How SIRA Assesses Hearing Loss Claims in NSW Motor Accidents
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 a motor accident in NSW, understanding how SIRA evaluates your claim is critical. SIRA (State Insurance Regulatory Authority) administers the Compulsory Third Party (CTP) scheme, which covers injuries like acoustic trauma caused by crashes, airbags, or road forces. This article explains how SIRA assesses hearing loss claims, the evidence required, and your options if your claim is disputed.
The Legal Framework Behind Hearing Loss Claims
Under the Motor Accident Injuries Act 2017, CTP claims cover injuries resulting from motor vehicle accidents, including hearing-related conditions. SIRA’s Motor Accident Guidelines define what constitutes a ‘threshold injury’ for benefits, which includes hearing loss caused by acoustic trauma. Acoustic trauma refers to damage to the ear from loud noises, such as those experienced during a crash or from an airbag deployment.
SIRA distinguishes between two types of hearing loss: sensorineural (damage to the inner ear or auditory nerve) and conductive (blockage in the ear canal or middle ear). Both may qualify if they meet the threshold injury criteria. However, claims must demonstrate a direct link between the accident and the injury.
Evidence Required for a Hearing Loss Claim
To support your claim, you’ll need:
- Medical documentation: Audiograms, ENT specialist reports, and hearing test results showing the extent of the injury.
- Accident details: Police reports, witness statements, and vehicle records to establish the incident’s circumstances.
- Medical opinion: A specialist must confirm the injury is caused by the accident and not pre-existing conditions.
- Impact on daily life: Evidence of how the hearing loss affects your ability to work, communicate, or engage in daily activities.
For example, a passenger who suffered hearing loss after an airbag deployed may need to provide audiograms showing a significant drop in hearing threshold and medical records linking the injury to the accident.
Time Limits and Dispute Resolution
CTP claims have strict time limits. Most benefits, including weekly payments and treatment benefits, are available for 52 weeks after the accident. If your injury is classified as a ‘threshold injury, ’ benefits may stop after this period unless you meet the criteria for a ‘whole person impairment’ (WPI) rating.
If your claim is disputed, SIRA provides a review process. You can request a review of your claim’s assessment, and if necessary, escalate to the NSW Civil and Administrative Tribunal (NCAT). It’s essential to act quickly, as delays can jeopardize your ability to receive benefits.
When to Seek Legal Advice
While SIRA handles most claims, complex cases, such as disputes over the severity of your injury or the impact on your livelihood, may require legal assistance. A solicitor can help you navigate the process, challenge an adverse assessment, or negotiate a fair settlement.
Next Steps for Claimants in Balmain
If you’re in Balmain or another NSW area and have suffered hearing loss from a motor accident, start by gathering all relevant medical and accident records. Contact SIRA directly to submit your claim, and consider seeking legal advice if your claim is rejected or if you need assistance with dispute resolution.
How to Get Help
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.