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).
Vision loss claims under NSW Compulsory Third Party (CTP) insurance require careful handling to ensure entitlements are not lost. Common mistakes include failing to document injuries properly, delaying medical treatment, and not preserving evidence. The Motor Accident Injuries Act 2017 (MAIA) and SIRA guidelines govern these claims, but claimants must act promptly and follow specific procedures to avoid errors.
Key Legal Framework for Vision Loss Claims
Under the MAIA, vision loss injuries are eligible for compensation if they meet the 'threshold injury' criteria outlined in the Motor Accident Guidelines. SIRA assesses claims based on medical evidence, including eye specialist reports, vision tests, and clinical records. Vision loss must be linked to the motor accident, and claimants must notify their insurer within 52 weeks of the accident to access statutory benefits.
Common Mistakes to Avoid
- Delaying Medical Attention: Failing to seek immediate medical evaluation after an eye injury can lead to disputes over causation. For example, a claimant who ignores symptoms of retinal damage may struggle to prove the injury resulted from the accident.
- Not Preserving Evidence: Accident reports, witness statements, and photographs of the scene are critical. A claimant who deletes or loses these records may weaken their case.
- Misunderstanding Time Limits: The 52-week deadline applies to statutory benefits like weekly payments. If injuries are only threshold injuries, benefits stop after 52 weeks, even if long-term vision loss persists.
- Ignoring SIRA Guidelines: SIRA requires detailed medical documentation to assess the severity of vision loss. Claimants who fail to provide this may face delays or denials.
Practical Steps to Avoid Errors
- Seek Immediate Medical Care: Visit an optometrist or ophthalmologist within 24 hours of the accident. Document all treatments and keep records of vision test results.
- Preserve Evidence: Save accident reports, witness contact details, and photos of the vehicle or scene. Avoid deleting messages or social media posts related to the incident.
- Notify the Insurer Promptly: Contact the at-fault driver’s insurer within 52 weeks. Delays may result in losing access to statutory benefits.
- Understand Threshold Injury Criteria: SIRA uses the Motor Accident Guidelines to assess injuries. For example, a claimant with partial vision loss requiring a magnifying glass may qualify, while a minor scratch may not.
When to Seek Legal Advice
If a claimant faces disputes over the severity of their vision loss or the insurer’s refusal to pay, they should consult a solicitor. Legal advice is particularly important if the injury involves complex medical conditions, such as optic nerve damage or glaucoma, which may require specialist assessments.
Example Scenario
A claimant in Bankstown suffered a corneal abrasion after a car accident but delayed seeking treatment for three days. By the time they visited an optometrist, the injury had worsened, and the doctor attributed the damage to a pre-existing condition. This delay led to the claim being denied, highlighting the importance of prompt medical attention.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.