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).
When proving a psychiatric injury claim under NSW's Compulsory Third Party (CTP) scheme, claimants in Auburn must avoid common errors that could jeopardise their case. The key lies in understanding the SIRA psychiatric injury threshold and meeting evidentiary standards. This article explains the most frequent mistakes and how to avoid them.
Understanding the Psychiatric Injury Threshold
Under the Motor Accident Injuries Act 2017, psychiatric injuries must meet specific criteria to qualify for CTP benefits. SIRA’s guidelines state that a claimant must demonstrate a threshold injury, meaning the injury must be severe enough to qualify as a 'major' injury under the Motor Accident Guidelines. This typically requires a diagnosis of a condition like PTSD, adjustment disorder, or a psychotic episode, supported by clinical evidence.
A common mistake is assuming that any psychological reaction to an accident qualifies. For example, a claimant who experiences temporary anxiety after a minor collision may not meet the threshold. SIRA requires that the injury must be sufficiently serious to impact daily functioning, such as sleep disturbances, work capacity, or social withdrawal.
Common Errors in Proving Psychiatric Injuries
- Lack of Professional Diagnosis: Claimants often fail to seek a formal psychiatric assessment. Without a documented diagnosis from a registered medical practitioner, claims may be dismissed. For instance, a claimant who self-diagnoses anxiety without a GP visit may not meet the evidentiary standard.
- Inadequate Documentation: Medical records must clearly link the injury to the accident. A claimant who does not record symptoms, treatment dates, or therapy sessions risks losing credibility. For example, a claimant who stops attending therapy after a few sessions without explaining the reason may appear inconsistent.
- Ignoring the 52-Week Statutory Limit: If a claimant’s only injuries are threshold injuries, benefits like weekly payments and treatment benefits generally stop after 52 weeks. A claimant who assumes they will receive long-term support without understanding this limit may face a sudden cutoff.
- Failing to Prove 'Whole Person Impairment': SIRA requires that the injury must result in a whole person impairment (WPI) of 10% or more. A claimant who does not undergo a WPI assessment may not qualify for ongoing payments.
Steps to Avoid Errors
To strengthen a claim, claimants should:
- Seek immediate medical attention and document all treatment.
- Obtain a detailed psychiatric report from a qualified practitioner.
- Keep records of how the injury affects daily life, such as work absences or relationship strain.
- Understand the 52-week statutory limit for weekly benefits.
When to Seek Legal Advice
If a claimant is unsure whether their injury meets the threshold, or if their claim is being disputed, consulting a solicitor specialising in CTP claims can help. Legal professionals can review medical evidence, assess the claim’s viability, and ensure all procedural requirements are met.
Time Limits and Disputes
CTP claims must be submitted within a reasonable time, though there is no strict statutory deadline. However, delays in reporting injuries or seeking treatment may weaken a claim. If a claimant disagrees with a decision, they may request a review through SIRA or seek mediation.
Final Advice
Proving a psychiatric injury under NSW CTP laws requires careful attention to both the legal threshold and the evidentiary standard. Claimants in Auburn should avoid common pitfalls by seeking timely medical care, maintaining thorough records, and understanding the statutory limits. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.