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).
Psychological treatment records are critical evidence for claiming compensation under NSW's Compulsory Third Party (CTP) scheme following a motor accident. This guide explains what records are required by SIRA, how to preserve them, and the legal standards for admitting such evidence in Balmain, NSW.
What SIRA Requires for Psychological Treatment Evidence
Under the Motor Accident Injuries Act 2017, SIRA requires evidence showing a psychological injury directly caused by a motor accident. For treatment records to be accepted, they must:
- Be created by a registered medical practitioner or psychologist
- Document the nature of the injury, treatment plan, and progress
- Link the injury to the accident through a medical opinion
- Follow the clinical guidelines in the Motor Accident Guidelines
SIRA’s website confirms that psychological injuries must meet the 'threshold injury' criteria, meaning they must be more than temporary and require ongoing treatment. Records must demonstrate this, including details like diagnosis codes, treatment duration, and functional limitations.
How to Maintain Psychological Treatment Records
In Balmain, individuals should:
- Keep all clinical notes from appointments with mental health professionals, including initial assessments and follow-up records
- Preserve therapy session summaries that outline treatment goals, methods, and progress
- Retain documentation of prescribed medications and any changes to treatment plans
- Maintain a record of all communication with SIRA or insurers, including dates and details of correspondence
It is essential to ensure records are dated, signed, and stored securely. If treatment spans multiple providers, ensure continuity of care is documented.
Legal Standards for Admitting Psychological Evidence
SIRA applies specific standards to psychological evidence:
- Clinical relevance: Records must show a direct connection between the accident and the psychological injury
- Expert opinion: A medical practitioner must confirm the injury meets the threshold injury definition under the Motor Accident Injuries Act 2017
- Consistency: Treatment records should align with the claimant’s reported symptoms and functional decline
For example, a psychologist’s report stating 'the claimant’s anxiety is a direct result of the motor accident and requires ongoing cognitive-behavioural therapy' would satisfy these criteria. Inconsistent or vague records may lead to disputes.
Time Limits and When to Seek Advice
CTP claims must be submitted within 52 weeks of the accident for treatment and care benefits, though this does not apply to all claims. Psychological injuries may require longer-term management, so claimants should:
- Submit a claim to SIRA within the 52-week period for initial benefits
- Seek legal advice if treatment extends beyond this timeframe or if disputes arise
Disputes over psychological evidence are common. If SIRA questions the validity of treatment records, claimants may need to provide additional documentation, such as a second opinion from a registered psychologist.
Example Scenario
A cyclist in Balmain suffered a traumatic brain injury in a motor vehicle accident. Their treating psychologist documented symptoms of post-traumatic stress disorder (PTSD), including flashbacks, sleep disturbances, and difficulty concentrating. The records linked these symptoms to the accident and outlined a 12-month treatment plan. This evidence was accepted by SIRA as meeting the threshold injury criteria.
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.