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 were a passenger in a motor vehicle accident and did not wear a seatbelt, the Personal Injury Commission (PIC) will assess how this affects your claim. Under NSW law, seatbelt non-use can impact the PIC’s decision on injury severity, fault, and entitlements. This article explains what the PIC evaluates in disputes, how to address common objections, and practical steps to support your claim.
What the PIC Considers When Assessing Seatbelt Non-Use
The PIC evaluates whether seatbelt non-use contributed to or worsened your injuries. Key factors include:
- Your actions: Did you fail to wear the seatbelt despite being able to? The PIC considers whether the non-use was a conscious choice or due to circumstances like a broken belt.
- Accident circumstances: How did the seatbelt non-use affect the injury? For example, if the seatbelt would have prevented head or spinal injuries, the PIC may reduce compensation.
- Medical evidence: Doctors must link your injuries to the accident, not pre-existing conditions or seatbelt non-use. The PIC may challenge claims where injuries could have occurred without the accident.
How Seatbelt Non-Use Impacts Injury Assessments
The PIC uses the Motor Accident Guidelines to determine if injuries meet the 'threshold injury' standard. Seatbelt non-use can:
- Reduce compensation: If the PIC concludes your injuries would have been less severe with a seatbelt, it may limit payments for treatment, income loss, or pain.
- Affect fault allocation: The PIC may find the claimant partially at fault for not wearing a seatbelt, which could reduce the amount of compensation received.
- Influence statutory benefits: Under the Motor Accident Injuries Act 2017, weekly benefits and treatment payments may be limited if injuries are deemed minor or not caused by the accident.
Common PIC Objections and How to Address Them
The PIC often disputes claims where seatbelt non-use is involved. Common objections include:
- 'No threshold injury': The PIC may argue your injuries are not serious enough. To counter this, provide detailed medical records showing neurological or musculoskeletal damage.
- 'Contributory fault': The PIC may find you partially responsible. Document why the seatbelt was not used (e.g., mechanical failure, distraction) to challenge this.
- 'No direct link to accident': The PIC may claim injuries could have occurred independently. Use expert testimony to show the accident caused specific harm.
Practical Steps to Support Your Claim
To strengthen your case, gather:
- Medical records showing injuries linked to the accident.
- Witness statements confirming seatbelt non-use or accident details.
- Photographs of the vehicle’s condition or seatbelt status.
- Accident reports from police or the driver’s insurer.
- Income records to support claims for lost wages.
Time Limits and When to Seek Advice
You have 52 weeks from the accident date to claim statutory benefits like weekly payments or treatment. After this period, the PIC may limit benefits unless you can prove the injury was not a 'threshold injury.' If disputes arise, seek legal advice promptly to challenge the PIC’s decision. The PIC’s internal review process allows for medical disputes to be referred to independent experts, but this does not guarantee a changed outcome.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.