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).
Spinal injuries in NSW motor accidents can lead to long-term disability and significant medical costs. Under the NSW Compulsory Third Party (CTP) scheme, injured people may claim compensation for treatment, income loss, and care. This article explains how SIRA evaluates spinal injury claims, what evidence is needed, and common questions about long-term support. If you’ve suffered a spinal injury in a motor accident, understanding your rights under the Motor Accident Injuries Act 2017 is essential.
What Spinal Injuries Qualify for CTP Compensation?
Spinal injuries must meet the definition of a 'threshold injury' under the Motor Accident Guidelines to qualify for CTP benefits. This includes injuries like herniated discs, spinal cord damage, or fractures that result in neurological signs such as weakness or numbness. SIRA assesses whether the injury meets the 'spinal nerve-root' criteria: a spinal nerve-root injury producing neurological signs other than radiculopathy may still count as a soft-tissue injury. Radiculopathy requires specific clinical signs, such as radicular pain or reflex changes, to qualify.
How SIRA Assesses Spinal Injury Claims
SIRA evaluates spinal injuries using the Motor Accident Guidelines, which outline medical criteria for injury severity. For example, a person with a herniated disc causing partial loss of function may receive weekly income payments and treatment benefits. SIRA also considers the impact on daily activities, such as difficulty walking or sitting, to determine long-term support needs. If the injury results in a whole person impairment (WPI) rating of 10% or more, additional compensation may be available.
Evidence Needed for a Spinal Injury Claim
To support a spinal injury claim, injured people must provide medical records confirming the injury, such as MRI or CT scans, and a doctor’s report detailing the diagnosis and treatment plan. Evidence of the accident, like a police report or witness statements, is also crucial. SIRA may request a medical assessment to verify the injury’s severity and link it to the accident. Keeping detailed records of treatment costs, such as physiotherapy sessions or medical equipment, is essential for claiming expenses.
Can You Claim Treatment Costs for Spinal Injuries?
Yes. Under the CTP scheme, injured people can claim treatment and care benefits for spinal injuries, including physiotherapy, chiropractic care, and medical equipment. SIRA covers these costs as part of the 'treatment and care' benefits, which are paid weekly for 52 weeks unless the injury is classified as a threshold injury. After 52 weeks, benefits may reduce if the injury is not severe enough to meet the threshold criteria.
How Spinal Injuries Affect Long-Term Compensation
Spinal injuries that result in chronic pain, mobility issues, or reduced function may qualify for long-term compensation. SIRA uses the whole person impairment (WPI) rating to assess the injury’s impact. For example, a person with a 20% WPI rating due to a spinal injury may receive ongoing weekly payments. If the injury leads to a permanent impairment, such as a 50% WPI rating, compensation may include a lump sum for loss of earning capacity.
Practical Steps for Injured People in Auburn
If you’ve suffered a spinal injury in a motor accident, seek medical attention immediately to document the injury. Preserve evidence of the accident, such as photographs of the scene, witness details, and a copy of the police report. Notify your insurer or SIRA as soon as possible to start the claims process. If you’re unsure about your entitlements, contact a legal professional for advice.
Time Limits and When to Seek Advice
You have 52 weeks from the accident date to claim treatment and care benefits under the CTP scheme. If your injury is classified as a threshold injury, you must notify SIRA within this period. For long-term claims, such as those involving whole person impairment, time limits may be extended, but it’s essential to act promptly. Delaying can reduce your chances of securing full compensation.
Example: A Spinal Injury Claim in Practice
Consider a person who suffered a herniated disc in a car accident. Medical records show the injury caused partial loss of function in their leg. SIRA assesses the injury under the Motor Accident Guidelines and determines it meets the threshold injury criteria. The injured person receives weekly income payments for 52 weeks and treatment benefits for physiotherapy. After 52 weeks, SIRA reviews the claim and finds the injury does not meet the threshold for ongoing benefits, but the person is still eligible for a one-time lump sum for long-term impairment.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.