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).
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 on the Central Coast, understanding what the Personal Injury Commission (PIC) expects in disputes is critical. This article explains the evidence, assessment criteria and dispute resolution processes under NSW's Compulsory Third Party (CTP) scheme for eye injuries resulting in vision loss.
What Evidence Supports a Vision Loss Claim?
To dispute a CTP claim involving vision loss, you must provide medical evidence confirming the injury's impact. The PIC requires:
- Detailed medical records showing the injury's cause and progression
- Vision test results (e.g., visual acuity, field tests) from an optometrist or ophthalmologist
- Evidence of daily life impact, such as difficulty reading, driving or working
- Witness statements or accident reports confirming the injury's onset
For example, if a car accident caused a corneal abrasion leading to blurred vision, medical records must link the injury to the accident and demonstrate its effect on your ability to perform everyday tasks.
How Does the PIC Assess Vision Loss Impact?
Under the Motor Accident Injuries Act 2017, the PIC evaluates vision loss claims based on:
- The severity of the injury (e.g., partial or total blindness)
- The permanence of the condition
- The impact on your ability to work, drive or manage personal care
- Whether the injury meets the 'threshold injury' definition under the Motor Accident Guidelines
The PIC may request a medical assessment to determine if the injury meets the threshold for ongoing benefits. For instance, a traumatic brain injury causing vision loss would be assessed differently than a temporary eye infection.
Dispute Resolution Options for Vision Loss Claims
If your claim is disputed, you can:
- Request an internal review by the PIC
- Seek a medical dispute pathway assessment
- Lodge a formal objection with the NSW Civil and Administrative Tribunal (NCAT)
The PIC's medical dispute pathway involves an independent expert reviewing your case. However, this does not guarantee a changed decision. You must provide new evidence or demonstrate an error in the original assessment.
Time Limits and Practical Steps
You have 52 weeks from the accident date to claim benefits for 'only injuries' under the CTP scheme. For vision loss claims, it's crucial to:
- Notify your insurer within 52 weeks
- Obtain medical records promptly
- Document how the injury affects your daily life
- Seek legal advice if your claim is disputed
When to Seek Independent Advice
If your vision loss claim is being contested, consult a solicitor specialising in CTP disputes. They can help:
- Navigate the PIC's assessment criteria
- Challenge incorrect medical opinions
- Explore options for further review
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.