Home Modifications and Daily Living Support in NSW CTP Claims
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 a serious motor accident injury in New South Wales and need home modifications to return to daily activities, the NSW Compulsory Third Party (CTP) scheme may cover these costs. Home modifications, such as wheelchair ramps, grab rails, or adapted bathrooms, are considered part of rehabilitation under the Motor Accident Injuries Act 2017. This article explains what home modifications are covered, how the CTP process funds them, and the evidence needed to claim support.
What Home Modifications Are Covered Under NSW CTP Claims?
The NSW CTP scheme funds home modifications that help injured people perform everyday tasks after a serious motor accident. These include:
- Mobility aids: Ramps, handrails, or stair lifts to improve access.
- Adaptive equipment: Specialist tools for cooking, bathing, or dressing.
- Environmental adjustments: Lighting changes, floor reinforcements, or bathroom modifications.
SIRA (State Insurance Regulatory Authority) guidelines state that modifications must be directly related to the injury and necessary for daily living. For example, a wheelchair ramp may be funded if the injury prevents safe independent mobility.
How Does the CTP Process Fund Home Modifications?
Funding for home modifications comes from the CTP insurer of the at-fault driver. The process involves:
- Medical assessment: A doctor or physiotherapist confirms the need for modifications after the injury.
- Claim submission: You submit a detailed plan to SIRA, including quotes from approved contractors.
- Approval and payment: SIRA evaluates the request against the Motor Accident Guidelines and approves eligible modifications.
Note: Funding is limited to what’s necessary for daily living, not lifestyle upgrades. For instance, a new kitchen appliance may not be funded unless it’s essential for mobility.
Evidence Required for Home Modifications Claims
To claim home modifications, you’ll need:
- Medical reports: From a specialist confirming the injury’s impact on daily activities.
- Accident details: Police reports, witness statements, or photos of the incident.
- Modification plans: Quotes, blueprints, or contractor estimates showing the work’s necessity.
- Before-and-after records: Evidence of how the modification improves daily living.
Keep all documentation organized. SIRA may request additional evidence if the claim is disputed.
Time Limits and When to Seek Advice
CTP claims must be made within 52 weeks of the accident if the injury is classified as a 'threshold injury' (per the Motor Accident Injuries Act 2017 s 4.4). For serious injuries requiring long-term support, time limits may be extended, but you should act promptly. If your claim involves disputes over modification costs or eligibility, seek legal advice before deadlines expire.
Example: A Real-Life Scenario
Consider a cyclist injured in a collision, leaving them unable to climb stairs. A medical report confirms limited mobility, and a physiotherapist recommends a stair lift. The claimant submits a quote for the lift and a plan showing how it enables independent travel. SIRA approves the modification as it directly supports daily living.
Next Steps
CTP home modifications are a vital part of recovery for serious injuries, but the process requires careful documentation and timely action. If you’re unsure about your eligibility or need help preparing a claim, complete the quick, no obligation enquiry form to request contact about your circumstances.