Traumatic brain injury claims in NSW: Key mistakes to avoid
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).
If you've suffered a traumatic brain injury in a motor accident in Albury, NSW, you may be eligible for compensation through the Compulsory Third Party (CTP) scheme. However, many claimants make critical errors that jeopardise their ability to receive support. This article explains the most common mistakes and how to avoid them under the Motor Accident Injuries Act 2017 and SIRA guidelines.
Understanding traumatic brain injury claims
Traumatic brain injuries (TBIs) are classified under the Motor Accident Guidelines as either 'threshold injuries' or more severe impairments. Threshold injuries typically involve mild symptoms like headaches or dizziness, while TBIs with neurological signs such as memory loss or speech difficulties fall into a higher category. Under the CTP scheme, claimants must demonstrate that their injury meets the 'whole person impairment' threshold outlined in the guidelines.
A critical distinction is the spinal nerve-root qualification: injuries causing neurological signs other than radiculopathy may still qualify as soft tissue injuries. However, this requires clinical evidence such as MRI scans or neurological assessments. Failing to establish this can result in a claim being limited to statutory benefits rather than full damages.
Common mistakes to avoid
1. Delaying medical assessment
One of the most frequent errors is not seeking immediate medical attention. Delayed diagnosis can undermine claims by making it harder to prove the injury's severity. For example, a claimant who ignores persistent headaches and only visits a doctor weeks later may struggle to demonstrate the injury's impact on daily life.
2. Failing to document the accident
Accurate records of the accident are essential. This includes police reports, witness statements, and photographs of the scene. Without this evidence, insurers may dispute the claim's validity. For instance, a claimant who doesn't note the vehicle's position or road conditions may struggle to prove the accident's circumstances.
3. Not following SIRA's requirements
SIRA (State Insurance Regulatory Authority) sets strict guidelines for claims. Claimants must submit medical reports that align with the Motor Accident Guidelines. Failing to provide evidence of 'whole person impairment' or 'neurological signs' can result in a claim being denied or limited to statutory benefits.
4. Missing time limits
The CTP scheme has strict deadlines. For threshold injuries, benefits are generally limited to 52 weeks unless the claimant can prove the injury meets the 'whole person impairment' threshold. Missing this deadline can mean losing access to ongoing support.
Practical steps to strengthen your claim
To avoid these mistakes, take the following actions:
- Seek immediate medical attention and keep all records
- Document the accident with photos, witness details, and police reports
- Submit medical reports that clearly outline neurological symptoms
- Notify your insurer within 52 weeks of the accident
- Consider consulting a legal professional if your claim is denied
When to seek legal advice
If your claim is denied or you're unsure about your options, seek legal advice promptly. Lawyers can help you:
- Challenge decisions based on incomplete or incorrect assessments
- Navigate disputes over injury severity
- Ensure you meet all SIRA requirements
- Explore options for long-term support if your injury is classified as a threshold injury
Final considerations
Traumatic brain injuries can have lasting effects, and the CTP scheme provides critical support. However, the process requires careful attention to detail. By avoiding common mistakes and following the correct procedures, you can maximise your chances of receiving the compensation you deserve. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.