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).
The 2017 reforms to NSW Compulsory Third Party (CTP) motor accident claims introduced significant changes to how psychological treatment plans are assessed and documented. These changes, implemented by the State Insurance Regulatory Authority (SIRA), now apply to all claims in Albury and across NSW. This article explains what changed, how claimants should prepare documentation, and when to seek legal advice.
What Changed in Psychological Treatment Plans After 2017?
Under the Motor Accident Injuries Act 2017, psychological treatment plans must now meet stricter documentation standards. SIRA’s updated guidelines require treatment plans to include:
- A clear diagnosis of a mental health condition
- Specific therapeutic goals aligned with clinical evidence
- A structured, time-bound treatment schedule
- Evidence of how the treatment addresses the injury’s impact
Previously, less formal documentation was accepted. Now, treatment plans must demonstrate a direct link between the psychological injury and the proposed therapy, as outlined in SIRA’s What You Can Claim guide.
Practical Steps for Claimants in Albury
To meet the new requirements, claimants should:
- Obtain a psychological assessment from a registered mental health practitioner
- Ensure the treatment plan includes clinical notes, therapy records, and progress reports
- Submit documentation that shows the treatment is addressing the injury’s specific effects (e.g., anxiety, depression, or post-traumatic stress)
- Keep records of all correspondence with insurers and healthcare providers
For example, a claimant with post-accident anxiety must provide evidence that their therapy targets symptoms like insomnia or hypervigilance, not just general stress management.
Time Limits and When to Seek Advice
Claimants must submit psychological treatment plans within 52 weeks of the accident, as per the Motor Accident Injuries Act 2017 s 4.4. After this period, benefits for threshold injuries (including psychological ones) are generally limited. If a claimant’s treatment extends beyond 52 weeks, they may need to demonstrate that their injury meets the whole person impairment threshold.
Disputes over treatment adequacy are common. If an insurer rejects a claim, claimants should seek advice before submitting a formal dispute. SIRA’s Making a Motor Accident Claim page outlines how to appeal decisions.
Key Takeaways
The 2017 reforms raised the bar for psychological treatment documentation. Claimants in Albury must ensure their treatment plans are clinically detailed and directly tied to their injury. Time limits apply, and disputes require careful preparation. For tailored guidance, complete the quick, no obligation enquiry form to discuss your circumstances.