What changed for psychological treatment plans after the 2017 CTP reforms in NSW?
The 2017 reforms to the NSW Compulsory Third Party (CTP) insurance scheme, implemented under the Motor Accident Injuries Act 2017, introduced significant changes to how psychological treatment plans are assessed and approved in motor accident claims. Prior to 2017, mental health treatment was often approved on a case-by-case basis with less structured requirements. Since the reforms, treatment plans for psychological injuries must now be developed by a qualified mental health professional and must clearly demonstrate that the treatment is necessary, appropriate, and directly related to injuries arising from the motor accident.
SIRA, the NSW regulator for motor accident claims, now requires that psychological treatment plans include specific elements: a diagnosis of the psychological injury, a description of the treatment to be provided, the expected duration, and evidence that the treatment is likely to improve the claimant’s condition. These requirements apply uniformly across Greater Sydney and the rest of NSW, and are not subject to local variation.
How SIRA assesses psychological treatment plans under current law
SIRA uses the Motor Accident Injuries Regulation 2017 and the Motor Accident Injuries Guidelines to assess psychological treatment plans. The assessment focuses on whether the treatment is clinically justified, evidence-based, and proportionate to the injury. Treatment must be delivered by a registered mental health professional, such as a clinical psychologist or psychiatrist, and must follow nationally recognised clinical practice standards.
A key change from before 2017 is that treatment plans must now be reviewed periodically to assess progress and ensure ongoing necessity. SIRA may request updates or modifications if treatment is not showing measurable benefit, or if the treatment plan exceeds what is considered reasonable for the injury. The claimant must also be actively engaged in treatment for it to be approved. Passive or non-compliant treatment is not supported under current CTP rules.
Practical steps to prepare an effective psychological treatment plan
To ensure a psychological treatment plan is accepted under CTP, claimants should take the following steps:
- Obtain a formal diagnosis of a psychological injury from a registered mental health practitioner, such as a psychologist or psychiatrist.
- Request a treatment plan that includes a clear description of the therapy (e.g., cognitive behavioural therapy, trauma-focused therapy), the frequency and duration of sessions, and the expected outcomes.
- Ensure the treatment plan is directly linked to the motor accident, including a statement from the practitioner that the injury is attributable to the accident.
- Submit the treatment plan to the CTP insurer as part of the claim for treatment and care benefits.
- Keep detailed records of all treatment sessions, including notes from the practitioner, session logs, and correspondence with the insurer.
Photographs of the accident scene, witness statements, and medical records from the time of the accident may also support the link between the accident and the psychological injury.
Time limits and dispute options
There is no fixed deadline for submitting a psychological treatment plan, but it is best to submit it as soon as possible after the accident to avoid delays in treatment. The CTP insurer must respond within 14 days of receiving a treatment plan. If the insurer refuses to approve the plan, the claimant may request a review under SIRA’s dispute resolution process.
If the insurer continues to refuse, the claimant may apply to the Civil and Administrative Tribunal (NCAT) for a determination. The tribunal will assess whether the treatment plan meets the criteria under the Motor Accident Injuries Act 2017 and the Guidelines.
Example: A claimant in Greater Sydney
A 38-year-old woman was involved in a rear-end collision in Sydney’s inner west in June 2024. She developed symptoms of anxiety and post-traumatic stress disorder (PTSD) in the weeks following the accident. Her treating psychologist diagnosed her with PTSD and prepared a treatment plan involving 12 weekly sessions of trauma-focused cognitive behavioural therapy. The plan included a progress review at week 6 and was submitted to the CTP insurer within 30 days of the accident. The insurer initially refused approval, citing a lack of documented symptoms in the first 14 days. The claimant requested a review, provided medical notes from her GP and a diary of her symptoms, and the insurer later approved the treatment plan.
When to seek independent advice
While SIRA provides guidance on treatment plans, the legal and procedural requirements for CTP claims can be complex. If a treatment plan is refused, or if the insurer disputes the link between the accident and the psychological injury, it may be necessary to seek independent legal advice. A solicitor experienced in CTP claims can assist in preparing a submission to SIRA or NCAT, and ensure that all evidence is properly presented.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.