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 involved in a motor accident claim that spans pre- and post-2017 CTP laws in Newcastle or Hunter, understanding how to resolve disputes is critical. Transitional claims under the Motor Accident Injuries Act (MAI) Act require specific dispute resolution steps, distinct from standard CTP claims. This article explains how to address disagreements with SIRA over benefits, timelines, or injury assessments, and highlights key differences in handling these claims.
Understanding Transitional Claims
Transitional claims arise when an accident occurred before 12 December 2017 (when the MAI Act replaced the old CTP scheme). These claims are governed by a hybrid of pre- and post-2017 rules, including the 52-week limit for threshold injuries. Under the MAI Act, claims must be resolved through specific dispute pathways, unlike standard CTP claims where fault is typically not an issue.
Dispute Resolution Pathways
Disputes over transitional claims must follow a structured process. First, claimants should request an internal review from SIRA within 28 days of receiving a decision. This allows SIRA to reassess the claim based on updated evidence or interpretations of the MAI Act. If unresolved, claimants can escalate to the Personal Injury Commission (PIC) for a medical dispute review. The PIC evaluates whether the injury meets the threshold injury criteria or if the 52-week limit applies. Note that challenges to SIRA decisions do not guarantee a change in outcome and must be supported by new evidence.
Key Differences from Standard CTP Claims
Unlike standard CTP claims, transitional claims involve complex legal boundaries. For example, disputes over 'threshold injuries' require strict adherence to the Motor Accident Guidelines, including the spinal nerve-root qualification. Additionally, transitional claims are subject to the 52-week statutory benefit cap, which applies only if the injury is classified as a threshold injury. These distinctions mean that resolving disputes often requires specialized legal input to navigate the hybrid legal framework.
Practical Steps for Claimants
To address disputes effectively, claimants should: 1) Gather all medical records, accident reports, and correspondence with SIRA; 2) Seek clarification on how the MAI Act applies to their specific injury type; 3) Consider engaging a solicitor familiar with transitional claims to challenge SIRA decisions. Time limits are strict, internal reviews must be requested within 28 days, and PIC reviews within 21 days of the initial decision.
When to Seek Legal Advice
Disputes over transitional claims often require expert legal guidance. A solicitor can help identify whether a claim falls within the transitional framework, challenge SIRA's interpretation of the MAI Act, or prepare for a PIC review. Legal assistance is particularly valuable when disputes involve complex medical evidence or contested injury classifications.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.