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).
The 2017 reforms to NSW's Compulsory Third Party (CTP) scheme significantly changed how pain and suffering damages are calculated for serious injury claims. This article explains the key changes, how Central Coast claims apply the reforms, and what injured people should know about assessing non-economic loss under the Motor Accident Injuries Act 2017.
What Changed in 2017?
Before 2017, pain and suffering damages were calculated using a percentage-based formula tied to the injured person's capacity for work. The reforms introduced a more structured approach, replacing this with a detailed assessment of the injury's impact on daily life, using the Motor Accident Guidelines. Key changes include:
- Elimination of the 'capacity for work' test: Injuries are now assessed based on their effect on personal life, not employment. For example, a broken leg that limits mobility would be evaluated for its impact on activities like walking, sleeping, or socializing.
- Introduction of 'whole person impairment': This concept evaluates how the injury affects the person's overall quality of life, including physical, emotional, and psychological factors. A 2023 SIRA guide explains that claims must demonstrate a 'significant and lasting' impact on the person's life.
- Greater emphasis on medical evidence: Claims now require detailed medical records showing the injury's progression and its effect on the person's daily functioning. For instance, a claimant with chronic back pain must provide evidence of ongoing treatment and how the condition limits their ability to perform everyday tasks.
How Central Coast Claims Apply the Reforms
While the 2017 reforms apply statewide, Central Coast claimants should note that local SIRA offices may have specific practices. For example, claims involving road accidents on the Central Coast must include accident reports from local police stations, as these are critical for determining fault and injury severity. SIRA's 2024 guidelines also highlight that claims from the Central Coast are reviewed with particular attention to the region's higher traffic density and accident statistics.
A practical example: A cyclist injured in a collision on the Central Coast would need to provide evidence of both the physical injury (e.g., scans showing ligament damage) and the emotional impact (e.g., therapy records for anxiety). The claimant must also demonstrate how the injury affects their ability to work, socialize, or engage in hobbies.
Practical Steps for Claimants
To support a pain and suffering claim, injured people should:
- Document all medical treatment: Keep records of all consultations, scans, and therapy sessions. This helps establish the injury's severity and progression.
- Record daily limitations: Note how the injury affects routine activities, such as difficulty sleeping or reduced mobility. A diary can provide concrete evidence of the injury's impact.
- Obtain accident reports: Police reports from the Central Coast are essential for proving the incident's circumstances and fault.
- Seek early legal advice: Claims must be submitted within 52 weeks of the accident for certain benefits. Delaying can result in lost entitlements, especially for claims involving long-term injuries.
Time Limits and Dispute Resolution
Under the 2017 reforms, claims for 'threshold injuries' (minor injuries like whiplash) are limited to 52 weeks of weekly benefits. However, serious injuries requiring long-term care or significant lifestyle changes are not subject to this cap. Claimants must ensure their injuries meet the 'threshold injury' definition in the Motor Accident Guidelines to avoid premature benefit cuts.
If a claim is disputed, injured people can request a review by SIRA or seek mediation through the NSW Civil and Administrative Tribunal (NCAT). For example, a claimant disputing a low settlement for a spinal injury would need to provide additional evidence of the injury's long-term effects, such as a specialist's opinion on future mobility limitations.
When to Seek Legal Advice
The 2017 reforms introduced complex rules for assessing non-economic loss, making it essential to consult a legal professional. A solicitor can help:
- Navigate the Motor Accident Guidelines to ensure claims meet the 'whole person impairment' threshold.
- Challenge decisions to cut benefits for serious injuries.
- Negotiate fair settlements that reflect the injury's full impact on the person's life.
Final Steps for Claimants
If you've been injured in a motor accident on the Central Coast, start by gathering medical records and accident details. Then, contact SIRA to confirm your claim's eligibility under the 2017 reforms. If you're unsure whether your injury qualifies for long-term compensation, complete the quick, no obligation enquiry form to request contact about your circumstances.
Every claim depends on its own facts. General information cannot determine whether a claim is available in an individual case. Time limits and procedural requirements may apply. To request contact about the next step, complete the quick, no obligation enquiry form.