If you sustained a shoulder injury in a motor vehicle accident in Bega, New South Wales, you may be entitled to compensation under the NSW Compulsory Third Party (CTP) scheme. This scheme provides benefits for injuries caused by motor vehicle accidents, including soft tissue injuries such as rotator cuff tears, shoulder dislocations, and fractures. To qualify, your injury must meet the legal definition of a threshold injury under the Motor Accident Injuries Act 2017, which includes certain soft tissue injuries that result in a permanent impairment or significant impact on daily life. The scheme operates the same way across NSW, including in Bega, and does not require proof of fault.
What Qualifies as a Threshold Injury
A threshold injury under the Motor Accident Injuries Act 2017 includes soft tissue injuries that result in a permanent impairment of at least 10% of the whole person. This includes injuries to the shoulder that cause lasting functional impairment, such as reduced range of motion, chronic pain, or nerve damage. A spinal nerve-root injury that produces neurological signs other than radiculopathy may also qualify as a soft tissue injury under this definition. The injury must be confirmed by a medical practitioner using the Motor Accident Guidelines, which set out the clinical criteria for assessing impairment and causation.
Benefits Available for Shoulder Injuries
If your shoulder injury qualifies as a threshold injury, you may be entitled to treatment and care benefits, weekly income payments, and, in some cases, lump sum damages. Treatment and care benefits cover the cost of medical treatment, rehabilitation, and allied health services related to the injury. Weekly income payments are available if your injury prevents you from working and you have lost income. These benefits are generally limited to 52 weeks after the accident if your only injuries are threshold injuries, as provided under sections 3.11 and 3.28 of the Motor Accident Injuries Act 2017. After this period, further benefits may only be available through a common law damages claim.
Evidence Required to Support a Claim
To make a successful claim, you must provide evidence that supports the connection between the accident and your shoulder injury. This includes:
- A medical report from a treating practitioner confirming the injury and its link to the accident
- Diagnostic imaging results such as MRI or X-ray showing the injury
- A formal assessment of whole person impairment by an accredited medical assessor
- A police report or accident statement, if available
- Details of any witnesses to the accident
- Records of lost income, if claiming weekly payments
Time Limits and Claim Process
You must notify the CTP insurer or SIRA within a reasonable time after the accident. While there is no fixed deadline for making a claim, delays may affect the availability of evidence or the insurer’s ability to assess your case. The 52-week limit on treatment and care benefits and weekly payments applies only if your only injuries are threshold injuries. If your injury leads to long-term or permanent disability, you may need to pursue a common law damages claim to recover additional compensation. Disputes over eligibility or benefit amounts can be reviewed by SIRA or resolved through the NSW Civil and Administrative Tribunal.
When to Seek Independent Advice
The CTP scheme provides a structured pathway for compensation, but the legal requirements for eligibility, evidence, and benefit limits can be complex. If your shoulder injury results in ongoing pain, limited mobility, or long-term impact on your ability to work, you may need to assess whether you meet the threshold for damages. A legal professional can help determine whether your claim qualifies for lump sum compensation and advise on the best steps to protect your rights. It is not necessary to have a lawyer to make a claim, but independent advice can help ensure you meet all procedural and evidentiary requirements.
Example Scenario
A resident of Bega was involved in a minor collision at a roundabout in the town. The driver sustained a rotator cuff tear confirmed by MRI and a medical assessment showing a 12% whole person impairment. The injury was determined to be a threshold injury under the Motor Accident Injuries Act 2017. The person received treatment and care benefits and weekly income payments for 52 weeks. After this period, they continued to experience chronic pain and were unable to return to full-time work. They later pursued a common law damages claim to seek compensation for ongoing care and loss of future earnings.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.