What Changed for Wrist Fracture Claims After the 2017 Reforms?
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).
Wrist fractures sustained in a motor accident in Greater Sydney are now governed by the Motor Accident Injuries Act 2017 (MAIA), which replaced the previous Motor Accidents Compensation Act 1999. The 2017 reforms introduced a new framework that prioritises early assessment, treatment and return to work, and significantly altered how compensation is calculated and paid for injuries like wrist fractures. Under the new system, most claims for wrist fractures are assessed under the statutory benefits scheme, which provides treatment and care benefits, weekly income payments and, in limited circumstances, damages. The reforms also established a threshold for injuries that qualify for damages, meaning not all wrist fractures will result in a damages claim. The changes apply to all motor accidents occurring on or after 1 December 2017, including those in Greater Sydney.
How the 2017 Reforms Affect Wrist Fracture Claims
The Motor Accident Injuries Act 2017 introduced a structured approach to assessing injury severity and entitlement to compensation. For a wrist fracture, the key change is that compensation is no longer automatically awarded based on the nature of the injury. Instead, the claim must be assessed under the statutory benefits framework, which includes:
- Treatment and care benefits for medical treatment, rehabilitation and support services
- Weekly income payments if the injury prevents return to work
- An assessment of whole person impairment (WPI) to determine if the injury meets the threshold for damages
A wrist fracture may be considered a threshold injury if it results in a WPI of 10% or more. However, the threshold is not automatically met. The assessment must be conducted by a qualified medical practitioner using the Motor Accident Guidelines, which define the clinical criteria for establishing impairment. For wrist injuries, this includes evidence of functional limitation, pain, and structural damage. A fracture that heals without lasting impairment may not qualify as a threshold injury.
What Evidence Matters for a Wrist Fracture Claim
To establish a valid claim under the 2017 reforms, claimants must provide clear and contemporaneous evidence. The most critical items include:
- Medical records from the initial assessment through to recovery, including X-rays, MRI scans, and specialist reports
- A formal impairment assessment conducted by a qualified medical assessor using the Motor Accident Guidelines
- Documentation of time off work, including a medical certificate and employer correspondence
- Photographs of the injury site, vehicle damage, or the accident scene, if available
- Witness statements describing how the injury occurred
The timing of medical treatment is also important. Prompt reporting and treatment improve the chances of receiving weekly income payments and ensure that the injury is properly documented. Delays in seeking treatment may affect the assessment of causation and the amount of benefits payable.
Time Limits and Procedural Steps
There are strict time limits for making a claim under the MAIA. A claim for treatment and care benefits must be made within 6 years of the accident. For a claim for damages, the time limit is 3 years from the date of the accident. These deadlines apply to all motor accidents in NSW, including those in Greater Sydney, and are not extended for injuries that are not immediately apparent.
The process begins by notifying the insurer of the CTP insurer (the green slip insurer) as soon as possible after the accident. This can be done online through the SIRA website or by completing a claim form. The insurer will then assess the claim and determine eligibility for benefits. If the claim is denied or the benefits are disputed, the claimant may request a review or apply to the NSW Civil and Administrative Tribunal (NCAT) for a determination.
When to Seek Legal Advice
The 2017 reforms have made the claims process more complex, particularly when determining whether a wrist fracture qualifies as a threshold injury for damages. Medical assessments, legal thresholds and insurer procedures can be difficult to navigate without assistance. It is advisable to seek advice from a qualified legal practitioner if:
- The insurer refuses to pay for treatment or income support
- The impairment assessment is disputed
- The claim is for damages and the injury is not clearly above the threshold
- There is a dispute over the amount of compensation offered
A legal practitioner can help ensure that all evidence is properly submitted, that the assessment process is followed correctly, and that the claimant’s rights under the MAIA are protected.
A Realistic Example
A 42-year-old office worker in Sydney was involved in a rear-end collision while driving to work. They sustained a Colles’ fracture in the right wrist and were treated in hospital. The injury required a cast and six weeks of physiotherapy. The medical assessment concluded a WPI of 12% due to ongoing pain and limited hand function. The insurer accepted the claim for treatment and care benefits and weekly income payments. However, the claim for damages was initially refused on the grounds that the injury was not a threshold injury. After a review by a second medical assessor, the WPI was confirmed as 12%, and the claim for damages was accepted. This example illustrates how the 2017 reforms require a formal assessment process to determine entitlement to damages, even for a common injury like a wrist fracture.
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