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 from a motor vehicle accident in Greater Sydney, understanding your rights under NSW's Compulsory Third Party (CTP) scheme is critical. This article explains how claimants can secure treatment and rehabilitation support for hearing loss injuries under the Motor Accident Injuries Act 2017 (MAIA), referencing SIRA guidelines and practical steps for claimants.
How the NSW CTP Scheme Handles Hearing Loss Claims
Under the MAIA, claimants with hearing loss caused by a motor accident may be entitled to treatment and rehabilitation benefits. SIRA's guidelines clarify that acoustic trauma injuries, including hearing loss, are covered under the 'treatment and care' category. This includes access to audiologists, hearing aids, and speech therapy to address the injury's impact on daily life.
The scheme distinguishes between 'threshold injuries' and more severe claims. Hearing loss meeting the threshold injury criteria under the Motor Accident Guidelines (MAG) qualifies for statutory benefits, including weekly income payments and treatment coverage. However, if the injury exceeds threshold levels, claimants may also pursue common law damages for additional compensation.
Practical Steps for Claimants
To ensure your treatment and rehabilitation needs are addressed, take these steps:
- Seek immediate medical attention to document the injury. A specialist report from an audiologist or ENT surgeon is essential to establish a connection between the accident and your hearing loss.
- Keep detailed records of all treatment, including audiograms, therapy notes, and communication with your GP. These records will support your claim for rehabilitation services.
- Notify your insurer under the CTP scheme. SIRA requires claimants to provide evidence of the injury's impact on their ability to work or perform daily activities.
- Request a rehabilitation plan from your treating physician. This should outline how your treatment addresses both the injury and its long-term effects, such as communication difficulties or social isolation.
Time Limits and When to Seek Advice
The MAIA imposes strict time limits for claims. For injuries meeting the threshold injury definition, weekly benefits and treatment coverage are generally limited to 52 weeks after the accident. If your hearing loss exceeds threshold levels, you may still have time to pursue additional compensation, but delays can affect your ability to claim.
Disputes over the severity of your injury or the availability of rehabilitation services are common. If your insurer refuses to cover your treatment or disputes the need for ongoing care, seek legal advice promptly. A solicitor can help you challenge decisions or negotiate a fair settlement.
Example Scenario
Consider a claimant who suffered hearing loss after an airbag deployment during a collision. Their audiologist confirmed the injury meets the threshold injury definition under the MAG. The claimant was entitled to weekly payments and access to a hearing aid. However, they also needed speech therapy to manage communication challenges. SIRA approved both the statutory benefits and the additional rehabilitation plan, demonstrating how claimants can secure comprehensive support.
Next Steps
CTP claims involving hearing loss require careful planning to ensure all treatment and rehabilitation needs are addressed. Time limits and insurer decisions can significantly impact your entitlements. To request contact about your circumstances, complete the quick, no obligation enquiry form.