Accessing psychological treatment under NSW CTP law
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 have suffered a psychological injury in a motor accident in Greater Sydney, you may be entitled to a psychological treatment plan under the NSW Compulsory Third Party (CTP) insurance scheme. This entitlement is governed by the Motor Accident Injuries Act 2017 (MAIA), which is the current legal framework for all CTP claims in New South Wales. A psychological injury may qualify as a threshold injury under the Act if it is not a recognised psychiatric illness and is caused by the accident. This includes conditions such as post-traumatic stress disorder (PTSD), anxiety, or depression, provided they are directly linked to the accident and supported by medical evidence.
What psychological treatment is available
Under the MAIA, you can claim treatment and care benefits for psychological injuries if they are deemed reasonable and necessary. These benefits cover therapy sessions, prescribed medication, and other forms of treatment provided by a registered health practitioner. A formal psychological treatment plan must be developed by a qualified mental health professional, such as a psychologist or psychiatrist, and must clearly outline the type, frequency, and duration of care. The insurer or the Motor Accident Injury Scheme (SIRA) may require a copy of the treatment plan to approve funding.
Evidence required to support a claim
To establish eligibility for a psychological treatment plan, you must provide evidence that your injury arose from the motor accident. This includes:
- A formal diagnosis from a registered psychologist or psychiatrist confirming a clinically recognised psychological condition.
- Medical records showing the onset of symptoms following the accident, including notes from initial assessments and ongoing treatment.
- A written psychological treatment plan that details the recommended interventions, expected duration, and treatment goals.
- A statement from your treating practitioner describing how the injury has affected your daily life, work, or social functioning.
Photographs of the accident scene, a police report, or witness statements may also help establish the circumstances of the accident, particularly if there is a dispute about the event or its psychological impact.
How claims are assessed by SIRA
SIRA administers the CTP scheme in NSW and is responsible for assessing claims for psychological injuries. When you submit a claim for a psychological treatment plan, SIRA will review whether the injury qualifies under the statutory definition and whether the treatment plan is appropriate and proportionate. If there is uncertainty about the diagnosis or the necessity of the treatment, SIRA may request additional information or arrange an independent assessment. You have the right to respond to any request and to provide further evidence, including from your treating practitioner.
Time limits and procedural steps
There is no fixed deadline for reporting a psychological injury, but it is essential to notify your insurer as soon as possible after the accident. Delaying notification may affect the insurer’s ability to investigate the claim or result in delays in receiving benefits. You should keep all records of treatment, correspondence with the insurer, and medical reports.
If your claim for a psychological treatment plan is denied or you believe the insurer is not acting in good faith, you may request a review from SIRA. You can also seek external review through the NSW Civil and Administrative Tribunal (NCAT) if the dispute remains unresolved.
When independent advice may be useful
Psychological injuries can be complex, and the CTP scheme has specific rules about eligibility and benefit limits. It is advisable to seek independent legal or claims advice early, particularly if:
- You have a history of mental health issues that may be relevant to the claim.
- The insurer disputes the connection between your injury and the accident.
- You are seeking damages in addition to treatment and care benefits, which requires meeting the threshold injury test under the MAIA.
A qualified professional can help you understand your rights, prepare your evidence, and ensure that your treatment plan is properly documented and submitted.
Practical example
A cyclist in Sydney was struck by a car at a roundabout in February 2025. Following the accident, they experienced severe anxiety, sleep disturbances, and avoidance of traffic. They consulted a clinical psychologist who diagnosed them with PTSD and developed a 12-week treatment plan involving cognitive behavioural therapy and mindfulness techniques. The psychologist provided a formal treatment plan and medical certificate linking the condition to the accident. The cyclist submitted the documentation to their insurer and received approval for treatment and care benefits under the CTP scheme.
Next steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.