What the PIC expects when assessing pain and suffering damages
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).
The Personal Injury Commission (PIC) in New South Wales evaluates pain and suffering claims under the Motor Accident Injuries Act 2017 (MAIA). When disputes arise, the PIC considers factors such as the nature of the injury, medical evidence, and the impact on the claimant’s daily life. For example, a claimant with a soft tissue injury requiring medical treatment may receive compensation for both physical and emotional distress, but the amount depends on the severity and long-term effects.
Key factors in assessing pain and suffering
SIRA’s guidelines state the PIC evaluates claims based on:
- Medical evidence: Detailed records showing the injury’s impact, including treatment history and recovery progress.
- Nature of the injury: Threshold injuries (such as soft tissue damage) are assessed differently from serious injuries with long-term impairment.
- Daily life impact: Evidence of how the injury affects work, family, or personal activities, such as reduced mobility or sleep disturbances.
- Subjective experience: Statements from the claimant about emotional distress, but these must be supported by medical opinion.
Evidence required for disputes
To support a pain and suffering claim, claimants should gather:
- Medical reports from registered practitioners documenting the injury’s progression.
- Expert opinions linking the injury to specific symptoms, such as chronic pain or anxiety.
- Witness statements or accident reports that establish the injury’s connection to the accident.
- Records of how the injury has affected income, relationships, or quality of life.
A hypothetical example: A cyclist with a fractured wrist and soft tissue damage may need to show how the injury caused ongoing pain, limited mobility, and emotional distress. The PIC would assess whether the compensation reflects both physical and emotional impacts.
Time limits and dispute resolution
Claims must be submitted within 52 weeks of the accident if only threshold injuries are involved. For serious injuries, the 52-week limit does not apply, but disputes over pain and suffering must be resolved through the PIC’s internal review process. Claimants can request a review if they believe the initial assessment was incorrect, though this does not guarantee a change in the decision.
When to seek legal advice
Disputes over pain and suffering damages often require expert legal guidance to ensure all evidence meets the PIC’s standards. A solicitor can help navigate the process, challenge incorrect assessments, and ensure claimants understand their rights under the MAIA.
Next steps
If you’re involved in a CTP claim dispute, it’s essential to act promptly and gather all relevant evidence. The PIC’s expectations are based on strict legal guidelines, and understanding these can help you prepare a strong case. Complete the quick, no obligation enquiry form to request contact about your circumstances.