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're dealing with a dispute over a legacy claim under the Motor Accident Compensation (MAC) Act in Ashfield, understanding your options is critical. The NSW government has specific processes for resolving conflicts over compensation decisions, which differ from standard Compulsory Third Party (CTP) claims. This guide explains how to challenge a decision, what evidence matters, and when to seek legal advice.
How SIRA Handles MAC Act Legacy Claims
The State Insurance Regulatory Authority (SIRA) administers claims under the old MAC Act. If your claim was made before 1 January 2018, you may still be eligible for benefits like weekly payments or treatment costs. However, disputes over these decisions require specific steps.
SIRA provides a formal review process for claimants who believe their compensation decision was incorrect. This includes:
- Submitting a written request for reconsideration within 28 days of the decision
- Providing new evidence or clarifying existing information
- Receiving a written response within 21 days
If your claim involves a medical dispute, you may also request a review by the Personal Injury Commission (PIC), which oversees medical assessments for CTP claims.
Key Differences Between Legacy and Standard CTP Claims
Legacy MAC Act claims differ from standard CTP claims in three key ways:
- Eligibility rules - The MAC Act used a 'threshold injury' test based on the 2001 Motor Accident Guidelines, while the current scheme uses the 2017 guidelines.
- Dispute pathways - Legacy claims require a separate review process through SIRA, whereas standard CTP claims typically go through the PIC.
- Time limits - You have 28 days to challenge a MAC Act decision, compared to 21 days for standard CTP claims.
Practical Steps for Resolving a MAC Act Dispute
If you're facing a dispute over your legacy claim, take these steps:
- Review your claim details - Ensure your claim was made under the MAC Act (before 1 January 2018) and check your claim number.
- Gather evidence - Collect medical records, accident reports, and any correspondence with SIRA. For medical disputes, obtain a second opinion from a registered medical practitioner.
- Request a review - Use SIRA's online form or contact them directly to ask for a reconsideration. Clearly explain why you believe the decision was incorrect.
- Seek independent advice - A solicitor can help you navigate the process and determine if you have a valid case for further review.
Example: Disputing a MAC Act Weekly Payment Decision
Consider this scenario: A claimant injured in 2015 receives a weekly payment decision based on the MAC Act's threshold injury rules. They believe their injury meets the current 2017 guidelines and request a review. SIRA may refer the case to the PIC for a medical assessment, which could result in a revised decision.
When to Seek Legal Advice
You should consult a solicitor if:
- You've exhausted SIRA's internal review process
- Your claim involves complex medical evidence
- You believe the decision was based on incorrect information
- You need help drafting a formal dispute request
Legal professionals can also help you understand whether your claim qualifies for a 'blameless accident' review or if there are other avenues for challenge.
Next Steps
Disputing a MAC Act legacy claim requires careful attention to time limits and evidence requirements. While SIRA provides a formal review process, complex cases often benefit from legal assistance. To discuss your options, complete the quick, no obligation enquiry form.