What the PIC Requires for Vehicle Modifications in CTP Claims
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 Personal Injury Commission (PIC) evaluates claims for vehicle modifications under the Motor Accident Injuries Act 2017. When disputing claims for hand controls, mobility aids, or other modifications, the PIC expects specific evidence to support the necessity of the changes. This includes medical documentation confirming the injury's impact on mobility, a detailed description of the modification, and evidence that the change is essential for daily living. For example, a claimant may need to provide a doctor's report linking their spinal injury to the need for a hand control device.
How PICs Handle Disputes in Illawarra and South Coast
In the Illawarra and South Coast regions, PICs apply the same legal standards as elsewhere in NSW but may have local practices influenced by the availability of medical specialists or regional case precedents. Claimants should ensure all evidence is submitted promptly and clearly, as delays can weaken the case. If the PIC disputes the modification's necessity, claimants may need to provide additional evidence, such as a second medical opinion or a comparison with standard mobility aids.
Key Differences in PIC Expectations for Modifications
Unlike standard CTP claims, vehicle modification disputes require proof that the change is directly related to the accident injury. The PIC will scrutinize whether the modification is 'reasonably necessary' under the Motor Accident Guidelines. For instance, a claim for a custom hand control may be denied if the injury does not meet the threshold for such an aid. Claimants must also demonstrate that the modification was made within 52 weeks of the accident, as benefits for threshold injuries are generally limited after that period.
Practical Steps for Claimants
To strengthen a vehicle modification claim, injured persons should:
- Obtain a detailed medical report from a specialist confirming the injury's impact on mobility.
- Document the modification's cost and specifications, including any quotes from installers.
- Submit evidence of how the modification improves daily functioning, such as a diary of usage.
- Respond to PIC requests for further information within the required timeframe.
When to Seek Legal Advice
Disputes over vehicle modifications can be complex, especially if the PIC challenges the claim's validity. Legal advice is recommended if:
- The PIC denies the claim without explanation.
- The claimant needs to challenge a medical assessment.
- There are disputes over the cost or necessity of the modification.
Time Limits and Internal Reviews
Claimants must submit vehicle modification claims within 52 weeks of the accident, as per the Motor Accident Injuries Act 2017. If the PIC disputes the claim, claimants can request an internal review by the PIC's medical advisory panel. However, internal reviews do not guarantee a changed decision and may take several months to resolve.
Final Steps for Claimants
Vehicle modification claims require precise evidence to meet the PIC's standards. If you're unsure whether your claim meets the requirements or need help challenging a dispute, complete the quick, no obligation enquiry form to request contact about your circumstances.