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 lumbar disc herniation in a motor accident in New South Wales, retaining the right evidence is critical to support your CTP claim. This guide explains what medical records, activity documentation and SIRA-compliant evidence you should keep to meet NSW CTP scheme requirements. Understanding what constitutes sufficient evidence for this specific injury type is essential to avoid claim delays or disputes.
What Medical Records Are Essential for Lumbar Disc Herniation Claims?
To prove a lumbar disc herniation injury under the NSW CTP scheme, you must provide evidence of both the injury and its impact. Key medical records include:
- MRI or CT scans showing disc herniation, with radiologist reports explaining findings
- Specialist reports from a musculoskeletal or spinal surgeon detailing diagnosis and treatment
- Physiotherapy records documenting rehabilitation progress and limitations
- Medical notes from general practitioners showing pre-accident fitness and post-accident changes
SIRA guidelines emphasize that evidence must clearly link the injury to the accident. For example, a specialist report should state that the herniation would not have occurred without the accident. Keep all records in their original format and consider making copies for safekeeping.
Documenting Daily Activity Limitations
CTP claims require evidence of how the injury affects your daily life. Document:
- Activity logs tracking tasks you can no longer perform (e.g., lifting, standing for prolonged periods)
- Workplace records showing reduced hours, modified duties or job loss due to the injury
- Household task records detailing chores you can no longer complete
- Transportation records showing difficulty driving or using public transport
A practical example: If you can no longer walk more than 500 meters without pain, keep a log of daily walks and note how this impacts your ability to run errands or exercise. This helps quantify the injury's effect on your quality of life.
SIRA Resources for Lumbar Disc Herniation Claims
SIRA provides specific guidance for this injury type. Key resources include:
- SIRA's 'What you can claim' page outlines benefits for spinal injuries, including weekly payments for treatment and income loss
- SIRA's 'Making a claim' guide explains how to submit medical evidence and activity records
- SIRA's 'Motor accident claims' page details the 52-week statutory benefit limit for threshold injuries
For lumbar disc herniations, SIRA considers injuries meeting the 'threshold injury' definition under the Motor Accident Injuries Act 2017. This includes injuries requiring treatment by a medical practitioner, such as spinal injections or surgery. Keep copies of all correspondence with SIRA and insurers.
Time Limits and Dispute Resolution
CTP claims must be submitted within 52 weeks of the accident for statutory benefits. If your injury is classified as a threshold injury, weekly payments and treatment benefits will generally stop after 52 weeks unless you have a permanent impairment. Always confirm with SIRA whether your injury meets the threshold criteria.
If you dispute a decision, you can request a review through SIRA's internal process. For complex cases involving permanent impairment assessments, independent medical opinions may be required. Always keep copies of all evidence and correspondence.
When to Seek Legal Advice
While this guide covers essential evidence, each claim is unique. A solicitor can help:
- Assess whether your injury meets SIRA's threshold criteria
- Challenge incorrect classifications of your injury
- Navigate disputes over benefit amounts
- Ensure all evidence is submitted correctly
If you're unsure about your claim's viability, seek advice before the 52-week deadline. Legal professionals can also help you understand how to challenge a decision if your injury is misclassified.
Next Steps
Retaining the right evidence is crucial for a successful CTP claim. If you're unsure whether your lumbar disc herniation injury meets SIRA's requirements or need help gathering evidence, contact a legal professional. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.