Wrist Fractures and NSW CTP Claims: Key Changes After 2017 Reforms
If you suffered a wrist fracture in a motor accident in New South Wales, the 2017 reforms to the Compulsory Third Party (CTP) scheme have changed how your claim is assessed. The reforms introduced stricter rules about injury severity, treatment plans, and time limits for benefits. This article explains how these changes affect your ability to claim compensation for a wrist fracture.
How the 2017 Reforms Changed Injury Assessments
Under the Motor Accident Injuries Act 2017, wrist fractures are now evaluated using the Motor Accident Guidelines to determine if they qualify as a 'threshold injury.' A threshold injury is defined as a soft tissue injury with a whole person impairment (WPI) of 5% or more. For a wrist fracture to meet this threshold, it must involve a spinal nerve-root injury producing neurological signs, such as radiculopathy, or meet specific clinical criteria.
The reforms also introduced a 52-week rule. If your only injuries are threshold injuries, weekly benefits and treatment benefits are generally limited after 52 weeks. This means your claim may stop paying benefits even if your wrist fracture hasn’t fully healed.
Evidence Required for a Wrist Fracture Claim
To support your claim, you must provide:
- Medical records confirming the wrist fracture and its severity.
- Accident reports from the police or insurance company.
- Witness statements or photographs of the accident scene.
- Income records if you’re claiming weekly benefits.
- Treatment plans approved by a medical practitioner, showing how your injury affects your daily activities.
SIRA (State Insurance Regulatory Authority) will assess whether your treatment plan aligns with the injury’s severity. For example, if your wrist fracture requires surgery, your claimant must demonstrate that the treatment is necessary and has been approved by a specialist.
How SIRA Evaluates Wrist Fractures
SIRA uses the Motor Accident Guidelines to determine if your wrist fracture qualifies for benefits. Key factors include:
- Neurological signs such as numbness or tingling.
- Imaging reports (e.g., X-rays, MRIs) showing the extent of the fracture.
- Medical opinion that the injury has caused a WPI of 5% or more.
If your claimant’s wrist fracture doesn’t meet the threshold injury criteria, SIRA may reject the claim. However, if the injury is severe enough to cause long-term disability, your claim may still qualify for additional benefits.
Time Limits and When to Seek Advice
You have 52 weeks from the date of the accident to claim weekly benefits for threshold injuries. If your claim involves a non-threshold injury (e.g., a fracture requiring surgery), there is no time limit, but your claim must be submitted within a reasonable period.
Disputes over injury severity or treatment plans can be resolved through the NSW Civil and Administrative Tribunal (NCAT). It’s important to seek legal advice if your claim is rejected or if you’re unsure whether your wrist fracture meets the threshold injury criteria.
Practical Example: A Wrist Fracture Claim
Imagine a claimant who fractured their wrist during a car collision. Their medical records show the fracture required surgery and caused a WPI of 10%. Under the 2017 reforms, this injury would qualify as a threshold injury, entitling them to weekly benefits and treatment benefits. However, if the claimant’s WPI was only 3%, SIRA would likely reject the claim.
Next Steps
If your wrist fracture claim has been rejected or you’re unsure about your entitlements, contact a legal professional to review your case. The 2017 reforms have made it more complex to prove injuries like wrist fractures, so expert guidance is essential.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.