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're unable to return to work after a car accident in Armidale and are disputing compensation, understanding your options under NSW CTP laws is critical. The Motor Accident Injuries Act 2017 and SIRA's assessment processes govern claims for work capacity and income support. This article explains how disputes over return-to-work claims are resolved, the evidence required, and when to seek legal advice.
How SIRA Assesses Return-to-Work Capacity
SIRA determines whether a claimant can return to work based on medical evidence and vocational assessments. Under the Motor Accident Injuries Act 2017, your work capacity is evaluated to decide if you qualify for weekly income payments or treatment benefits. If your injury meets the 'threshold injury' criteria (e.g., soft tissue injuries with neurological signs), benefits may be limited to 52 weeks. SIRA considers factors like your pre-accident job, medical reports, and rehabilitation progress.
Dispute Resolution Options
If you disagree with SIRA's assessment of your work capacity, you have two main options: internal review or external review. First, you can request an internal review by SIRA within 28 days of the decision. If unresolved, you may apply to the Personal Injury Commission (PIC) for an external review. The PIC will assess whether SIRA's decision was legally sound. Note that a challenge does not guarantee a changed outcome and must be based on new evidence or legal errors.
Key Evidence for Disputes
To support a dispute, gather documents like:
- Medical records confirming your injury's severity and treatment
- Vocational assessments from a registered occupational therapist
- Evidence of your pre-accident job duties and physical demands
- Any correspondence with SIRA or insurers
Time Limits and Practical Steps
You must notify SIRA of a dispute within 28 days of their decision. Delays can jeopardize your ability to challenge the assessment. If you're unsure about your work capacity or the process, seek advice from a solicitor or the NSW Workers Compensation Commission (WCC) for additional guidance.
When to Seek Legal Advice
Disputes over work capacity often involve complex legal and medical considerations. A solicitor can help you:
- Challenge SIRA's interpretation of your injury's severity
- Navigate the PIC review process
- Ensure all evidence meets legal standards
If your accident date falls before 1 July 2022, the old 'no-fault' CTP scheme may apply. Always confirm the applicable scheme with your insurer or SIRA.
Example Scenario
Consider a claimant who suffered a soft-tissue injury after a car accident. SIRA determines they can return to work part-time, but the claimant argues their injury prevents full-time work. The dispute hinges on whether the injury meets the 'threshold injury' definition under the Motor Accident Guidelines. Medical evidence showing prolonged recovery time could support a challenge.
Next Steps
Time limits and procedural requirements mean delays can impact your claim. If you're facing a dispute over return-to-work capacity, act promptly. Complete the quick, no obligation enquiry form to request contact about your circumstances.