Wrist Fractures in NSW CTP Claims: What the PIC Expects in Disputes
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).
If you've suffered a wrist fracture in a motor accident in New South Wales, the Personal Injury Commission (PIC) will assess whether your claim meets the criteria for compensation. Disputes over wrist fractures are common, and the PIC expects specific evidence to support your case. This article explains what the PIC looks for, how SIRA guidelines apply, and steps to take in Bathurst and elsewhere.
What the PIC Looks For in Wrist Fracture Claims
The PIC evaluates claims based on the Motor Accident Injuries Act 2017 and SIRA guidelines. For wrist fractures, the PIC will consider:
- Medical evidence: A doctor’s report confirming the fracture, its severity, and its link to the accident. Imaging (X-rays, MRI) must show the injury.
- Accident details: Evidence showing how the fracture occurred, such as witness statements, police reports, or vehicle damage assessments.
- Medical necessity: Whether treatment (e.g., surgery, splinting) was required and documented.
- Impact on daily life: How the fracture affects your ability to work, drive, or perform routine tasks.
SIRA’s What You Can Claim page states that injuries must meet the threshold injury definition under the Motor Accident Guidelines. For wrist fractures, this typically requires a spinal nerve-root injury producing neurological signs, or a fracture with documented clinical impact.
Steps to Take if the PIC Disputes Your Claim
If the PIC questions your wrist fracture claim, take these steps:
- Provide detailed medical records: Ensure your GP or specialist includes the date of injury, treatment plan, and how the fracture affects your mobility. For example, if you needed a sling for two weeks, document this.
- Submit accident reports: Include police reports, witness statements, and photos of the scene. If you braced your wrist during the collision (as in many hand/wrist injuries), explain how this caused the fracture.
- Request a medical review: SIRA may require an independent assessment. Cooperate with this process to avoid delays.
- Seek legal advice: A solicitor can help challenge the PIC’s decision if you believe the assessment is incorrect. For example, if the PIC dismisses your claim without reviewing your MRI scans.
Time Limits and Dispute Resolution
CTP claims must be submitted within five years of the accident. However, disputes over injuries like wrist fractures can extend this timeline if further medical evidence is needed. Under the Motor Accident Injuries Act 2017 s 4.4, benefits for threshold injuries (including wrist fractures) are limited to 52 weeks unless the injury meets the whole-person impairment threshold. If your claim is disputed after this period, you may need to re-establish your case with new evidence.
When to Seek Help
Disputes over wrist fractures often hinge on medical documentation and clearly linking the injury to the accident. If the PIC rejects your claim, consider:
- Independent medical opinions to challenge the PIC’s assessment.
- Legal review to ensure your claim meets all criteria, including SIRA’s guidelines on soft tissue injuries.
Example: A Disputed Wrist Fracture Claim
Imagine a cyclist in Bathurst who fractured their wrist after bracing for impact during a collision. The PIC disputes the claim, arguing the fracture was not severe enough. To counter this, the cyclist must:
- Show medical records proving the fracture required treatment.
- Demonstrate how the injury impacts daily activities (e.g., difficulty gripping objects).
- Provide evidence the fracture occurred during the accident, not pre-existing.
Next Steps
CTP claims involving wrist fractures require careful documentation and adherence to SIRA guidelines. If the PIC disputes your claim, you may need to re-evaluate your evidence or seek legal assistance. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.