Traumatic brain injury claims under NSW CTP
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 traumatic brain injury (TBI) in a motor vehicle accident in New South Wales, you may be eligible for compensation through the Compulsory Third Party (CTP) scheme. This article explains how SIRA assesses claims for TBIs, outlines practical steps to take, and provides a Balmain-based example to illustrate the process.
Key legal rules for TBI claims
Under the Motor Accident Injuries Act 2017, traumatic brain injuries are classified as 'threshold injuries' if they meet specific clinical criteria. SIRA uses the Motor Accident Guidelines to determine whether a TBI qualifies for statutory benefits. For example, a head injury causing neurological signs like memory loss or speech difficulties may be considered a threshold injury, even if imaging shows no visible damage.
CTP claims for TBIs typically cover treatment costs, income loss, and daily living support. However, benefits are limited to 52 weeks unless the injury results in a whole person impairment (WPI) of 10% or more. This distinction is critical: injuries below the threshold may not qualify for long-term benefits.
Practical steps and evidence needed
To support a TBI claim, you must provide:
- Medical records confirming the injury (e.g., MRI scans, neurological assessments)
- Accident reports detailing the incident
- Witness statements or police reports
- Proof of income to calculate lost earnings
- Evidence of ongoing treatment, such as therapy records
In Balmain, residents should contact SIRA directly to report the claim. For example, a cyclist injured in a car park near Balmain Station might need to provide a doctor's report linking the accident to symptoms like dizziness and cognitive fog.
Time limits and when to seek advice
You must notify SIRA of your claim within 52 weeks of the accident. If you wait longer, you may lose access to statutory benefits. However, you can still seek legal advice at any time to explore options like a common law damages claim.
Disputes over TBI claims often arise when the injury doesn't meet the threshold definition. In such cases, consulting a solicitor with experience in SIRA assessments is advisable. For instance, if a claimant's symptoms improve within 52 weeks but they later develop chronic issues, they may need to reapply under a different scheme.
Next steps
CTP claims involving traumatic brain injuries depend on precise medical evidence and timely action. If you're in Balmain or elsewhere in NSW, contact the approved enquiry form to discuss your circumstances. Every claim depends on its own facts.