Hearing Loss Claims in NSW CTP: Common Mistakes to Avoid
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 hearing loss due to acoustic trauma in a motor accident in Balmain, you may be eligible for compensation through NSW's Compulsory Third Party (CTP) scheme. However, many claimants make errors that could harm their case. This article explains how SIRA assesses hearing loss claims, outlines critical documentation, and highlights common mistakes to avoid.
Understanding SIRA's Approach to Hearing Loss Claims
SIRA (State Insurance Regulatory Authority) administers NSW's CTP scheme. For hearing loss caused by acoustic trauma, such as damage from crash forces, airbags, or loud noises, SIRA evaluates claims based on medical evidence and the Motor Accident Guidelines. Key factors include:
- Medical documentation: A qualified audiologist or ENT specialist must confirm the injury. SIRA requires detailed reports showing the injury's cause, severity, and link to the accident.
- Threshold injury definition: Under the Motor Accident Injuries Act 2017, injuries must meet specific criteria. For example, a spinal nerve-root injury producing neurological signs (even without radiculopathy) may qualify as a soft-tissue injury.
- Impairment assessment: SIRA uses the Whole Person Impairment (WPI) scale to determine long-term effects. Hearing loss must be shown to significantly impact daily life, such as difficulty working or communicating.
Practical Steps and Evidence to Support Your Claim
To strengthen your claim, take these steps:
- Seek immediate medical attention: Delaying treatment can weaken your case. Document all medical visits, including audiograms and specialist reports.
- Preserve accident details: Gather evidence like police reports, witness statements, and photographs of the scene. If airbags deployed, note their condition and any visible damage.
- Track income and expenses: If your hearing loss affects your ability to work, provide payslips, tax returns, and medical certificates. SIRA considers lost wages and potential future earnings.
- Avoid self-diagnosis: Do not assume your injury is due to the accident. A medical professional must confirm the link between the trauma and your hearing loss.
Common Mistakes to Avoid
Claimants often make these errors:
- Failing to document the injury: Without medical records, SIRA may dismiss your claim. For example, a person who ignored early symptoms and only sought help after months may struggle to prove the injury's connection to the accident.
- Missing deadlines: The 52-week statutory benefit period applies only to injuries meeting the threshold. If your claim involves long-term impairment, you must demonstrate how the injury exceeds the threshold.
- Not addressing disputes: If SIRA disputes your claim, you may need to request a review. Under the Motor Accident Injuries Act 2017 s 4.4, you can challenge decisions by providing additional evidence or seeking independent medical opinions.
Time Limits and When to Seek Advice
CTP claims must be submitted within 52 weeks of the accident, unless an extension applies. However, this period applies only to injuries meeting the threshold. For complex cases involving long-term impairment, you may have more time, but delays can still harm your case. If SIRA rejects your claim, you can request a review within 28 days. For disputes over the assessment of your injury, seek legal advice promptly.
Next Steps
CTP claims depend on the accident date, injury type, and evidence. To request contact about your circumstances, complete the quick, no obligation enquiry form. Every claim depends on its own facts.