If you're seeking physiotherapy treatment approval for a NSW CTP claim, understanding what evidence to keep is crucial. Under the Motor Accident Injuries Act 2017, insurers must approve treatment that is medically necessary and directly related to your injury. This article explains the specific records you should retain to support your claim, based on SIRA guidelines.
What Evidence is Needed for Physiotherapy Approval?
To secure approval, you must demonstrate that your physiotherapy treatment is both clinically necessary and directly linked to your motor accident injury. Key evidence includes:
- A detailed medical report from your treating physiotherapist explaining the nature of your injury and the treatment plan.
- A treatment plan outlining specific exercises, frequency, and expected outcomes.
- Documentation showing the treatment was recommended by a medical practitioner.
- Records of communication with the insurer, such as emails or letters confirming your treatment is approved.
SIRA guidelines stress that treatment must be 'reasonably necessary' and 'directly related' to the injury. For example, if your injury is a soft tissue injury (like a whiplash), the physiotherapy should target symptoms like neck pain or restricted movement.
Records to Keep for Your Claim
Maintain thorough records of all treatment-related documents. This includes:
- Copies of all medical reports and imaging results.
- Treatment records showing dates, duration, and type of therapy.
- Notes from consultations with your physiotherapist.
- Correspondence with the insurer, including any rejections or approvals.
- Evidence of your injury's impact, such as a diary of symptoms or a doctor's opinion on recovery time.
In Bankstown, claimants should ensure their records clearly connect the treatment to the accident. For instance, if you were injured in a car park, the physiotherapy should address injuries like sprains or whiplash caused by the collision.
Time Limits and Dispute Resolution
Under the Motor Accident Injuries Act 2017, weekly benefits for threshold injuries (like soft tissue injuries) are generally limited to 52 weeks. If your treatment exceeds this period, you must demonstrate that your injury meets the 'whole person impairment' threshold. If your claim is disputed, SIRA provides a review process to challenge decisions.
When to Seek Advice
If your insurer refuses to approve your treatment, it's essential to review your records and ensure they meet SIRA's requirements. A legal professional can help you challenge a decision or negotiate a better outcome.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.