How the 10% Impairment Threshold Affects Daily Activities in NSW CTP Claims
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).
In New South Wales, the 10% whole person impairment threshold under the Motor Accident Injuries Act 2017 (MAIA) determines whether a motor accident injury qualifies for compensation related to daily living. This threshold means injuries must result in a permanent impairment of at least 10% to access certain benefits. If your injury affects your ability to perform everyday tasks like cooking, cleaning, or working, you may need to prove this meets the threshold.
NSW CTP Rules Behind the Impairment Threshold
The MAIA defines a 'permanent impairment' as a lasting loss of function or capacity due to an injury. SIRA (State Insurance Regulatory Authority) assesses claims using the Motor Accident Guidelines, which outline clinical signs and tests to determine impairment levels. For example, a spinal nerve-root injury with neurological signs may qualify as a threshold injury, even if it doesn't meet the radiculopathy criteria.
The threshold injury rules mean injuries below 10% are generally not eligible for compensation under the CTP scheme. However, if your injury causes daily activity limitations, you may still claim treatment benefits or weekly payments for up to 52 weeks, regardless of impairment level.
Evidence to Prove Daily Activity Limitations
To support your claim, you'll need medical evidence showing your injury impacts daily living. This includes:
- Detailed medical records from your GP or specialist
- A report from a registered medical practitioner assessing your ability to perform daily tasks
- Evidence of reduced work capacity or household duties
- Statements from family or carers about your limitations
SIRA requires these documents to demonstrate how your injury affects your ability to work, manage household responsibilities, or engage in personal care. For example, if your injury prevents you from lifting groceries, this must be clearly documented.
How SIRA Evaluates Daily Activity Claims
SIRA assesses whether your injury meets the 10% threshold by comparing your symptoms to the Motor Accident Guidelines. If your impairment is below 10%, you may still receive treatment benefits for up to 52 weeks. However, compensation for daily activity limitations typically requires a higher impairment rating.
In cases where your injury affects daily living but doesn't meet the threshold, you may need to pursue a common law claim for damages. This requires proving fault and how your injury impacts your quality of life.
Practical Steps for Injured Road Users
If your injury affects your ability to perform daily activities, take these steps:
- Seek immediate medical attention to document your condition
- Keep a diary of how your injury impacts your daily routine
- Request a formal assessment from your treating medical practitioner
- Notify your insurer about your claim within the required time limits
- Consider seeking legal advice if your injury meets the 10% threshold
Remember, time limits apply. You must notify your insurer within 52 weeks of the accident if you're claiming weekly payments. For compensation claims, you have 3 years from the date of the accident to pursue legal action.
When to Seek Legal Advice
Consult a legal professional if:
- Your injury meets or exceeds the 10% threshold
- You're unsure whether your daily activity limitations qualify
- You need help navigating the claims process
- You want to pursue a common law damages claim
A solicitor can help you understand your options and ensure you meet all requirements for compensation.
Next Steps for Your Claim
If your injury affects your ability to perform daily activities, act quickly to preserve your rights. Complete the quick, no obligation enquiry form to request contact about your circumstances. Every claim depends on its own facts, and the available options may depend on the evidence and applicable law.