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 or eye injury in a motor accident in the Newcastle and Hunter region, avoiding common mistakes is critical to securing compensation under NSW's Compulsory Third Party (CTP) scheme. This article explains the legal rules, practical steps and evidence needed to support a claim for vision loss, while highlighting errors that could harm your case.
Key CTP Rules for Vision Loss Claims
Under the Motor Accident Injuries Act 2017, vision loss injuries must meet specific criteria to qualify for CTP benefits. The New South Wales Motor Accident Guidelines define 'threshold injury' as a condition that results in a whole person impairment (WPI) of 10% or more, or requires treatment and care. For eye injuries, this includes conditions like optic nerve damage, retinal detachment or permanent visual field loss.
A common mistake is assuming all vision loss injuries qualify automatically. Injuries must be documented by a medical practitioner and linked to the accident. For example, a corneal abrasion with full recovery may not meet the threshold, while a traumatic brain injury causing permanent vision loss would. The NSW Government's SIRA website explains that 'vision loss' claims require evidence of a clinical diagnosis and a direct connection to the accident.
Evidence and Practical Steps to Avoid Mistakes
To support your claim, you must provide:
- Medical records showing the injury's diagnosis, treatment and prognosis
- A detailed accident report from the NSW Police or relevant authority
- Witness statements if available
- Proof of income if you're claiming weekly benefits
A critical error is delaying medical attention. Vision loss injuries often require prompt specialist assessment, such as an ophthalmologist's report. Failing to seek treatment within 24 hours of the accident could weaken your claim, as the CTP scheme requires injuries to be 'reasonably foreseeable' as a result of the accident.
Time Limits and Dispute Options
You have 52 weeks from the accident date to claim weekly benefits for threshold injuries. After this period, benefits are generally limited unless the injury results in a whole person impairment of 10% or more. For example, if a vision loss leads to a 20% WPI after 52 weeks, you may still qualify for ongoing payments.
If your claim is disputed, you can request a review by the NSW Civil and Administrative Tribunal (NCAT). SIRA provides a checklist for disputing decisions, including submitting new evidence or a second medical opinion. However, disputes often hinge on whether the injury meets the threshold criteria, so early legal advice is recommended.
Realistic Example of a Common Mistake
Consider a case where a driver suffered a fractured orbital bone but delayed seeking medical attention. The injury resolved within a week, but the claimant failed to document the initial treatment. The insurer argued the injury was not 'reasonably foreseeable' as a result of the accident, leading to a denied claim. This highlights the importance of prompt medical records and clear evidence of a direct link to the accident.
When to Seek Legal Advice
While many vision loss claims are handled through SIRA's online portal, complex cases, such as those involving multiple injuries or disputes over impairment ratings, require legal assistance. A solicitor can help navigate the 52-week time limit, challenge incorrect impairment assessments, or pursue additional compensation for long-term effects.
Next Steps
CTP claims for vision loss depend on accurate documentation, timely action and understanding the legal thresholds. To request contact about your circumstances, complete the quick, no obligation enquiry form.