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).
If you've developed post-traumatic stress disorder (PTSD) following a road trauma in Ashfield, understanding your options under NSW's Compulsory Third Party (CTP) scheme is critical. This article explains how SIRA handles PTSD claims, dispute resolution pathways, and evidence requirements specific to your situation.
How SIRA Approves PTSD Claims Under NSW CTP
SIRA evaluates PTSD claims based on the Motor Accident Guidelines, which define threshold injuries. For a psychiatric injury to qualify, it must result from the accident and meet clinical criteria. Medical evidence, such as a psychologist's report, is essential to demonstrate the link between the trauma and your condition. SIRA may also consider treatment records, therapy notes, and expert opinions to assess the injury's severity and impact.
Dispute Resolution Options for PTSD Claims
If your claim is disputed, you can request an internal review by SIRA. This involves a reassessment of your medical evidence and the injury's classification. If the review outcome is unsatisfactory, you may escalate the matter to the Personal Injury Commission (PIC), which oversees disputes over injury severity and compensation. The PIC can order independent medical assessments to resolve conflicts.
Practical Steps and Evidence for PTSD Claims
To support your claim, gather: medical records confirming PTSD diagnosis, details of the accident (including witness statements), and evidence of how the injury affects your daily life. SIRA requires documentation showing the injury resulted from the road trauma and meets the threshold for compensation. Keep records of all correspondence with insurers and medical professionals.
Time Limits and When to Seek Advice
You must notify SIRA of your claim within 52 weeks of the accident. If your PTSD is disputed, act quickly: internal reviews can take up to 28 days, and PIC referrals may extend the process. Delays can jeopardize your right to benefits. Seek legal advice if you face challenges proving the injury's connection to the accident or if your claim is rejected.
Example: Navigating a PTSD Dispute
Consider a scenario where a claimant develops PTSD after a collision but is told their injury doesn't meet the threshold. They can challenge this by providing a detailed medical report from a specialist, demonstrating how the trauma caused persistent symptoms like flashbacks and anxiety. SIRA may then reclassify the injury or adjust benefits.
Next Steps
CTP disputes involving PTSD require careful attention to evidence and deadlines. While SIRA provides a framework for claims, disputes often need independent review or legal intervention. For personalized guidance, complete the quick, no obligation enquiry form to discuss your circumstances.