Psychiatric Injury Threshold in NSW CTP Claims
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've suffered a psychiatric injury in a motor accident in NSW, you may be wondering whether your claim meets the legal threshold for compensation under the Compulsory Third Party (CTP) scheme. The Motor Accident Injuries Act 2017 (MAIA) and SIRA guidelines define what qualifies as a 'threshold injury' for CTP claims. Psychiatric injuries, such as anxiety, depression or post-traumatic stress disorder (PTSD), must meet specific criteria to be eligible for benefits.
How SIRA Assesses Psychiatric Injuries
SIRA evaluates psychiatric injuries using the Motor Accident Guidelines, which require a clinical diagnosis and evidence of a 'threshold injury'. This means your injury must be:
- A result of the motor accident
- A genuine psychiatric condition
- Severe enough to meet the threshold injury definition
SIRA considers factors like the nature of the injury, its impact on daily life, and medical evidence. For example, a diagnosis of PTSD from a registered psychologist may qualify, while a generalised anxiety disorder without clinical signs may not.
Practical Steps for Injured People
To support your claim, gather:
- Medical records showing a diagnosis and treatment
- Accident reports and witness statements
- Evidence of how the injury affects your daily life
- Any correspondence with insurers or SIRA
It's important to seek medical attention promptly and document your symptoms. Delayed treatment may affect your claim's eligibility.
Regional Considerations for Illawarra and South Coast
While SIRA applies the same threshold criteria across NSW, regional differences may arise in:
- Access to specialist mental health services
- Local SIRA office processing times
- Availability of trauma specialists in rural areas
Injured people in Illawarra and South Coast should contact their local SIRA office for region-specific advice. The NSW Government's Illawarra and South Coast offices have dedicated teams to assist with CTP claims.
Time Limits and Dispute Options
You have 52 weeks from the accident date to claim benefits for threshold injuries. After this period, you may need to pursue a common law damages claim instead. If your claim is disputed, you can:
- Request a review from SIRA
- Seek mediation through the NSW Civil and Administrative Tribunal (NCAT)
- Consult a legal professional for dispute resolution
When to Seek Legal Advice
If your psychiatric injury involves complex symptoms, long-term effects, or disputes with insurers, it's wise to consult a solicitor. A lawyer can help you:
- Navigate SIRA's assessment process
- Challenge denied claims
- Pursue additional compensation for non-threshold injuries
Next Steps
CTP entitlements depend on the accident date, injury type, and claim history. To request contact about your circumstances, complete the quick, no obligation enquiry form.