If you suffered a shoulder injury in a car accident in NSW, the 2017 reforms to the Compulsory Third Party (CTP) scheme have changed how your claim is assessed. This article explains the key legal changes affecting shoulder injuries, including how SIRA evaluates your case and what evidence you need to support your claim.
What Changed in the 2017 NSW CTP Reforms?
The 2017 reforms to the Motor Accident Injuries Act 2017 shifted the focus of CTP claims from common law damages to statutory benefits. For shoulder injuries, this means:
- Threshold injuries now define the scope of benefits. A shoulder injury may qualify as a threshold injury if it meets the Motor Accident Guidelines’ criteria, such as a rotator cuff tear or shoulder dislocation.
- Soft tissue injuries must meet specific clinical signs. For example, a spinal nerve-root injury causing neurological signs (other than radiculopathy) may still count as a threshold injury, but radiculopathy requires specified clinical evidence.
- Weekly benefits are limited to 52 weeks if your injury is classified as a threshold injury. After this period, you may need to pursue additional compensation through other avenues.
These changes mean that not all shoulder injuries automatically qualify for ongoing weekly payments. SIRA assesses each claim based on the injury’s severity and whether it meets the threshold definition.
What Evidence Supports a Shoulder Injury Claim?
To claim compensation for a shoulder injury, you must provide:
- Medical records showing the injury, including imaging (e.g., MRI) and clinical notes.
- Accident details such as the date, location, and circumstances of the collision.
- Witness statements or police reports if available.
- Evidence of treatment like physiotherapy records or specialist consultations.
- Income records if you’ve lost wages due to the injury.
SIRA uses the Motor Accident Guidelines to determine whether your injury meets the threshold for benefits. For example, a rotator cuff tear may qualify, but a minor strain might not.
Practical Steps for Shoulder Injury Claims
If you’ve suffered a shoulder injury in a car accident, take these steps:
- Seek immediate medical attention to document the injury.
- Report the accident to the police and your insurer.
- Keep all medical records and correspondence with healthcare providers.
- Notify your insurer about your injury and claim.
- Review your claim with a legal professional if you’re unsure about your entitlements.
Time Limits and Dispute Options
You have 28 days to notify your insurer of your injury under the CTP scheme. If you fail to meet this deadline, your claim may be denied. If your claim is disputed, you can:
- Request a review by SIRA.
- Seek legal advice to challenge the decision.
Hypothetical Example: Rotator Cuff Tear
Consider a driver who suffered a rotator cuff tear in a low-speed collision. Under the 2017 reforms, this injury may qualify as a threshold injury, entitling them to weekly benefits and treatment coverage. However, if the injury is minor and heals within 52 weeks, benefits may stop, and the claimant may need to pursue additional compensation through other means.
When to Seek Legal Advice
The 2017 reforms have made CTP claims more complex, especially for injuries like shoulder trauma. If your claim is denied, or you’re unsure about your rights, contact a legal professional. They can help you understand your options and ensure your claim meets the new requirements.
Next Steps
CTP entitlements depend on the date of your accident, the nature of your injury, and the evidence you provide. To request contact about your circumstances, complete the quick, no obligation enquiry form.