI) Guidelines issued by the State Insurance Regulatory Authority (SIRA). These guidelines define scarring as a permanent or long-term physical change to the skin that may affect function, appearance, or psychological well-being.
Facial scarring may be considered a threshold injury if it results in a permanent impairment, but it may also form part of a claim for damages if it causes significant impact on daily life, emotional distress, or loss of enjoyment. The presence of scarring alone does not automatically qualify for damages. The injury must meet the threshold for damages under MAIA section 4.4, which requires that the injury be more than minor and that it causes a significant and permanent impact on your life.
Evidence That Supports a Facial Scarring Claim
To establish a claim for facial scarring, you must provide objective and contemporaneous evidence. The most critical evidence includes:
- Detailed medical records from the initial treatment and follow-up appointments, including notes on wound depth, location, and treatment (e.g., sutures, skin grafts, laser therapy).
- Photographs taken as close as possible to the time of the accident and at regular intervals during recovery, showing the scar’s development and current appearance.
- A formal assessment of whole person impairment (WPI) by an accredited medical practitioner, which quantifies the impact of the scarring on your body’s function and quality of life.
- Evidence of psychological impact, such as a report from a psychologist or psychiatrist, if the scarring has caused anxiety, depression, or social withdrawal.
- Statements from witnesses or family members describing changes in your confidence, social behaviour, or daily functioning.
Preparing for Your Medical Assessment
Medical assessments for facial scarring are conducted by independent medical practitioners appointed under the CTP scheme. These assessments are not routine check-ups but formal evaluations that determine the nature and long-term effect of your injury. To prepare effectively:
- Bring all relevant medical records, including prior health conditions that may affect scarring outcomes.
- Carry a set of clear, well-lit photographs of the scar, taken in natural light and from multiple angles.
- Be ready to discuss how the scarring affects your daily life, e.g., difficulty wearing glasses, challenges with makeup, avoidance of social situations, or emotional distress.
- If you have undergone or are undergoing treatment such as laser therapy, dermabrasion, or reconstructive surgery, bring documentation of the treatment plan and progress.
- Do not alter your appearance for the assessment (e.g., avoid heavy makeup or concealers) as this may affect the assessor’s ability to assess the scar accurately.
A common mistake is assuming that a scar is not compensable because it is not visible to others. However, the law recognises that scarring can have a significant impact even if it is not immediately visible, particularly if it causes pain, limits movement, or affects mental health.
Time Limits and Dispute Options
There is a 3-year time limit from the date of the motor accident to begin a claim for compensation under the CTP scheme. This time limit applies regardless of when symptoms or scarring become apparent. If you have not yet made a claim, it is important to act promptly.
If you disagree with the outcome of a medical assessment, you may request a review by a different medical assessor or apply to the NSW Civil and Administrative Tribunal (NCAT) for a review of the assessment. Disputes are common in claims involving scarring, particularly when the impact on quality of life is not easily measurable. You must provide new or additional evidence to support your case during a review.
When to Seek Independent Advice
While general information can help you understand the process, the outcome of your claim depends on your individual medical history, the nature of the scarring, and how it affects your life. A claim involving facial scarring may require specialist assessment and legal guidance to ensure all relevant factors are considered. It is advisable to seek independent advice before finalising a medical assessment or accepting a settlement offer.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.