Where a person's only injuries resulting from the accident are threshold injuries, weekly benefits and treatment and care generally cease after 52 weeks (ss 3.11 and 3.28).
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 Balmain, documenting your injuries properly is essential for a successful NSW Compulsory Third Party (CTP) claim. This guide explains what evidence to gather, how to organize it, and which SIRA guidelines apply to shoulder injuries under the NSW CTP scheme.
What Medical Documents Are Essential for a Shoulder Injury Claim?
To support a CTP claim for a shoulder injury, you must provide evidence of the injury and its connection to the accident. Key documents include:
- Medical records from a registered medical practitioner confirming the injury (e.g., rotator cuff tear, dislocation, or fracture)
- Imaging reports (X-rays, MRI, or ultrasound) showing structural damage
- Treatment records detailing physiotherapy, injections, or surgery
- Diagnosis notes specifying the type and severity of the injury
- Doctor’s notes explaining how the injury affects daily activities
Under the Motor Accident Guidelines, injuries must meet the 'threshold injury' criteria to qualify for statutory benefits. For example, a rotator cuff tear requiring surgical repair would typically meet this threshold.
How to Organize Documentation for a Shoulder Injury Claim
Create a clear, chronological record of events and treatment. Include:
- Accident details: Date, time, location, and description of the collision
- Witness statements from people who saw the accident
- Photographs of the injury site, vehicle damage, and accident scene
- Medical bills and receipts for treatment
- Income records showing lost wages or reduced earning capacity
- Correspondence with insurers or SIRA
SIRA guidelines emphasize that documentation must clearly link the injury to the accident. For instance, a shoulder dislocation caused by a collision would need medical evidence showing the injury occurred during the accident.
Time Limits, Disputes and When to Seek Advice
CTP claims must be submitted within 52 weeks of the accident under the Motor Accident Injuries Act 2017. If your only injuries are 'threshold injuries' (e.g., a minor shoulder strain), benefits may stop after 52 weeks. However, if your injury results in long-term impairment (e.g., chronic shoulder pain requiring ongoing treatment), you may still qualify for continued support.
Disputes over documentation are common. For example, an insurer might challenge a claim for a shoulder injury if there’s no medical evidence of a diagnosed condition. In such cases, consulting a legal professional familiar with SIRA guidelines is advisable.
Example: Documenting a Rotator Cuff Tear
Consider a scenario where a cyclist sustains a shoulder injury after a car collision. Medical records confirming a torn rotator cuff, combined with imaging showing tendon damage, would support a claim. Keeping a diary of symptoms and treatment progress can also strengthen the case.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.