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 accident and did not wear a seatbelt, this may affect your Compulsory Third Party (CTP) claim in New South Wales. Seatbelt non-use is a key factor in determining whether your injuries qualify for compensation under the Motor Accident Injuries Act 2017. This article explains how SIRA assesses treatment and rehabilitation plans for passengers in regional NSW, and outlines practical steps to support your claim.
How Seatbelt Non-Use Impacts CTP Claims
Under NSW law, the CTP scheme considers whether an injury was caused by the accident. If you did not wear a seatbelt, this may reduce the likelihood that your injuries meet the 'threshold injury' criteria for compensation. SIRA's Motor Accident Guidelines state that seatbelt non-use can affect the assessment of injuries, particularly if the injury is minor or soft-tissue in nature.
For example, if you suffered whiplash but were not wearing a seatbelt, SIRA may argue that the injury was not a direct result of the accident. This is because seatbelts are designed to prevent injuries in motor accidents, and their absence may mean the injury would have occurred regardless of the accident. You must demonstrate that your injuries are a direct consequence of the accident, not pre-existing conditions or other factors.
SIRA Guidelines for Treatment and Rehabilitation Planning
SIRA evaluates whether treatment and rehabilitation plans are reasonable and necessary for your injuries. In regional NSW, access to specialists or facilities may be limited, which could affect the treatment plan. SIRA considers:
- Whether the treatment is directly related to the accident
- The reasonableness of the treatment plan in your area
- Whether the treatment is likely to improve your recovery
If your treatment plan is delayed or limited due to regional constraints, you should document this with medical records and explain how it affects your recovery. SIRA may adjust the treatment benefits accordingly.
Practical Steps for Regional NSW Claimants
- Seek immediate medical attention: Document all injuries and treatment, even if they seem minor. A medical report is essential to support your claim.
- Preserve accident details: Gather evidence such as police reports, witness statements, and photographs of the scene. This helps establish the accident's circumstances and your role in it.
- Notify your insurer: Contact the at-fault driver's CTP insurer as soon as possible. Delays may affect your ability to claim treatment benefits.
- a Record treatment progress: Keep detailed notes on your recovery, including dates of appointments, treatments received, and any changes in your condition. This supports your rehabilitation plan.
Time Limits and Dispute Resolution
You have 52 weeks from the accident date to claim treatment and care benefits under the CTP scheme. After this period, benefits are generally limited unless you have a 'threshold injury' (a serious injury meeting specific criteria). If your claim is disputed, you may need to:
- Request a review from SIRA
- Seek legal advice to challenge the decision
In regional NSW, delays in accessing legal support can be a challenge. If you believe your claim is being undervalued or denied, contact a solicitor specialising in CTP claims.
When to Seek Legal Advice
If you are unsure whether your seatbelt non-use affects your claim, or if your treatment plan is being challenged, seek legal advice. A solicitor can help you:
- Assess whether your injuries meet the threshold for compensation
- Challenge decisions about your treatment plan
- Navigate the CTP claims process in regional NSW
Next Steps
CTP claims depend on the specific facts of your case, including the accident date, injury type, and treatment history. If you are in regional NSW and need help with your claim, complete the quick, no obligation enquiry form to request contact about your circumstances.