Spinal Injuries and the 2017 NSW CTP Reforms
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 suffered a spinal injury in a motor accident in New South Wales, the 2017 reforms to the Compulsory Third Party (CTP) scheme significantly changed how your claim is assessed and compensated. Before 2017, spinal injuries were often evaluated under common law principles, but the reforms shifted to a statutory framework governed by the Motor Accident Injuries Act 2017. This article explains the key changes, how SIRA assesses spinal injuries, and what claimants need to know to navigate their case.
How the 2017 Reforms Changed Spinal Injury Claims
The 2017 reforms introduced a statutory benefits scheme that replaces common law damages claims for most spinal injuries. Under the new system:
- Spinal injuries are categorized as 'threshold injuries' if they meet specific clinical criteria in the Motor Accident Guidelines. These injuries qualify for statutory benefits, including weekly income payments and treatment and care benefits.
- Whole person impairment (WPI) claims are now limited to cases where the injury results in a whole person impairment rating of 10% or more. Spinal injuries that don’t meet this threshold are generally not eligible for WPI compensation.
- SIRA (Spinal Injuries Reference Authority) now oversees the assessment of spinal injuries. SIRA evaluates whether a spinal injury meets the threshold injury definition, including the spinal nerve-root qualification. This means a spinal injury producing neurological signs other than radiculopathy may still qualify as a threshold injury, provided it meets the clinical criteria.
What Steps Should Claimants Take?
To ensure your spinal injury claim is processed correctly under the new regime, take these steps:
- Seek immediate medical attention to document the injury. Medical records must show the injury’s nature, severity, and link to the accident.
- Preserve evidence of the accident, including police reports, witness statements, and photographs of the scene. This evidence helps establish the injury’s connection to the motor accident.
- Notify your insurer as soon as possible. Under the CTP scheme, insurers must respond to claims within 28 days. Delays can affect your ability to claim statutory benefits.
- Work with SIRA to assess your injury. SIRA’s guidelines define what constitutes a threshold injury, and their assessment determines whether you qualify for statutory benefits.
Time Limits and Dispute Resolution
The 2017 reforms also changed time limits for spinal injury claims. For injuries classified as threshold injuries, weekly income benefits and treatment and care benefits are generally limited to 52 weeks. After this period, claimants may need to pursue a separate WPI claim if their injury meets the whole person impairment threshold.
If your claim is disputed, you can request a review by SIRA. If the dispute continues, you may need to seek legal advice to challenge the decision through the NSW Civil and Administrative Tribunal (NCAT).
A Hypothetical Example
Consider a claimant who suffered a spinal injury after a car accident. Medical records show the injury caused neurological signs but not radiculopathy. Under the 2017 reforms, SIRA would assess whether this injury meets the threshold injury definition. If it does, the claimant is entitled to statutory benefits for up to 52 weeks. If the injury also results in a whole person impairment rating of 10% or more, the claimant may pursue additional compensation for long-term impairment.
When to Seek Legal Advice
While the CTP scheme provides a clear pathway for spinal injury claims, navigating the new rules requires careful attention to detail. If you’re unsure whether your injury qualifies for statutory benefits or WPI compensation, or if your claim is rejected, it’s important to seek legal advice. A solicitor can help you understand your options and ensure your claim is processed correctly.
Next Steps
The 2017 reforms have changed how spinal injuries are assessed and compensated under the NSW CTP scheme. If you or a loved one has suffered a spinal injury in a motor accident, it’s essential to understand the new rules to ensure you receive the support you’re entitled to. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.