Shoulder Injuries in Car Accidents: Common Mistakes to Avoid in Balmain NSW
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, NSW, you may be eligible for compensation under the NSW Compulsory Third Party (CTP) scheme. However, many claimants make errors that could reduce or block their entitlements. This article explains the most common mistakes to avoid, based on the NSW Motor Accident Injuries Act 2017 and SIRA guidelines.
Key CTP Rules for Shoulder Injuries
Under the NSW CTP scheme, compensation is available for injuries resulting from motor vehicle accidents. Shoulder injuries, including rotator cuff tears and dislocations, are typically covered if they meet the 'threshold injury' definition in the Motor Accident Guidelines. This means the injury must result in a measurable impact on your ability to work or perform daily activities.
SIRA (State Insurance Regulatory Authority) provides the official framework for assessing claims. For example, a shoulder injury that causes chronic pain or limits mobility may qualify for weekly income benefits or treatment and care payments. However, injuries that are minor or temporary, such as a bruise without functional limitation, may not meet the threshold.
Practical Steps to Avoid Claim Errors
To ensure your claim is processed correctly, take these steps:
- Seek immediate medical attention. A doctor's report is essential to document the injury and its impact. Delaying treatment may lead to disputes about the injury's cause.
- Keep detailed records. Save all medical records, accident reports, and correspondence with insurers. SIRA requires evidence of the injury's severity and how it affects your daily life.
- Notify your insurer promptly. Under the CTP scheme, you must notify the at-fault driver's insurer within 52 weeks of the accident. Failing to do so may result in lost benefits.
- Avoid downplaying your injury. Even if your shoulder injury seems minor, it must meet the threshold criteria. SIRA assesses injuries based on clinical signs, not subjective pain.
Time Limits and Dispute Options
The CTP scheme has strict time limits. For example, weekly income benefits are generally available for 52 weeks after the accident, unless the injury is classified as a 'whole person impairment' (WPI) of 10% or more. If your injury doesn't meet the threshold, you may still be eligible for treatment benefits, but these are limited to 52 weeks.
If your claim is rejected, you can request a review by the NSW Civil and Administrative Tribunal (NCAT). SIRA also provides a free 'Dispute Resolution' process for claimants who believe their injury meets the threshold but was denied.
When to Seek Legal Advice
Common mistakes include failing to document the injury's impact, missing time limits, or not understanding the difference between statutory benefits and common law damages. For example, a shoulder injury that doesn't meet the threshold may still qualify for treatment benefits, but you may need to pursue a separate claim for compensation if the injury is later found to be more severe.
If you're unsure whether your injury meets the threshold or how to proceed, contact a legal professional. While this article provides general guidance, your circumstances may require tailored advice.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.