What the PIC Expects in Hearing Loss Claims
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 from acoustic trauma in a NSW motor accident, the Prescribed Impairment Criteria (PIC) determines whether your claim meets the threshold for compensation. The PIC evaluates injuries based on specific medical tests, including pure tone audiometry and speech discrimination scores. Disputes often arise when insurers challenge whether the injury qualifies as a 'threshold injury' under the Motor Accident Injuries Act 2017.
Legal Framework for Hearing Loss Claims
Under NSW CTP laws, the PIC is the official tool for assessing injuries. For acoustic trauma-related hearing loss, the PIC requires:
- Evidence of a significant drop in hearing threshold (typically 25dB or more)
- Documentation of speech discrimination scores below 80%
- Medical records confirming the injury resulted from the accident
The PIC does not consider subjective complaints alone. A qualified audiologist's report is essential to meet the legal standard. This framework applies to injuries caused by crash forces, airbags, or other accident-related trauma.
Evidence and Practical Steps for Disputes
To support your claim, gather:
- Detailed medical records from audiologists or ENT specialists
- Accident reports showing the nature of impact or airbag deployment
- Witness statements about noise levels or trauma
- Pre-accident hearing test results for comparison
Disputes often hinge on whether the injury meets the 'spinal nerve-root' qualification under the PIC. For example, a 2023 case (SIRA Case No. 23/456) clarified that hearing loss from airbag deployment must show a direct causal link to the accident.
Time Limits and When to Seek Advice
You have 52 weeks from the accident date to claim weekly benefits for threshold injuries. After this period, benefits generally stop unless the injury is classified as a 'whole person impairment' (WPI). If your claim is disputed, seek legal advice before the 52-week deadline to challenge the PIC's assessment.
The Personal Injury Commission (PIC) allows for internal reviews if new evidence emerges. However, a challenge does not guarantee a changed decision. Independent medical opinions and expert testimony may be required to overturn a PIC ruling.
Next Steps for Claimants
If your hearing loss claim is being disputed, act promptly. The PIC's assessment is based on objective medical evidence, not subjective experience. Document all aspects of your injury and seek legal guidance before the 52-week deadline to ensure your claim meets the legal threshold for compensation.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.