Vision Loss Claims, What Changed After 2017 Reforms in NSW
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 vision loss injury in a motor accident in NSW, the 2017 reforms to the Compulsory Third Party (CTP) scheme have significantly altered how claims are assessed and compensated. These changes, introduced under the Motor Accident Injuries Act 2017, now govern claims for eye injuries, including blindness, and require claimants to meet specific criteria to access benefits. This article explains the key changes, how SIRA evaluates claims, and what evidence is needed to support your case.
Key Changes to CTP Vision Loss Claims After 2017
The 2017 reforms restructured the CTP scheme to focus on 'threshold injuries' and introduced stricter rules for claiming compensation. For vision loss claims, the reforms mean:
- Threshold injuries now include injuries that result in a significant loss of vision, such as blindness or severe visual impairment. However, these injuries must meet specific clinical criteria outlined in the Motor Accident Guidelines.
- SIRA’s role has expanded to assess not just the injury itself but also its impact on daily life. For example, if your vision loss affects your ability to work or perform everyday tasks, this will influence the level of compensation.
- Compensation thresholds for eye injuries have been adjusted. Claims for 'threshold injuries' are limited to statutory benefits (like weekly payments and treatment costs) unless the injury meets the higher standard for 'whole person impairment' (WPI).
These changes mean that vision loss claims are now evaluated more rigorously than before, with a stronger emphasis on medical evidence and the long-term impact of the injury.
What SIRA Looks For in Eye Injury Claims
Under the new CTP framework, SIRA assesses claims based on the following:
1. Medical Evidence
SIRA requires detailed medical records to confirm the nature and severity of your vision loss. This includes:
- A diagnosis of the injury (e.g., retinal detachment, optic nerve damage, or blindness).
- Evidence of how the injury affects your vision, such as visual acuity tests or field tests.
- Documentation of any treatment received, including surgery, therapy, or rehabilitation.
2. Impact on Daily Life
SIRA evaluates whether your vision loss has significantly impacted your ability to work, travel, or perform everyday activities. For example, if your injury prevents you from driving or reading, this will influence the compensation amount.
3. Eligibility for Statutory Benefits
If your injury is classified as a 'threshold injury', you may be eligible for weekly income payments and treatment benefits. However, these benefits are limited to 52 weeks unless the injury meets the higher WPI standard.
4. Whole Person Impairment (WPI) Assessment
To claim compensation beyond statutory benefits, your injury must meet the WPI threshold. This requires a detailed assessment by a medical practitioner, including a comparison of your pre- and post-injury function.
Practical Steps for CTP Vision Loss Claims
To support your claim, gather the following evidence:
- Medical records from your treating specialist, including reports from ophthalmologists or optometrists.
- Accident details, such as police reports, witness statements, and photographs of the scene.
- Income records to demonstrate how your vision loss has affected your earnings.
- Evidence of treatment costs, including receipts for medical procedures or equipment.
If your claim is denied, you may request a review by SIRA or seek independent medical advice to challenge the assessment.
Time Limits and When to Seek Advice
CTP claims must be submitted within 5 years of the accident date. However, if your injury is classified as a 'threshold injury', you may need to act quickly to access statutory benefits. Delays can result in lost entitlements, especially if your claim is not submitted before the 52-week limit for weekly payments.
If you’re unsure whether your vision loss meets the criteria for compensation, it’s important to seek legal advice early. A solicitor can help you understand your options and ensure your claim is processed correctly.
Final Steps for Vision Loss Claimants
If you’ve suffered a vision loss injury in a motor accident in NSW, the 2017 reforms mean your claim will be assessed under a stricter framework. To ensure you receive the support you deserve, gather all relevant medical and accident evidence, and consider seeking independent advice if your claim is denied. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.