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've developed post-traumatic stress disorder (PTSD) after a road trauma in New South Wales, you may be eligible for compensation through the Compulsory Third Party (CTP) scheme. This article explains how PTSD claims are handled under NSW law, using practical examples from Greater Sydney. It covers how your injury is assessed, what evidence is needed, and time limits that apply.
How PTSD Is Assessed in NSW CTP Claims
Under the Motor Accident Injuries Act 2017, PTSD is treated as a psychological injury. To qualify, your symptoms must meet the clinical criteria outlined in the Motor Accident Guidelines. These include persistent re-experiencing of the trauma, avoidance of reminders, and heightened arousal. SIRA (State Insurance Regulatory Authority) uses these guidelines to determine whether your PTSD falls within the 'threshold injury' category, which qualifies for statutory benefits.
For example, a Greater Sydney resident who developed PTSD after a car accident involving a cyclist may claim treatment and care benefits. SIRA requires medical evidence, such as a psychologist’s report, to confirm your diagnosis and its connection to the accident.
What Types of PTSD Claims Are Eligible?
CTP claims cover injuries resulting from road trauma, including psychological injuries like PTSD. However, your claim must demonstrate a direct link between the accident and your mental health condition. This includes:
- Medical records showing PTSD diagnosis
- Evidence of trauma-related symptoms
- Proof of how the injury impacts your daily life
If your PTSD is severe enough to meet the 'whole person impairment' threshold (e.g., significant functional loss), you may also be eligible for damages beyond statutory benefits. However, this requires a specialist report from a registered medical practitioner.
Practical Examples from Greater Sydney
A 2023 case in Sydney’s inner west involved a pedestrian who developed PTSD after being hit by a car. The claimant provided:
- Police accident report
- Witness statements
- Therapy records showing ongoing treatment
- A letter from a psychiatrist confirming PTSD
SIRA approved treatment benefits, though the claimant later pursued a separate common law damages claim for additional compensation.
Another example involves a motorcyclist in the Central Coast who experienced PTSD after a collision. SIRA accepted the claim based on medical evidence, but the claimant had to wait 52 weeks before benefits could be extended beyond the initial 52-week statutory period.
Time Limits and Dispute Options
You have 52 weeks from the accident date to claim statutory benefits like treatment and care. If your injury is classified as a 'threshold injury, ' benefits may stop after this period unless your condition worsens. For claims involving higher impairment, time limits depend on the evidence of ongoing disability.
If your claim is disputed, you can request a review by SIRA or apply to the NSW Civil and Administrative Tribunal (NCAT). It’s important to act quickly, as delays can affect your ability to prove ongoing injury.
When to Seek Legal Advice
While SIRA handles most CTP claims, complex cases involving PTSD may require legal assistance. A solicitor can help navigate disputes, ensure you meet all evidentiary requirements, and explore options for common law damages if your injury exceeds threshold criteria.
Next Steps
CTP claims involving PTSD depend on accurate diagnosis, timely action, and proper documentation. If your circumstances are unique or your claim is contested, seek professional guidance. Every claim depends on its own facts.
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