How the 2017 Reforms Affect Shoulder Injury Claims in NSW
If you suffered a shoulder injury in a car accident in Bankstown, the 2017 reforms to New South Wales’ Compulsory Third Party (CTP) scheme may impact your compensation. The reforms redefined 'threshold injuries' to include certain soft tissue injuries like rotator cuff tears. This article explains how the changes affect eligibility for benefits and damages, using SIRA guidelines as the key reference.
Changes to Threshold Injury Definitions
Under the revised Motor Accident Injuries Act 2017, injuries classified as 'threshold injuries' now include specific soft tissue injuries. For shoulder injuries:
- Rotator cuff tears and other minor shoulder trauma may qualify as threshold injuries if they meet clinical criteria in the Motor Accident Guidelines. A spinal nerve-root injury with neurological signs (even without radiculopathy) may also count.
- Statutory benefits like weekly payments and treatment benefits are limited to 52 weeks if the injury is classified as a threshold injury. After this period, benefits stop unless the injury is later reclassified as a more serious impairment.
- Common law claims for damages are now limited to injuries exceeding the threshold definition. Not all shoulder injuries will qualify for a damages claim under the CTP scheme.
These changes mean shoulder injuries must be carefully assessed against the updated guidelines to determine eligibility for benefits or damages.
Using SIRA Guidelines to Assess Shoulder Injuries
SIRA’s Motor Accident Guidelines define 'threshold injuries' as those that are 'not serious' but may still require treatment. For example:
- Minor rotator cuff tears or shoulder contusions may qualify as threshold injuries.
- If your injury meets the threshold definition, you may receive weekly income payments and treatment benefits for up to 52 weeks. After this period, benefits stop unless the injury is later reclassified as a more serious impairment.
- Injuries exceeding the threshold may qualify for a damages claim. This requires a medical report confirming the injury’s severity and a determination that it falls outside the threshold definition.
SIRA’s online tools, such as the 'What you can claim' page, help injured people understand their options. However, the assessment of shoulder injuries often requires specialist medical input to meet the updated criteria.
Practical Steps for Bankstown Residents
If you’ve suffered a shoulder injury in a car accident in Bankstown, take these steps:
- Seek immediate medical attention. A doctor’s report is essential to document the injury and its severity. Ensure the report includes details like the type of injury (e.g., rotator cuff tear), treatment provided, and any clinical signs of a threshold injury.
- Preserve accident details. Gather evidence such as police reports, witness statements, and photographs of the scene. This helps establish the circumstances of the accident and supports your claim.
- Notify your insurer. If you’re the at-fault driver, your insurer will manage the claim. If you’re the injured party, contact the at-fault driver’s insurer. SIRA’s 'Making a motor accident claim' guide outlines the process.
- Review your injury against the threshold definition. Use SIRA’s guidelines to determine whether your shoulder injury qualifies for statutory benefits or a damages claim. This may require a specialist medical opinion.
Time Limits and Dispute Options
CTP claims have strict time limits. You must notify the insurer of your injury within 52 weeks of the accident. If you fail to meet this deadline, you may lose your right to claim statutory benefits. However, you may still have options for a damages claim if the injury was not classified as a threshold injury.
If your claim is disputed, you can request a review by SIRA. In some cases, mediation or tribunal proceedings may be necessary. It’s important to act quickly, as delays can reduce your chances of securing benefits or compensation.
When to Seek Legal Advice
The 2017 reforms have significantly changed how shoulder injuries are assessed under the CTP scheme. If your injury falls within the threshold definition, you may not be eligible for a damages claim. Conversely, if your injury exceeds the threshold, you may have a stronger case for compensation. Given the complexity of these rules, it’s advisable to seek legal advice if:
- Your injury is not clearly classified as a threshold injury.
- You’re unsure whether you qualify for statutory benefits.
- Your claim has been rejected or is under review.
Legal professionals can help you understand your options and ensure your claim is processed correctly under the revised CTP scheme.
Next Steps
CTP entitlements and deadlines depend on the date of your accident, the nature of your injury, and the evidence you provide. If you’re in Bankstown and have suffered a shoulder injury in a car accident, take the next step by completing the quick, no obligation enquiry form. A legal professional can assess your circumstances and advise you on the best course of action.