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).
The 2017 reforms to NSW Compulsory Third Party (CTP) motor accident compensation introduced significant changes to how vehicle modifications are assessed in claims. These changes, outlined in the Motor Accident Injuries Act 2017 and supported by SIRA guidelines, now require claimants to demonstrate the necessity of modifications rather than the type of injury. This shift impacts regional NSW claims, where access to specialist assessments and documentation may differ from metropolitan areas. Understanding these changes is critical for claimants seeking compensation for injuries requiring hand controls, mobility aids, or other vehicle adaptations.
What Changed in the 2017 Reforms?
Under the 2017 reforms, SIRA now evaluates vehicle modifications based on clinical necessity, not the severity of the injury. For example, a soft tissue injury (threshold injury) may no longer qualify for long-term modification benefits unless it results in a whole person impairment of 10% or more. This aligns with the Motor Accident Guidelines, which specify that modifications must address functional limitations caused by the accident.
The reforms also clarified that fault does not affect eligibility for modification benefits, as CTP claims are based on the accident’s occurrence, not who was at fault. However, claimants must prove that the modification is directly related to the injury and not a pre-existing condition. This distinction is crucial in regional NSW, where medical records may be less detailed or harder to access.
How SIRA Assesses Vehicle Modifications in Regional NSW
SIRA’s assessment process for regional claims now prioritizes clinical evidence over subjective claims. Claimants must provide:
- A medical report confirming the injury’s impact on mobility or function
- Documentation of the modification’s cost and necessity (e.g., a doctor’s note or specialist opinion)
- Evidence that the modification was not required before the accident
In regional areas, delays in accessing specialist assessments or delays in processing claims may occur. Claimants should seek independent medical opinions if their initial assessment is disputed, as SIRA requires clinical justification for modifications.
Practical Steps for CTP Claims Involving Modifications
- Seek immediate medical attention to document the injury’s effect on mobility. A specialist report is essential to link the injury to the modification.
- Preserve all accident-related evidence, including photos of the vehicle, witness statements, and repair records.
- Notify your insurer within 52 weeks of the accident, as benefits for threshold injuries are generally limited after this period.
- Request a detailed assessment of the modification’s necessity from a registered medical practitioner.
Regional Differences in CTP Claim Processing
While the legal framework is uniform across NSW, regional claims may face longer processing times due to fewer SIRA offices or limited access to specialists. Claimants in regional areas should also consider travel costs and availability of local medical experts when planning their claim. SIRA’s regional offices may have different case management timelines, so it’s important to confirm processing times directly.
When to Seek Legal Advice
If your claim is denied or you’re unsure about the modification’s eligibility, seek legal advice. A solicitor can help:
- Challenge a decision based on incomplete or incorrect clinical evidence
- Navigate dispute resolution processes with SIRA
- Ensure timely submission of all required documentation
Example: A Regional Claim for Hand Controls
Consider a cyclist in regional NSW who sustained a spinal injury, requiring hand controls to operate their vehicle. Under the 2017 reforms, the claimant must prove:
- The injury caused permanent mobility limitations
- The hand controls were medically necessary to drive safely
- The modification was not pre-existing and directly linked to the accident
This example highlights the need for clear clinical evidence and specialist input in regional claims, where access to such resources may be limited.
Next Steps
CTP claims involving vehicle modifications depend on specific facts, including the injury’s nature, the modification’s necessity, and the claim’s timing. Regional NSW claimants may face additional challenges, such as delays in assessments or limited access to specialists. To request contact about your circumstances, complete the quick, no obligation enquiry form.