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 motor accidents on the Central Coast may entitle injured drivers, passengers or pedestrians to compensation under NSW's Compulsory Third Party (CTP) scheme. However, claimants often make errors that delay payments or result in disputes. This article explains the legal framework, practical steps and common pitfalls to avoid when seeking compensation for wrist fractures under the Motor Accident Injuries Act 2017.
Key CTP Rules for Wrist Fractures
Under NSW CTP laws, injuries must meet specific criteria to qualify for benefits. Wrist fractures are classified as 'threshold injuries' if they result from a motor accident and meet the spinal nerve-root definition in the Motor Accident Guidelines. This means the injury must involve a spinal nerve-root injury producing neurological signs, such as tingling or numbness, even if radiculopathy (nerve root irritation) is not present.
CTP insurers typically pay for treatment and care benefits, weekly income payments, and lump sum damages if the injury meets the 'whole person impairment' threshold. However, claims for wrist fractures often face scrutiny because these injuries are considered minor under the scheme. Claimants must provide clear evidence that their wrist fracture meets the legal definition of a threshold injury to avoid disputes.
Practical Steps to Avoid Claim Denials
- Seek immediate medical attention: Document the injury with a medical professional within 24 hours of the accident. Delayed treatment may lead to disputes over the injury's connection to the collision.
- Preserve accident evidence: Collect details like police reports, witness statements, and photographs of the scene. For wrist fractures, evidence of bracing or hand trauma during the collision is critical.
- Notify your insurer promptly: Under NSW CTP rules, claimants must notify their insurer within 52 weeks of the accident. Delays beyond this period may result in lost benefits.
- Follow SIRA guidelines: The State Insurance Regulatory Authority (SIRA) requires claimants to submit medical records and evidence of the injury's connection to the accident. Failing to meet these requirements can lead to claim rejections.
Common Mistakes to Avoid
- Assuming all wrist fractures qualify: Not all wrist fractures meet the legal definition of a threshold injury. For example, a simple hairline fracture without neurological signs may not qualify for CTP benefits.
- Ignoring the 52-week rule: If your only injuries are threshold injuries, weekly benefits and treatment payments stop after 52 weeks. This applies to wrist fractures that do not meet the whole person impairment threshold.
- Failing to document daily impact: CTP insurers assess the effect of the injury on daily life. Claimants must provide evidence of reduced mobility, pain, or inability to work, especially if the wrist fracture affects hand function.
Hypothetical Example
Consider a Central Coast driver who fractured their wrist while bracing during a collision. If the medical records show neurological signs like tingling and the injury is linked to the accident, the claimant may qualify for treatment benefits. However, if the fracture is a simple break without nerve involvement, the claim may be denied unless the injury meets the whole person impairment threshold.
Time Limits and Dispute Options
CTP claimants have 52 weeks from the accident date to notify their insurer. If the injury is not a threshold injury, claimants may still pursue a common law damages claim, but this requires proving fault and meeting the 'threshold injury' definition. Disputes over wrist fractures often require mediation through SIRA or legal action if the claimant believes the insurer is acting unfairly.
When to Seek Advice
Central Coast claimants should consult a solicitor if their wrist fracture claim is denied, if they face disputes over the injury's classification, or if they need help navigating SIRA's requirements. Legal advice can help ensure claimants meet all legal and evidentiary standards.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.