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).
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 a pillion passenger injured on a motorcycle in Balmain, preparing for medical assessments is a critical step in claiming compensation under NSW's Compulsory Third Party (CTP) scheme. This guide explains how to meet SIRA's requirements, what evidence matters, and how medical assessments influence your claim.
What to Expect During a Medical Assessment
Under the Motor Accident Injuries Act 2017, SIRA requires medical assessments to determine the nature and severity of injuries. For pillion passengers, this involves documenting both physical and neurological impacts. Medical professionals will evaluate whether your injuries meet the 'threshold injury' criteria, which includes spinal nerve-root injuries producing neurological signs. This assessment directly affects whether you qualify for statutory benefits or common law damages.
Practical Steps Before Your Assessment
Before your assessment, gather all relevant documentation: medical records from your initial treatment, accident reports, witness statements, and photographs of the scene. SIRA's guidelines stress the importance of accurate records showing the progression of your injuries. If you've been referred to a specialist, ensure you follow up on all appointments and keep copies of all correspondence.
Documentation That Matters
SIRA requires evidence of your injuries and their impact on daily life. This includes:
- Detailed medical records from your treating practitioner
- Statements from healthcare professionals about your recovery
- Records of lost income or time off work
- Any reports from independent medical experts
Your claim's success hinges on how clearly these documents demonstrate the link between your injuries and the accident.
How Assessments Affect Your Claim
Medical assessments determine whether your injuries fall under the 'only injuries' provision. If your injuries are classified as threshold injuries, you may be limited to statutory benefits after 52 weeks. More severe injuries, such as those requiring long-term care, may qualify for additional compensation. SIRA's guidelines specify that neurological signs other than radiculopathy must be documented to meet the soft-tissue injury threshold.
Time Limits and When to Seek Advice
You have 52 weeks from the accident date to claim statutory benefits for threshold injuries. For more serious injuries, time limits depend on the nature of your condition. If you're unsure about your claim's viability, seek legal advice before your medical assessments conclude. Independent legal counsel can help ensure your evidence meets SIRA's standards.
Example Scenario
Consider a pillion passenger who suffered a spinal nerve-root injury after a collision. Their treating doctor documented neurological signs, including reduced reflexes and muscle weakness. This evidence met the threshold injury criteria, allowing the passenger to claim statutory benefits. However, if the injury had been classified as a minor soft-tissue injury without neurological signs, the claim would have been limited to the 52-week statutory period.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.