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've suffered a shoulder injury in a car accident in NSW and are struggling to return to daily activities, understanding how the Compulsory Third Party (CTP) scheme assesses your claim is critical. The New South Wales Motor Accident Injuries Act 2017 and SIRA guidelines determine whether you qualify for benefits like weekly income payments, treatment costs, or compensation for lost earnings. This article explains how to prove your injury affects daily life, what evidence matters, and when to seek legal advice in Ashfield.
How SIRA Assesses Shoulder Injury Claims
- SIRA evaluates claims based on the
- Motor Accident Guidelines* and the
- Motor Accident Injuries Act 2017*. For shoulder injuries, the focus is on whether the injury impacts your ability to perform everyday tasks like lifting objects, driving, or household chores. A key factor is documenting how the injury limits your capacity to work or manage personal care.
The SIRA guidelines require claimants to provide:
- Medical evidence showing a diagnosed shoulder injury (e.g., rotator cuff tear, dislocation)
- Evidence of daily activity limitations (e.g., inability to lift groceries, difficulty dressing)
- A link between the injury and the accident
For example, if your shoulder injury prevents you from lifting your child, this directly affects your ability to care for dependents and may qualify for weekly income benefits under the CTP scheme.
Proving Daily Activity Limitations
To establish that your shoulder injury impacts daily life, you must provide:
- Medical records from a registered medical practitioner detailing the injury's severity and recovery timeline
- Witness statements or photographs of your injury and its effect on daily tasks
- Employer records or caregiver notes showing reduced capacity to work or manage household duties
- A rehabilitation plan from a physiotherapist or occupational therapist
- SIRA may request a
- medical assessment* to evaluate whether your injury meets the
- threshold injury* criteria under the Act. For instance, if your injury results in chronic pain limiting your ability to work, you may qualify for ongoing weekly payments.
Time Limits and Dispute Resolution
CTP claims must be made within 52 weeks of the accident, unless the injury is classified as a threshold injury (which requires specific clinical signs under the guidelines). If your injury doesn't meet the threshold, benefits may stop after 52 weeks, even if you're still recovering.
If you dispute a decision, you can request a review by SIRA or seek mediation through the NSW Civil and Administrative Tribunal (NCAT). It's important to act quickly, as delays can jeopardize your ability to claim benefits for daily activity limitations.
When to Seek Legal Advice
Consult a solicitor if:
- You're unsure whether your injury qualifies for benefits
- Your claim is being denied without explanation
- You need help documenting how your injury affects daily life
A lawyer can help you navigate SIRA's requirements and ensure you receive all available support, including compensation for lost income or treatment costs.
Example: Shoulder Injury Impacting Daily Tasks
Consider a scenario where a car accident causes a shoulder dislocation. The injured person struggles to lift their child, cook meals, or drive to work. Medical records showing the injury's severity, combined with evidence of daily activity limitations, would support a claim for weekly income benefits under the CTP scheme.
Next Steps
If your shoulder injury is affecting your ability to perform daily tasks, act promptly to gather evidence and understand your options. Time limits apply, and delays can reduce your entitlements. For personalized guidance, complete the quick, no obligation enquiry form to request contact about your circumstances.